ArticleScientific reports2024
Finite element study on the micromechanics of cement-augmented proximal femoral nail anti-rotation (PFNA) for intertrochanteric fracture treatment.
Article in Scientific reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The clinical efficacy of proximal femoral nail antirotation and proximal femoral bionic nail in the treatment of intertrochanteric fractures of the femur in the elderly: A systematic review and meta-analysis.Joint diseases and related surgery · 2025Pooled it
- The necessity of cement augmentation in metastatic femur stabilization explored by finite element analysis.Scientific reports · 2026Article
- Article
- 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
- More severe microdamage and micromechanical alterations: altered subchondral bone remodeling in varus knee osteoarthritis with osteoporosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 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
- Five states of reduction in OTA/AO A1.3 intertrochanteric fractures of the femur a biomechanical study.BMC musculoskeletal disorders · 2024Article
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Authors and funding
6 authors.
Funding
Abstract
Blade cut-out is a common complication when using proximal femoral nail anti-rotation (PFNA) for the treatment of intertrochanteric fractures. Although cement augmentation has been introduced to overcome the cut-out effect, the micromechanics of this approach remain to be clarified. While previous studies have developed finite element (FE) models based on lab-prepared or cadaveric samples to study the cement-trabeculae interface, their demanding nature and inherent disadvantages limit their application. The aim of this study was to develop a novel 'one-step forming' method for creating a cement-trabeculae interface FE model to investigate its micromechanics in relation to PFNA with cement augmentation. A human femoral head was scanned using micro-computed tomography, and four volume of interest (VOI) trabeculae were segmented. The VOI trabeculae were enclosed within a box to represent the encapsulated region of bone cement using ANSYS software. Tetrahedral meshing was performed with Hypermesh software based on Boolean operation. Finally, four cement-trabeculae interface FE models comprising four interdigitated depths and five FE models comprising different volume fraction were established after element removal. The effects of friction contact, frictionless contact, and bond contact properties between the bone and cement were identified. The maximum micromotion and stress in the interdigitated and loading bones were quantified and compared between the pre- and post-augmentation situations. The differences in micromotion and stress with the three contact methods were minimal. Micromotion and stress decreased as the interdigitation depth increased. Stress in the proximal interdigitated bone showed a correlation with the bone volume fraction (R
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