• Finite element analysis is sensitive to thread parameters; screw thread type and characteristics should be considered in model construction.
• The addition of an internal support plate reduces stress and deformation in the femur, providing a more stable mechanical environment for bone healing.
• Internal fixation methods reduce the fatigue life of the femoral system, with more implants leading to lower fatigue life.
• The fixation scheme with an internal support plate has the lowest fatigue life, indicating the need for comprehensive consideration of implant number and fixation method in clinical design.