A triangle or an inverted triangle configuration, using failure of fixation as the primary outcome. Methods: Clinical and radiographic data for patients with intracapsular femoral neck fractures treated with either triangle fixation (one proximal screw and two distal screws) or inverted triangle fixation (two proximal screws and one distal screw), between January 1, 2000, and July 30, 2009, were analyzed. Results: A total of 202 patients, seventy-six men and 126 women with an average age (and standard deviation) of 64.53 ± 15.81 years (range, nineteen to ninety-three years), were included in the analysis. Union occurred in 158 patients, and nonunion occurred in forty-four. There were no differences between the union and nonunion groups with respect to age, sex, fracture side, fracture angle, fracture level, or estimated bone density. There were significant differences in fracture type, fixation configuration, reduction quality, and screw-tip subchondral purchase between patients with and without union. The estimated odds ratio for fracture nonunion was 2.93 (95% confidence interval [CI], 1.08, 7.96) in subjects with displaced fractures compared with those without displaced fractures (p = 0.035), 18.92 (95% CI, 1.91, 187.09) in subjects with borderline and unacceptable reduction compared with those with anatomic reduction (p = 0.012), and 2.92 (95% CI, 1.27, 6.69) for internal fixation with a triangle configuration compared with fixation with an inverted triangle configuration (p = 0.010). Conclusions: Screw fixation with a triangle configuration, a displaced fracture, and poor reduction are risk factors for nonunion in intracapsular femoral neck fractures treated with fixation with multiple screws. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence....

Background and Purpose. Hip dislocation combined with acetabular fracture remains a challenging condition for orthopedic surgeons. In this study, we utilized a computer-assisted simulation and three-dimensional (3D) printing technology to treat patients with hip dislocation combined with acetabular fracture. We hypothesized that the 3D printing-assisted method would shorten the internal fixation time and surgical time. Methods. We retrospectively reviewed 16 patients diagnosed with traumatic posterior dislocation of hip combined with acetabular fractures and treated with plate fixation from September 2013 to August 2017. Patients were divided into two groups: (1) traditional method and (2) 3D printing groups. In the traditional method group, the plates were contoured during the surgery, whereas in the 3D printing group, the patient’s pelvic computed tomography image was transformed to the 3D medical image software for processing preoperatively. The fracture reduction was simulated by the computer. Thereafter, the 1:1 scale 3D printing model was used to design the surgical plan and contour patient-specific plates preoperatively. Results. The internal fixation time was significantly shorter in the 3D printing group than in the traditional method group (-33 min, P<0.05). The mean operative time was shorter than that in the traditional method group (-43 min). However, blood loss and postoperative radiograph results were similar between the groups. The complication rate was lower in the 3D printing group (2/7) than in the traditional method group (5/9). Interpretation. Computer-assisted simulation with 3D printing technology is a more efficient method for treating hip dislocation combined with acetabular fractures.