Torsional stability of fixation methods in basicervical femoral neck fractures: a biomechanical study
Issued Date
2024-12-01
Resource Type
eISSN
1749799X
Scopus ID
2-s2.0-85196638541
Journal Title
Journal of Orthopaedic Surgery and Research
Volume
19
Issue
1
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SCOPUS
Bibliographic Citation
Journal of Orthopaedic Surgery and Research Vol.19 No.1 (2024)
Suggested Citation
Mahaisavariya C., Jitprapaikulsarn S., Mahaisavariya B., Chantarapanich N. Torsional stability of fixation methods in basicervical femoral neck fractures: a biomechanical study. Journal of Orthopaedic Surgery and Research Vol.19 No.1 (2024). doi:10.1186/s13018-024-04842-5 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/99181
Title
Torsional stability of fixation methods in basicervical femoral neck fractures: a biomechanical study
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Abstract
Background: Basicervical femoral neck fracture is a rare proximal femur fracture with a high implant failure rate. Biomechanical comparisons between cephalomedullary nails (CMNs) and dynamic hip screws (DHSs) under torsion loading are lacking. This study compared the biomechanical performance of three fixations for basicervical femoral neck fractures under torsion load during early ambulation. Methods: The biomechanical study models used three fixations: a DHS, a DHS with an anti-rotation screw, and a short CMN. Finite element analysis was used to simulate hip rotation with muscle forces related to leg swing applied to the femur. The equivalent von Mises stress (EQV) on fixation, fragment displacement, and strain energy density at the proximal cancellous bone were monitored for fixation stability. Results: The EQV of the short CMN construct (304.63 MPa) was comparable to that of the titanium DHS construct (293.39 MPa) and greater than that of the titanium DHS with an anti-rotation screw construct (200.94 MPa). The proximal fragment displacement in the short CMN construct was approximately 0.13 mm, the greatest among the constructs. The risk of screw cutout for the lag screw in short CMNs was 3.1–5.8 times greater than that for DHSs and DHSs with anti-rotation screw constructs. Conclusions: Titanium DHS combined with an anti-rotation screw provided lower fragment displacement, stress, and strain energy density in the femoral head than the other fixations under torsion load. Basicervical femoral neck fracture treated with CMNs may increase the risk of lag screw cutout. Graphical abstract: (Figure presented.)
