ArticleClinics in orthopedic surgery2024
What is the Optimal Nail Length to Treat Osteoporotic Subtrochanteric Fractures? A Finite Element Analysis.
Article in Clinics in orthopedic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- ChatGPT in Orthopedic Trauma: Consistency, Accuracy, and Agreement With Textbook and Expert Opinion.Cureus · 2026Article
- Effect of intramedullary nail length on the biomechanical performance of internal fixation for subtrochanteric femoral fractures.BMC musculoskeletal disorders · 2026Article
- Finite element analysis of PFNA in the treatment of osteoporotic intertrochanteric A2.3 fractures of the femur.Frontiers in bioengineering and biotechnology · 2026Article
- 320 mm InterTan nail optimizes biomechanics in AO/OTA 31A2.3 fractures: superior stress distribution, micromotion, and strain for enhanced healing.Frontiers in bioengineering and biotechnology · 2026Article
- Optimisation strategies for intramedullary nailing parameters in subtrochanteric fractures of the femur: a multimodal assessment based on finite element and biomechanical experiments.International journal of surgery (London, England) · 2025Article
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4 authors.
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Abstract
Background: Operative management with intramedullary nail fixation remains the definitive treatment of choice for osteoporotic subtrochanteric (ST) fractures; however, there remains no consensus regarding the proper nail length. We aimed to use 3-dimensional finite element (FE) analysis to determine the optimal nail length for the safe fixation of osteoporotic ST fractures. Methods: Nine modes of FE models were constructed using 9 different lengths of cephalomedullary nails (short nails: 170, 180, and 200 mm; long nails: 280, 300, 320, 340, 360, and 380 mm) from the same company. The interfragmentary motion was analyzed. Additionally, the peak von Mises stress (PVMS) in the cortical bone, cancellous bone of the femoral head, and the nail were measured, and the yielding risk for each subject was investigated. Results: Long nails were associated with less interfragmentary motion. In the cortical bone, the PVMS of short nails was observed at the distal locking screw holes of the femoral medial cortex; however, in long nails, the PVMS was observed at the lag screw holes on the lateral cortex. The mean yielding risk of long nails was 40.1% lower than that of short nails. For the cancellous bone of the femoral head, the PVMS in all 9 FE models was in the same area: at the apex of the femoral head. There was no difference in the yielding risk between short and long nails. For implants, the PVMS was at the distal locking screw hole of the nail body in the short nails and the nail body at the fracture level in the long nails. The mean yielding risk was 74.9% lower for long nails than that for short nails. Conclusions: Compared to short nails, long nails with a length of 320 mm or more showed less interfragmentary motion and lower yielding risk in low-level osteoporotic ST fractures. The FE analysis supports long nails as a safer option than short nails, especially for treating transverse-type low-level osteoporotic ST fractures.
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