Influence of the Trochanteric Fracture Configurations on Dynamic Hip Screw Performance: In Silico Study
Post-traumatic treatment of intertrochanteric fracture is performed by stabilizing the fracture with fixation devices, to allow the early weight bearing. Among available fixation devices, Dynamic Hip Screw (DHS) attached to the lateral side of proximal femur is considered to be an accepted treatment procedure. Key elements which influence the success bone healing process are strength of implant and stability of fracture site. The stability of fracture site mechanically depends on how the fixation device deforms while loading under different fracture configurations, it is desirable to evaluate the biomechanical performance of DHS attached to various intertrochanteric fracture configurations to raise awareness in surgical technique. In this study, there were three fracture configurations under consideration which were A1, A2 and A3 fracture types according to AO classification. The biomechanical evaluations were performed in term of stress and strain using finite element analysis. In all fracture configurations, the maximum stresses occurred on contact region between lag screw and sliding plate. The A1-simple trochanteric fracture revealed the lowest stress level whereas A3-reverse oblique fracture revealed the highest stress level. The stress level occurred in A2-multifragmentary fracture was slightly higher than the A1-simple trochanteric fracture approximately 1.3%. Focusing on the fracture site stability, the A1-simple trochanteric fracture and the A3-reverse oblique fracture types presented best and worse stability, respectively. Since the A3-reverse oblique fracture type yielded the highest stress and lowest stability among all configurations, as a result, the DHS is not recommended to use to avoid undesired post-operative outcome.
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Document Type: Research Article
Publication date: December 1, 2013
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