ArticleBMC musculoskeletal disorders2021
Cement augmentation of the proximal femoral nail antirotation for the treatment of two intertrochanteric fractures - a comparative finite element study.
Article in BMC musculoskeletal disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 22 citations in OpenAlex.
- Advances in internal fixation methods for intertrochanteric femoral fractures: A narrative review.Pakistan journal of medical sciences · 2026Review
- Atraumatic anterior hip dislocation after cephalomedullary nailing for an intertrochanteric femoral fracture: a case report highlighting the importance of initial reduction and prevention of excessive telescoping.BMC musculoskeletal disorders · 2026Article
- Finite-Element Comparison of a Proximal Femoral Laterally Bionic Intramedullary Nail (PFLBN) Versus PFNA and PFBN for AO/OTA 31-A3.1 Intertrochanteric Fractures.Orthopaedic surgery · 2026Article
- Systematic evaluation of the biomechanical characteristics of PFNA, PFBN, and InterTan fixation for intertrochanteric fractures under gradient variations of proximal femoral lateral wall thickness and delineation of optimal fixation domains.Journal of orthopaedic surgery and research · 2026Article
- Subcapital Femoral Neck Fracture Despite Cement-Augmented Cephalomedullary Nail Fixation for an Osteoporotic Intertrochanteric Fracture: A Case Report and Position- and Sliding-Based Decision Guide.Clinics and practice · 2025Article
- New proximal femoral nail antirotation in the treatment of elderly intertrochanteric fractures with lateral wall fractures.BMC musculoskeletal disorders · 2025Article
- Comparison of mechanical and clinical outcomes between cement-augmented and conventional cephalomedullary nailing in osteoporotic trochanteric fractures: a propensity score-matched cohort study.BMC musculoskeletal disorders · 2025Article
- Short versus long proximal femoral nail anti-rotation-II (PFNA-II) in the management of unstable intertrochanteric fractures.International journal of burns and trauma · 2025Article
- Finite element study on the micromechanics of cement-augmented proximal femoral nail anti-rotation (PFNA) for intertrochanteric fracture treatment.Scientific reports · 2024Article
- Article
- Comparison of the clinical outcomes between proximal femoral nail anti-rotation with cement enhancement and hemiarthroplasty among elderly osteoporotic patients with intertrochanteric fracture.BMC musculoskeletal disorders · 2024Article
- The significance of reduction of valgus-intercalated femoral neck fracture with valgus angle > 15°and the selection of internal fixation by finite element analysis.BMC musculoskeletal disorders · 2024Article
- Comparison of the therapeutic efficacy of hip arthroplasty and proximal femoral nail antirotation internal fixation for unstable intertrochanteric femur fractures.American journal of translational research · 2024Article
- Risk factors for excessive lateral migration of the blade in proximal femoral nail anti-rotation in elderly patients with intertrochanteric femur fracture.American journal of translational research · 2024Article
- Mechanical Gains Associated With Virtual Prophylactic Intramedullary Nail Fixation in Femurs With Metastatic Disease.The Iowa orthopaedic journal · 2023Article
- Reconstruction of massive bone defects after femoral tumor resection using two new-designed 3D-printed intercalary prostheses: a clinical analytic study with the cooperative utilization of multiple technologies.BMC musculoskeletal disorders · 2023Article
- In Silico Finite Element Modeling of Stress Distribution in Osteosynthesis after Pertrochanteric Fractures.Journal of clinical medicine · 2022Article
- Two Cannulated Screws Provide Sufficient Biomechanical Strength for Prophylactic Fixation in Adult Patients With an Aggressive Benign Femoral Neck Lesion.Frontiers in bioengineering and biotechnology · 2022Article
- Comparison of Curative Effect between PFNA and PCCP in the Treatment of Femoral Intertrochanteric Fractures.Emergency medicine international · 2022Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are concerns regarding initial stability and cutout effect in proximal femoral nail antirotation (PFNA) treating intertrochanteric fractures. No study have used finite element analysis (FEA) to investigate the biomechanics. This study aimed to compare the cutout effect, stress and displacement between stable (AO31-A1.3) and unstable (AO31-A2.2) intertrochanteric fractures treated by cement augmented PFNA.
methodsFour femoral finite element models (FEMs) were constructed and tested under the maximum loading during walking. Non-augmented and augmented PFNA in two different intertrochanteric fractures were respectively simulated, assuming Tip Apex Distance (TAD) < 25 mm within each FEM. The cutout effect, stress and displacement between femur and PFNA were compared in each condition.
resultsCutout effect was observed in both non-augmented femoral head and was more apparently in unstable intertrochanteric fracture model. After reinforced by bone cement, no cutout effect occurred in two models. Stress concentration were observed on medial part of intertrochanteric region and the proximal part of helical blade before augmented while were observed on femoral shaft and the conjunction between blade and nail after augmented in both FEMs. Displacement mainly appeared on femoral head and the helical blade tip before augmented while distributed moderately on intertrochanteric region and the upper part of nail after augmented in both FEMs. The maximum stress and displacement value of femur decreased both in stable and unstable model after augmented but was more significantly in the unstable one. The maximum stress and displacement value of PFNA increased both in stable and unstable model after augmented but was more significantly in the unstable one.
conclusionOur FEA study indicated that the cement augmentation of the PFNA biomechanically enhances the cutout resistance in intertrochanteric fracture, this procedure is especially efficient for the unstable intertrochanteric fracture.
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