Biomechanical analysis of various internal fracture fixation devices used for treating femoral neck fractures: A comparative finite element analysis.

Autor: Mahapatra B; Department of Mechanical Engineering, Indian Institute of Engineering Science and Technology, Shibpur, Howrah 711103, West Bengal, India., Pal B; Department of Mechanical Engineering, Indian Institute of Engineering Science and Technology, Shibpur, Howrah 711103, West Bengal, India. Electronic address: bidyutpal@mech.iiests.ac.in.
Jazyk: angličtina
Zdroj: Injury [Injury] 2024 Oct; Vol. 55 (10), pp. 111717. Date of Electronic Publication: 2024 Jul 08.
DOI: 10.1016/j.injury.2024.111717
Abstrakt: Introduction: Several internal fixation devices are available for treating Pauwels type I, II and III femoral neck fractures. The present study compared various fixation implants for all Pauwels fracture types using a CT-based subject-specific finite element model of the femur and determined the most effective implant for each fracture type.
Materials and Methods: The analysis included four different configurations of cannulated screw models, Femoral Neck System, Dynamic Hip Screw and Dynamic Condylar Screw (with and without anti-rotational screw). Ti-alloy was considered as the implant material. Heterogeneous bone material property was assigned based on CT grey value. Frictional contact was assumed in the contact interfaces. Peak loading corresponding to normal walking and stair-climbing were considered. Equivalent strain in bone, equivalent stress in the implants, femoral head deformation and rotation, micromotion in the contact interfaces, and strain-shielding in bone were evaluated for each implanted model.
Results: Stresses generated in the implants were within the yield limit of the implant material. In Pauwels I and II, the micromotion predicted at the contact regions in all the implanted models was within 100 µm, which is suitable for bone integration. However, in Pauwels III fracture, most of the implanted models other than DHS with AR-screw model exhibited micromotion of more than 150 µm in the contact regions, which is expected to inhibit bone growth.
Conclusions: The DHS with AR-screw implanted model was identified as the most effective in treating Pauwels I and III fractures. However, for Pauwels type II, DCS with an AR-screw implant was deemed superior to the other configurations.
Competing Interests: Declaration of competing interest We hereby state that there are no financial and personal relationships with other people and organizations with regard to the submission of this manuscript.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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