ArticleBMC musculoskeletal disorders2026
Biomechanical comparison of four different internal fixation constructs applied to stabilise Letenneur type I Hoffa fractures: a finite element analysis.
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo simulate and compare the biomechanical characteristics of different internal fixation constructs for treating Letenneur type I Hoffa fractures via finite element analysis to establish a theoretical foundation for selecting a fixation method in clinical practice.
methodsOn the basis of computed tomography (CT) data acquired from a healthy adult male volunteer, a finite element model of Letenneur type I Hoffa fracture—characterized by a fracture line oriented parallel to the posterior femoral cortex—was developed. Four different internal fixation constructs were constructed: anteroposterior cannulated screw fixation (AP group), posteroanterior cannulated screw fixation (PA group), posteroanterior cannulated screws with a posterior plate (PA + P-plate group), and posteroanterior cannulated screws with a lateral plate (PA + L-plate group). Under a vertical load of 2100 N, the displacement distribution, stress distribution, and peak values of the internal fixation and femur were analyzed.
resultsUnder a 2100 N axial load, the AP and PA groups presented the highest and comparable peak displacement values in the femur and internal fixation (3.80 mm, 3.46 mm, and 3.84 mm, 3.41 mm, respectively). The PA + P-plate group presented the lowest peak displacement value (1.85 mm and 1.58 mm), followed by the PA + L-plate group (2.25 mm and 2.19 mm). Similarly, the AP and PA groups presented the highest peak stresses in the internal fixation (535.65 and 574.39 MPa, respectively), whereas the PA + P-plate group presented the lowest peak stress (287.21 MPa). The stress distribution patterns in the femur were similar across all groups, with concentrations primarily on both sides of the fracture line, the posterolateral region, and the anterior aspect.
conclusionsThe mechanical stability of Anteroposterior (AP) and posteroanterior (PA) screws is comparable. While the addition of a plate significantly enhanced fixation stability, the posterior plate demonstrated superior biomechanical performance compared with the lateral plate.
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