ArticleBalkan medical journal2017
Numerical Optimization of the Position in Femoral Head of Proximal Locking Screws of Proximal Femoral Nail System; Biomechanical Study.
Article in Balkan medical journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 10 citations in OpenAlex.
- Extra Medullary Fixation in Unstable Proximal Femoral Fractures by PF-LCP.Indian journal of orthopaedics · 2024Article
- Article
- In Silico Optimization of Femoral Fixator Position and Configuration by Parametric CAD Model.Materials (Basel, Switzerland) · 2019Article
- Impact of tip-apex distance and femoral head lag screw position on treatment outcomes of unstable intertrochanteric fractures using cephalomedullary nails.The Journal of international medical research · 2018Article
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Authors and funding
2 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundProximal femoral fracture rates are increasing due to osteoporosis and traffic accidents. Proximal femoral nails are routinely used in the treatment of these fractures in the proximal femur.
aimsTo compare various combinations and to determine the ideal proximal lag screw position in pertrochanteric fractures (Arbeitsgemeinschaft für Osteosynthesefragen classification 31-A1) of the femur by using optimized finite element analysis. STUDY
designBiomechanical study.
methodsComputed tomography images of patients' right femurs were processed with Mimics. Afterwards a solid femur model was created with SolidWorks 2015 and transferred to ANSYS Workbench 16.0 for response surface optimization analysis which was carried out according to anterior-posterior (-10°<anterior-posterior<10°), inferior-superior (-6°<inferior-superior<7°) and tip-apex distance (10 mm<tip-apex distance<30 mm) proximal lag screw positions in the fracture region. The optimum position of the proximal lag screw was determined based on the von Mises stress values occurring on the fracture line. Initial analysis of the system was realized under the surgeon's normal positioning conditions (anterior-posterior, inferior-superior=0°; tip-apex distance=12 mm).
resultsThe maximum and minimum (compression) von Mises stresses were found to be 438 MPa and 0.003 MPa, respectively, and risky stresses for the system occurred in the regions where the proximal lag screw passes through the proximal femoral nail hole, the small diameter portion of stem joints with a large diameter and lag screw mounts to the stem. The most suitable position of the proximal lag screw was found at the middle position of the tip-apex distance (20 mm) and femoral neck (anterior-posterior, inferior-superior=0°), according to von Mises compression stress values occurring on the fracture line.
conclusionIn our study, we couldn't find any correlation between proximal lag screw movement and tip-apex distance on stresses of the fracture surfaces, but the proximal lag screw position in the inferior (inferior-superior<0)-superior (inferior-superior>0) and posterior-anterior directions of the femur neck significantly increased these stresses. The most suitable position of the proximal lag screw was confirmed as the middle of the femoral neck by using optimized finite element analysis.
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