Fracture orientation and screw configuration: The optimization of femoral neck fracture immobilization using finite element analysis

Hdl Handle:
http://hdl.handle.net/10149/92946
Title:
Fracture orientation and screw configuration: The optimization of femoral neck fracture immobilization using finite element analysis
Authors:
Bradley, E. J. (Edward); Nabhani, F. (Farhad); Spears, I. R. (Iain); Wright, M. D. (Matthew)
Affiliation:
University of Teesside. School of Science and Technology; University of Teesside. School of Social Sciences and Law.
Citation:
Bradley, E. J. et al. (2009) 'Fracture orientation and screw configuration: The optimization of femoral neck fracture immobilization using finite element analysis', Current Orthopaedic Practice, 20 (5), pp.534-540.
Publisher:
Lippincott, Williams & Wilkins
Journal:
Current Orthopaedic Practice
Issue Date:
Oct-2009
URI:
http://hdl.handle.net/10149/92946
DOI:
10.1097/BCO.0b013e31819f1ac6
Abstract:
Background: Achieving stability at the site of a femoral neck fracture is an important factor for callus formation in the postoperative period. For minimally displaced fractures, cannulated screws are commonly used in North-East England. However, the placement of the screws currently is based on the surgeon's choice. The purpose of this study was to quantify the stability of a simulated fracture for a range of fracture orientations to determine optimal configuration. Methods: Finite element analysis was employed to create a model of the proximal femur. A fracture was created at 508 to the horizontal, which was rotated to give an orientation range of 40-608. The femur was subjected to two loading regimes representing joint contact force and the action of the abductor muscles during slowwalking. Interfragmentary movement was quantified by the amount of relative motion occurring between paired nodes on either side of the fracture. Results: Greater amounts of movement were found at more vertical obliquities, indicating a more unstable fracture from reduction in the amount of compression across the fracture. For fractures at 588or less, a triangular configuration with a superior apical screw achieved the greatest stability, while for fractures above 588 the triangular configuration with an inferior apical screw achieved the greatest stability. Conclusions: The findings of this study provide an empirical base from which surgeons can make informed decisions of the choice about femoral neck fracture fixation. The results demonstrate the important interaction between loading direction during the gait cycle and fracture orientation.
Type:
Article
Language:
en
Keywords:
femoral neck fracture angle; finite element analysis; gait cycle; screw fixation configuration; stability; immobilisation
ISSN:
1940-7041
Rights:
Subject to restrictions, author can archive post-print (ie final draft post-refereeing). For full details see http://www.sherpa.ac.uk/romeo/ [Accessed 24/02/2010]
Citation Count:
0 [Scopus, 24/02/2010]

Full metadata record

DC FieldValue Language
dc.contributor.authorBradley, E. J. (Edward)en
dc.contributor.authorNabhani, F. (Farhad)en
dc.contributor.authorSpears, I. R. (Iain)en
dc.contributor.authorWright, M. D. (Matthew)en
dc.date.accessioned2010-02-24T15:36:29Z-
dc.date.available2010-02-24T15:36:29Z-
dc.date.issued2009-10-
dc.identifier.citationCurrent Orthopaedic Practice; 20 (5): 534-540en
dc.identifier.issn1940-7041-
dc.identifier.doi10.1097/BCO.0b013e31819f1ac6-
dc.identifier.urihttp://hdl.handle.net/10149/92946-
dc.description.abstractBackground: Achieving stability at the site of a femoral neck fracture is an important factor for callus formation in the postoperative period. For minimally displaced fractures, cannulated screws are commonly used in North-East England. However, the placement of the screws currently is based on the surgeon's choice. The purpose of this study was to quantify the stability of a simulated fracture for a range of fracture orientations to determine optimal configuration. Methods: Finite element analysis was employed to create a model of the proximal femur. A fracture was created at 508 to the horizontal, which was rotated to give an orientation range of 40-608. The femur was subjected to two loading regimes representing joint contact force and the action of the abductor muscles during slowwalking. Interfragmentary movement was quantified by the amount of relative motion occurring between paired nodes on either side of the fracture. Results: Greater amounts of movement were found at more vertical obliquities, indicating a more unstable fracture from reduction in the amount of compression across the fracture. For fractures at 588or less, a triangular configuration with a superior apical screw achieved the greatest stability, while for fractures above 588 the triangular configuration with an inferior apical screw achieved the greatest stability. Conclusions: The findings of this study provide an empirical base from which surgeons can make informed decisions of the choice about femoral neck fracture fixation. The results demonstrate the important interaction between loading direction during the gait cycle and fracture orientation.en
dc.language.isoenen
dc.publisherLippincott, Williams & Wilkins-
dc.rightsSubject to restrictions, author can archive post-print (ie final draft post-refereeing). For full details see http://www.sherpa.ac.uk/romeo/ [Accessed 24/02/2010]en
dc.subjectfemoral neck fracture angleen
dc.subjectfinite element analysisen
dc.subjectgait cycleen
dc.subjectscrew fixation configurationen
dc.subjectstabilityen
dc.subjectimmobilisationen
dc.titleFracture orientation and screw configuration: The optimization of femoral neck fracture immobilization using finite element analysisen
dc.typeArticleen
dc.contributor.departmentUniversity of Teesside. School of Science and Technology; University of Teesside. School of Social Sciences and Law.en
dc.identifier.journalCurrent Orthopaedic Practiceen
ref.citationcount0 [Scopus, 24/02/2010]en
or.citation.harvardBradley, E. J. et al. (2009) 'Fracture orientation and screw configuration: The optimization of femoral neck fracture immobilization using finite element analysis', Current Orthopaedic Practice, 20 (5), pp.534-540.-
All Items in TeesRep are protected by copyright, with all rights reserved, unless otherwise indicated.