Biomechanical analysis of the treatment of intertrochanteric hip fracture with different lengths of dynamic hip screw side plates

2020 ◽  
Vol 28 (6) ◽  
pp. 593-602
Author(s):  
Cheng-Chi Wang ◽  
Cheng-Hung Lee ◽  
Ning-Chien Chin ◽  
Kun-Hui Chen ◽  
Chien-Chou Pan ◽  
...  
Keyword(s):  
Hip Fractures ◽  
Dynamic Hip Screw ◽  
Biomechanical Analysis ◽  
Element Analysis ◽  
Side Plate ◽  
Lag Screw ◽  
Pull Out ◽  
Cortical Screw ◽  
Hip Screw ◽  
Biomechanical Effect

BACKGROUND: Dynamic hip screw (DHS) is a common implant used to treat stable-type intertrochanteric hip fractures. There are many factors that can affect the success rate of the surgery, including the length of side plates. It is therefore important to investigate the biomechanical effect of different DHS side plates on bones. OBJECTIVE: In order to reduce the likelihood of an implant failure, the aim of this study was to use finite element analysis (FEA) to investigate and understand the effect of side plates with different lengths in DHS. METHODS: In this FEA study, a 3D model with cortical bone, cancellous bone, side plate, lag screw, and cortical screws to simulate the implantation of DHS with different lengths of side plate (2-hole, 4-hole, and 6-hole) for intertrochanteric hip fractures was constructed. The loading condition was used to simulate the force (400 N) on the femoral head and the stress distribution on the lag screw, side plate, cortical screws, and femur was measured. RESULTS: The highest stress points occured around the region of contact between the screw and the cortical bones. The stress on the femur at the most distal cortical screw was the greatest. The shorter the length of the side plate, the greater the stress on the cortical screws, resulting in an increased stress on the femur surrounding the cortical screws. CONCLUSIONS: The use of DHS with 2-hole side plate may increase the risk of side plate pull-out. The results of this study provide a biomechanical analysis for selection of DHS implant lengths that can be useful for orthopaedic surgeons.

EFFECTS OF DIFFERENT LATERAL FEMORAL WALL THICKNESSES IN INTERTROCHANTERIC HIP FRACTURE TREATED WITH DYNAMIC HIP SCREW

2019 ◽  
Vol 19 (02) ◽  
pp. 1940022
Author(s):  
CHENG-CHI WANG ◽  
CHENG-HUNG LEE ◽  
KUN-HUI CHEN ◽  
CHIEN-CHOU PAN ◽  
KUO-CHIH SU
Keyword(s):  
Hip Fractures ◽  
Stress Shielding ◽  
Simulation Models ◽  
Lateral Wall ◽  
Dynamic Hip Screw ◽  
Shielding Effect ◽  
Element Analysis ◽  
Lag Screw ◽  
Hip Screw ◽  
Biomechanical Effect

Dynamic hip screw (DHS) is commonly used for stable-type intertrochanteric hip fractures. The importance of lateral femoral wall has been mentioned while treating intertrochanteric hip fractures with DHS. The aim of this study was mainly to investigate the biomechanical effect of different thickness of lateral femoral wall using finite element analysis (FEA). This study constructed FEA simulation models for five different lateral femoral wall thicknesses, and demonstrated the stress distribution on the femoral bone, the cortical screws, the cancellous bone around the lag screw, and the lag screw. The main results showed that when the DHS is implanted, less stress will be distributed at the implantation site on the femur due to the stress-shielding effect. The stress on the cortical screws will be greater at the junction of the cortical screws and the cortical bone. Intertrochanteric hip fractures with a thinner lateral wall thickness may cause higher stress on the femur after DHS is implanted.

BIOMECHANICAL EFFECT OF DIFFERENT LAG SCREW LENGTHS WITH DIFFERENT BARREL LENGTHS IN DYNAMIC HIP SCREW SYSTEM: A FINITE ELEMENT ANALYSIS STUDY

2017 ◽  
Vol 17 (01) ◽  
pp. 1750008 ◽  
Author(s):  
CHUNG-YUH TZENG ◽  
KUI-CHUO HUANG ◽  
YUN-CHE WU ◽  
CHU-LING CHANG ◽  
KUAN-RONG LEE ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Intertrochanteric Fracture ◽  
High Stress ◽  
Dynamic Hip Screw ◽  
Element Analysis ◽  
Side Plate ◽  
Lag Screw ◽  
Hip Screw ◽  
Biomechanical Effect

The dynamic hip screw (DHS) system is commonly used to treat intertrochanteric fracture of the hip joint. Breakage of the lag screw was noted in clinical practice and the length of lag screw as well as the length of the side plate in the DHS system appeared to play a role in the risk of breakage. Thus, the aim of this study was to investigate the biomechanical effect of different lag screw lengths and barrel plate lengths in the DHS implant system by finite element analysis (FEA). Four FEA simulation models were created according to different lengths of lag screw (79[Formula: see text]mm and 63[Formula: see text]mm) and different lengths of barrel side plate (43[Formula: see text]mm and 37[Formula: see text]mm). The von Mises stress was used as the observation indicator. The results showed that the maximum tensile stress on the long lag screw was slightly greater than that of the shorter lag screw. Use of a shorter barrel side plate may also cause high stress between the lag screw and the barrel side plate. This finding provides biomechanical reference data that may be of value to orthopedic surgeons with respect to choice of implant size and length in the treatment of intertrochanteric fracture with a DHS system to prevent complications such as implant failure caused by broken lag screws.

scholarly journals Design and biomechanical study of slide-poking external fixator for hip fracture

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052095093
Author(s):  
Hua-Biao Chen ◽  
Hong-Bo Wu ◽  
Min Chen ◽  
Yu-Liang Huang
Keyword(s):  
Hip Fracture ◽  
Femoral Head ◽  
Hip Fractures ◽  
External Fixator ◽  
Dynamic Hip Screw ◽  
Control Groups ◽  
Vertical Loading ◽  
Hip Screw ◽  
The Mean ◽  
And Control

Background Femoral head collapse and coxa vara lead to internal fixator failure in elderly patients with hip fracture. External fixator application is an optimal choice; however, the existing methods have many disadvantages. Methods Type 31-A1.3 hip fracture models were developed in nine pairs of 1-year-old fresh bovine corpse femur specimens. Each left femur specimen was fixed by a dynamic hip screw (control group), and each right femur specimen was fixed by the slide-poking external fixator (experimental group). Vertical loading and torsion tests were then performed in both groups. Results In the vertical loading experiment, a 1000-N load was implemented. The mean vertical downward displacement of the femoral head in the experimental and control groups was 1.49322 ± 0.116280 and 2.13656 ± 0.166374 mm, respectively. In the torsion experiment, when the torsion was increased to 10.0 Nm, the mean torsion angle in the experimental and control groups was 7.9733° ± 1.65704° and 15.4889° ± 0.73228°, respectively. The slide-poking external fixator was significantly more resistant to compression and rotation than the dynamic hip screw. Conclusion The slide-poking external fixator for hip fractures that was designed and developed in this study can provide sufficient stability to resist compression and rotation in hip fractures.

Gotfried percutaneous compression plating (PCCP) versus dynamic hip screw (DHS) in hip fractures: blood loss and 1-year mortality

2014 ◽  
Vol 26 (5) ◽  
pp. 497-503 ◽  
Author(s):  
Diego Gaddi ◽  
Giorgio Piarulli ◽  
Andrea Angeloni ◽  
Marta Gandolla ◽  
Daniele Munegato ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hip Fractures ◽  
Dynamic Hip Screw ◽  
Hip Screw ◽  
Compression Plating

Biomechanical analysis of the sliding hip screw, cannulated screws and Targon® FN in intracapsular hip fractures in cadaver femora

Injury ◽  
2011 ◽  
Vol 42 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Erwin Brandt ◽  
Nico Verdonschot ◽  
Arie van Vugt ◽  
Albert van Kampen
Keyword(s):  
Hip Fractures ◽  
Biomechanical Analysis ◽  
Cannulated Screws ◽  
Sliding Hip Screw ◽  
Hip Screw

scholarly journals Comparison between Conventional and Minimally Invasive Dynamic Hip Screws for Fixation of Intertrochanteric Fractures of the Femur

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
A. Mahmood ◽  
M. Kalra ◽  
M. K. Patralekh
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Early Mobilization ◽  
Dynamic Hip Screw ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Intertrochanteric Fractures ◽  
Tissue Destruction ◽  
Side Plate ◽  
Hip Screw

Background. Intertrochanteric fractures of the proximal femur are one of the most common fractures encountered, and dynamic hip screw with a side plate is the standard treatment. We compared a minimally invasive surgical technique with the conventional surgical technique used in the fixation of intertrochanteric fractures with the dynamic hip screw (DHS) device. Methods. Thirty patients with such fractures were treated with the conventional open technique and 30 with a new minimally invasive technique. Patients in both groups were followed up for 1 year. Results. There was less blood loss, minimal soft tissue destruction, shorter hospital stay, and early mobilization with the minimally invasive technique. Conclusion. The present study finds minimally invasive technique superior to conventional (open) DHS.

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