Pre-sliding of femoral neck system improves fixation stability in pauwels type III femoral neck fracture: a finite element analysis
Abstract Background Femoral neck fractures are a common injury in older adults and their management presents a significant challenge for orthopedic surgeons. The Femoral Neck System (FNS) was recently introduced for the fixation of femur neck fractures. Although neck shortening was reduced with the...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-06-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-06631-3 |
| _version_ | 1797795923547389952 |
|---|---|
| author | Yonghan Cha Jun Young Chung Chang-Ho Jung Jin-Woo Kim Jeyoon Lee Jun-Il Yoo Jung-Taek Kim Yongho Jeon |
| author_facet | Yonghan Cha Jun Young Chung Chang-Ho Jung Jin-Woo Kim Jeyoon Lee Jun-Il Yoo Jung-Taek Kim Yongho Jeon |
| author_sort | Yonghan Cha |
| collection | DOAJ |
| description | Abstract Background Femoral neck fractures are a common injury in older adults and their management presents a significant challenge for orthopedic surgeons. The Femoral Neck System (FNS) was recently introduced for the fixation of femur neck fractures. Although neck shortening was reduced with the FNS, the complication rates were not reduced. Thus, improvements to enhance fixation stability should be made for the FNS. We hypothesized that (1) the pre-sliding technique and (2) the use of longer anti-rotation screw would increase fracture stability. This study aimed to determine the change in fracture stability using the pre-sliding technique and long anti-rotation screw in the FNS for fixation of Pauwels type III femoral neck fractures. Methods Finite element models of Pauwels type III femoral neck fracture fixed with pre-sliding FNS and 5-mm longer anti-rotation screw were established. The models were subjected to normal walking load. The material properties of the elements belonging to the bone were mapped by assigning the formulation with the computed tomography Hounsfield unit. Results Pauwels type III femoral neck fractures fixed with pre-slided FNS showed better fracture stability, decreasing fracture gap and sliding by 14% and 12%, respectively, under normal walking load. No element of cortical bone in any of the models had an absolute value of principal strain that exceeded 1%. The peak von Mises stress (VMS) of the implants ranged from 260 to 289 MPa, and the highest peak VMS value was 50% lower than the yield strength of the titanium alloy (800 MPa). The longer anti-rotation screw did not affect fracture stability. Conclusions The pre-sliding technique using the FNS showed higher fracture stability than the standard fixation technique for a Pauwels type III femoral neck fracture. The longer anti-rotation screw did not contribute significantly to fixation stability. As this finite element analysis considered the inhomogeneous mechanical property of the bone, it offered equivalent mechanical conditions to investigate the components of interest. |
| first_indexed | 2024-03-13T03:25:22Z |
| format | Article |
| id | doaj.art-8f73c8f951ba49cc9146ea935a93e7df |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-13T03:25:22Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-8f73c8f951ba49cc9146ea935a93e7df2023-06-25T11:03:48ZengBMCBMC Musculoskeletal Disorders1471-24742023-06-0124111110.1186/s12891-023-06631-3Pre-sliding of femoral neck system improves fixation stability in pauwels type III femoral neck fracture: a finite element analysisYonghan Cha0Jun Young Chung1Chang-Ho Jung2Jin-Woo Kim3Jeyoon Lee4Jun-Il Yoo5Jung-Taek Kim6Yongho Jeon7Department of Orthopaedic Surgery, Eulji university hospitalDepartment of Orthopedic Surgery, Ajou University School of Medicine, Ajou Medical CenterDepartment of Mechanical Engineering, Ajou UniversityDepartment of Orthopaedic Surgery, Nowon Eulji Medical Center, Eulji UniversityDepartment of Orthopedic Surgery, Ajou University School of Medicine, Ajou Medical CenterDepartment of Orthopedic Surgery, Inha University HospitalDepartment of Orthopedic Surgery, Ajou University School of Medicine, Ajou Medical CenterDepartment of Mechanical Engineering, Ajou UniversityAbstract Background Femoral neck fractures are a common injury in older adults and their management presents a significant challenge for orthopedic surgeons. The Femoral Neck System (FNS) was recently introduced for the fixation of femur neck fractures. Although neck shortening was reduced with the FNS, the complication rates were not reduced. Thus, improvements to enhance fixation stability should be made for the FNS. We hypothesized that (1) the pre-sliding technique and (2) the use of longer anti-rotation screw would increase fracture stability. This study aimed to determine the change in fracture stability using the pre-sliding technique and long anti-rotation screw in the FNS for fixation of Pauwels type III femoral neck fractures. Methods Finite element models of Pauwels type III femoral neck fracture fixed with pre-sliding FNS and 5-mm longer anti-rotation screw were established. The models were subjected to normal walking load. The material properties of the elements belonging to the bone were mapped by assigning the formulation with the computed tomography Hounsfield unit. Results Pauwels type III femoral neck fractures fixed with pre-slided FNS showed better fracture stability, decreasing fracture gap and sliding by 14% and 12%, respectively, under normal walking load. No element of cortical bone in any of the models had an absolute value of principal strain that exceeded 1%. The peak von Mises stress (VMS) of the implants ranged from 260 to 289 MPa, and the highest peak VMS value was 50% lower than the yield strength of the titanium alloy (800 MPa). The longer anti-rotation screw did not affect fracture stability. Conclusions The pre-sliding technique using the FNS showed higher fracture stability than the standard fixation technique for a Pauwels type III femoral neck fracture. The longer anti-rotation screw did not contribute significantly to fixation stability. As this finite element analysis considered the inhomogeneous mechanical property of the bone, it offered equivalent mechanical conditions to investigate the components of interest.https://doi.org/10.1186/s12891-023-06631-3Anti-rotation screwFemoral Neck SystemPauwels type III neck fracturePre-sliding technique |
| spellingShingle | Yonghan Cha Jun Young Chung Chang-Ho Jung Jin-Woo Kim Jeyoon Lee Jun-Il Yoo Jung-Taek Kim Yongho Jeon Pre-sliding of femoral neck system improves fixation stability in pauwels type III femoral neck fracture: a finite element analysis BMC Musculoskeletal Disorders Anti-rotation screw Femoral Neck System Pauwels type III neck fracture Pre-sliding technique |
| title | Pre-sliding of femoral neck system improves fixation stability in pauwels type III femoral neck fracture: a finite element analysis |
| title_full | Pre-sliding of femoral neck system improves fixation stability in pauwels type III femoral neck fracture: a finite element analysis |
| title_fullStr | Pre-sliding of femoral neck system improves fixation stability in pauwels type III femoral neck fracture: a finite element analysis |
| title_full_unstemmed | Pre-sliding of femoral neck system improves fixation stability in pauwels type III femoral neck fracture: a finite element analysis |
| title_short | Pre-sliding of femoral neck system improves fixation stability in pauwels type III femoral neck fracture: a finite element analysis |
| title_sort | pre sliding of femoral neck system improves fixation stability in pauwels type iii femoral neck fracture a finite element analysis |
| topic | Anti-rotation screw Femoral Neck System Pauwels type III neck fracture Pre-sliding technique |
| url | https://doi.org/10.1186/s12891-023-06631-3 |
| work_keys_str_mv | AT yonghancha preslidingoffemoralnecksystemimprovesfixationstabilityinpauwelstypeiiifemoralneckfractureafiniteelementanalysis AT junyoungchung preslidingoffemoralnecksystemimprovesfixationstabilityinpauwelstypeiiifemoralneckfractureafiniteelementanalysis AT changhojung preslidingoffemoralnecksystemimprovesfixationstabilityinpauwelstypeiiifemoralneckfractureafiniteelementanalysis AT jinwookim preslidingoffemoralnecksystemimprovesfixationstabilityinpauwelstypeiiifemoralneckfractureafiniteelementanalysis AT jeyoonlee preslidingoffemoralnecksystemimprovesfixationstabilityinpauwelstypeiiifemoralneckfractureafiniteelementanalysis AT junilyoo preslidingoffemoralnecksystemimprovesfixationstabilityinpauwelstypeiiifemoralneckfractureafiniteelementanalysis AT jungtaekkim preslidingoffemoralnecksystemimprovesfixationstabilityinpauwelstypeiiifemoralneckfractureafiniteelementanalysis AT yonghojeon preslidingoffemoralnecksystemimprovesfixationstabilityinpauwelstypeiiifemoralneckfractureafiniteelementanalysis |