Cargando…

Finite Element Analysis of Cannulated Screws as Prophylactic Intervention of Hip Fractures

INTRODUCTION: The frequency of hip fractures, a major cause of morbidity and mortality for geriatric patients, is expected to increase exponentially in the next few decades. The aim of this study is to assess the ability of stainless-steel cannulated screws to reduce the risk of a femoral neck fract...

Descripción completa

Detalles Bibliográficos
Autores principales: Rhee, Brian, Tommasini, Steven M., Milligan, Kenneth, Moulton, Julia, Leslie, Michael, Wiznia, Daniel H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8637371/
https://www.ncbi.nlm.nih.gov/pubmed/34868723
http://dx.doi.org/10.1177/21514593211055890
_version_ 1784608729418694656
author Rhee, Brian
Tommasini, Steven M.
Milligan, Kenneth
Moulton, Julia
Leslie, Michael
Wiznia, Daniel H.
author_facet Rhee, Brian
Tommasini, Steven M.
Milligan, Kenneth
Moulton, Julia
Leslie, Michael
Wiznia, Daniel H.
author_sort Rhee, Brian
collection PubMed
description INTRODUCTION: The frequency of hip fractures, a major cause of morbidity and mortality for geriatric patients, is expected to increase exponentially in the next few decades. The aim of this study is to assess the ability of stainless-steel cannulated screws to reduce the risk of a femoral neck fracture, if placed prophylactically prior to a fall. MATERIALS AND METHODS: We created finite element models from computed tomography (CT) scan-based 3D models of a geriatric patient through 3D-image processing and model generation software. We used linear finite element simulations to analyze the effect of cannulated screws in the proximal femur in single-leg stance and lateral fall, which were processed for peak von Mises stresses and element failure. FINDINGS: Prophylactically placed cannulated screws significantly reduced failure in an osteoporotic proximal femur undergoing lateral fall. Three implanted screws in an inverted triangle formation decreased proximal femoral trabecular failure by 21% and cortical failure by 5%. This reduction in failure was achieved with a 55% decrease in femoral neck failure and 14% in lateral cortex failure. CONCLUSION: Our results indicate that cannulated hip screws in an inverted triangle formation may strengthen an osteoporotic proximal femur in the event of a lateral fall. Mechanical testing on cadaveric or composite models is required to validate these results.
format Online
Article
Text
id pubmed-8637371
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-86373712021-12-03 Finite Element Analysis of Cannulated Screws as Prophylactic Intervention of Hip Fractures Rhee, Brian Tommasini, Steven M. Milligan, Kenneth Moulton, Julia Leslie, Michael Wiznia, Daniel H. Geriatr Orthop Surg Rehabil Original Manuscript INTRODUCTION: The frequency of hip fractures, a major cause of morbidity and mortality for geriatric patients, is expected to increase exponentially in the next few decades. The aim of this study is to assess the ability of stainless-steel cannulated screws to reduce the risk of a femoral neck fracture, if placed prophylactically prior to a fall. MATERIALS AND METHODS: We created finite element models from computed tomography (CT) scan-based 3D models of a geriatric patient through 3D-image processing and model generation software. We used linear finite element simulations to analyze the effect of cannulated screws in the proximal femur in single-leg stance and lateral fall, which were processed for peak von Mises stresses and element failure. FINDINGS: Prophylactically placed cannulated screws significantly reduced failure in an osteoporotic proximal femur undergoing lateral fall. Three implanted screws in an inverted triangle formation decreased proximal femoral trabecular failure by 21% and cortical failure by 5%. This reduction in failure was achieved with a 55% decrease in femoral neck failure and 14% in lateral cortex failure. CONCLUSION: Our results indicate that cannulated hip screws in an inverted triangle formation may strengthen an osteoporotic proximal femur in the event of a lateral fall. Mechanical testing on cadaveric or composite models is required to validate these results. SAGE Publications 2021-11-24 /pmc/articles/PMC8637371/ /pubmed/34868723 http://dx.doi.org/10.1177/21514593211055890 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Manuscript
Rhee, Brian
Tommasini, Steven M.
Milligan, Kenneth
Moulton, Julia
Leslie, Michael
Wiznia, Daniel H.
Finite Element Analysis of Cannulated Screws as Prophylactic Intervention of Hip Fractures
title Finite Element Analysis of Cannulated Screws as Prophylactic Intervention of Hip Fractures
title_full Finite Element Analysis of Cannulated Screws as Prophylactic Intervention of Hip Fractures
title_fullStr Finite Element Analysis of Cannulated Screws as Prophylactic Intervention of Hip Fractures
title_full_unstemmed Finite Element Analysis of Cannulated Screws as Prophylactic Intervention of Hip Fractures
title_short Finite Element Analysis of Cannulated Screws as Prophylactic Intervention of Hip Fractures
title_sort finite element analysis of cannulated screws as prophylactic intervention of hip fractures
topic Original Manuscript
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8637371/
https://www.ncbi.nlm.nih.gov/pubmed/34868723
http://dx.doi.org/10.1177/21514593211055890
work_keys_str_mv AT rheebrian finiteelementanalysisofcannulatedscrewsasprophylacticinterventionofhipfractures
AT tommasinistevenm finiteelementanalysisofcannulatedscrewsasprophylacticinterventionofhipfractures
AT milligankenneth finiteelementanalysisofcannulatedscrewsasprophylacticinterventionofhipfractures
AT moultonjulia finiteelementanalysisofcannulatedscrewsasprophylacticinterventionofhipfractures
AT lesliemichael finiteelementanalysisofcannulatedscrewsasprophylacticinterventionofhipfractures
AT wizniadanielh finiteelementanalysisofcannulatedscrewsasprophylacticinterventionofhipfractures