Impact of tip–apex distance and femoral head lag screw position on treatment outcomes of unstable intertrochanteric fractures using cephalomedullary nails
Background Cephalomedullary nails are frequently used in unstable intertrochanteric fractures. The implant position is an important factor for surgical success. Thus, in the present study, finite element analysis methods were used to investigate the biomechanical behavior of five different cephalome...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2018-06-01
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| Series: | Journal of International Medical Research |
| Online Access: | https://doi.org/10.1177/0300060518775835 |
| _version_ | 1818727223353409536 |
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| author | Cheng-Hung Lee Kuo-Chih Su Kun-Hui Chen Chien-Chou Pan Yun-Che Wu |
| author_facet | Cheng-Hung Lee Kuo-Chih Su Kun-Hui Chen Chien-Chou Pan Yun-Che Wu |
| author_sort | Cheng-Hung Lee |
| collection | DOAJ |
| description | Background Cephalomedullary nails are frequently used in unstable intertrochanteric fractures. The implant position is an important factor for surgical success. Thus, in the present study, finite element analysis methods were used to investigate the biomechanical behavior of five different cephalomedullary nail positions in unstable intertrochanteric fractures. Methods Five different cephalomedullary nail implant positions were investigated. The observed indicators were the maximum displacement of the lag screw, the stress on the intertrochanteric fracture with involvement of the posteromedial cortex, and the tip–apex distance. Results The smallest lag screw displacement was achieved when the implant was closer to the inferior femoral head. Lower stress was placed on the posteromedial cortex when the implant was positioned closer to the inferior femoral head. However, the tip–apex distance increased when the lag screw was positioned more inferiorly. Conclusions The results of this study suggest that positioning the lag screw closer to the inferior aspect of the femoral head can reduce stress on the posteromedial cortex and deformation of the implant in unstable intertrochanteric fractures. These findings provide a biomechanical basis for selection of the cephalomedullary nail implantation site. Level of evidence III. |
| first_indexed | 2024-12-17T22:10:41Z |
| format | Article |
| id | doaj.art-b451ff6c82114f108f3bbfd54dd4456b |
| institution | Directory Open Access Journal |
| issn | 0300-0605 1473-2300 |
| language | English |
| last_indexed | 2024-12-17T22:10:41Z |
| publishDate | 2018-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of International Medical Research |
| spelling | doaj.art-b451ff6c82114f108f3bbfd54dd4456b2022-12-21T21:30:45ZengSAGE PublishingJournal of International Medical Research0300-06051473-23002018-06-014610.1177/0300060518775835Impact of tip–apex distance and femoral head lag screw position on treatment outcomes of unstable intertrochanteric fractures using cephalomedullary nailsCheng-Hung LeeKuo-Chih SuKun-Hui ChenChien-Chou PanYun-Che WuBackground Cephalomedullary nails are frequently used in unstable intertrochanteric fractures. The implant position is an important factor for surgical success. Thus, in the present study, finite element analysis methods were used to investigate the biomechanical behavior of five different cephalomedullary nail positions in unstable intertrochanteric fractures. Methods Five different cephalomedullary nail implant positions were investigated. The observed indicators were the maximum displacement of the lag screw, the stress on the intertrochanteric fracture with involvement of the posteromedial cortex, and the tip–apex distance. Results The smallest lag screw displacement was achieved when the implant was closer to the inferior femoral head. Lower stress was placed on the posteromedial cortex when the implant was positioned closer to the inferior femoral head. However, the tip–apex distance increased when the lag screw was positioned more inferiorly. Conclusions The results of this study suggest that positioning the lag screw closer to the inferior aspect of the femoral head can reduce stress on the posteromedial cortex and deformation of the implant in unstable intertrochanteric fractures. These findings provide a biomechanical basis for selection of the cephalomedullary nail implantation site. Level of evidence III.https://doi.org/10.1177/0300060518775835 |
| spellingShingle | Cheng-Hung Lee Kuo-Chih Su Kun-Hui Chen Chien-Chou Pan Yun-Che Wu Impact of tip–apex distance and femoral head lag screw position on treatment outcomes of unstable intertrochanteric fractures using cephalomedullary nails Journal of International Medical Research |
| title | Impact of tip–apex distance and femoral head lag screw position on treatment outcomes of unstable intertrochanteric fractures using cephalomedullary nails |
| title_full | Impact of tip–apex distance and femoral head lag screw position on treatment outcomes of unstable intertrochanteric fractures using cephalomedullary nails |
| title_fullStr | Impact of tip–apex distance and femoral head lag screw position on treatment outcomes of unstable intertrochanteric fractures using cephalomedullary nails |
| title_full_unstemmed | Impact of tip–apex distance and femoral head lag screw position on treatment outcomes of unstable intertrochanteric fractures using cephalomedullary nails |
| title_short | Impact of tip–apex distance and femoral head lag screw position on treatment outcomes of unstable intertrochanteric fractures using cephalomedullary nails |
| title_sort | impact of tip apex distance and femoral head lag screw position on treatment outcomes of unstable intertrochanteric fractures using cephalomedullary nails |
| url | https://doi.org/10.1177/0300060518775835 |
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