Fig. 3

Case 1. (A) A patient with a Garden III type femoral neck fracture. (B) Preoperative DSA showed thickening and interruption of the superior supporting artery supply entering the femoral head. (C) The fracture was fixed with two cannulated screws. (D) At the 6-month postoperative X-ray examination, ischemic necrosis changes were observed in the upper outer portion of the femoral head. Case 2. (E–F) A patient with a Garden II type femoral neck fracture, fixed with three cannulated screws. (G) At 7 months postoperative, X-ray revealed ischemic necrosis and collapse in the weight-bearing area of the femoral head. (H) DSA indicated that the superior supporting artery supply did not extend to the bone area within the screw implantation zone. Case 3. (I) A patient with a Garden I type femoral neck fracture. (J) Preoperative DSA revealed disruption of the superior supporting artery supply at the head-neck junction. (K) The fracture was fixed with a single porous tantalum metal screw, ensuring the distal end did not surpass the epiphyseal line. (L) At 26 months postoperative follow-up, good fracture healing was observed, and DSA demonstrated that the superior supporting artery supply entered the femoral head through the epiphyseal line.