2016
DOI: 10.1155/2016/5470798
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Comparison of the Lag Screw Placements for the Treatment of Stable and Unstable Intertrochanteric Femoral Fractures regarding Trabecular Bone Failure

Abstract: Background. In this study, the cut-out risk of Dynamic Hip Screw (DHS) was investigated in nine different positions of the lag screw for two fracture types by using Finite Element Analysis (FEA). Methods. Two types of fractures (31-A1.1 and A2.1 in AO classification) were generated in the femur model obtained from Computerized Tomography images. The DHS model was placed into the fractured femur model in nine different positions. Tip-Apex Distances were measured using SolidWorks. In FEA, the force applied to th… Show more

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Cited by 8 publications
(10 citation statements)
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References 29 publications
(61 reference statements)
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“…Good implant positioning is best determined by centre-centre and centre-inferior position of the lag screw in the femoral head in the AP and lateral radiograph4,15. A study conducted by Celik et al in 2016 (17) , reported strongest trabecular bone pattern in central and inferior region of femoral head whereby screw cut-out rate are less. The concept of TAD describes the position of lag screw within the femoral head and was shown to be highly predictive of fixation failure by screw cut out (18) .…”
Section: Discussionmentioning
confidence: 99%
“…Good implant positioning is best determined by centre-centre and centre-inferior position of the lag screw in the femoral head in the AP and lateral radiograph4,15. A study conducted by Celik et al in 2016 (17) , reported strongest trabecular bone pattern in central and inferior region of femoral head whereby screw cut-out rate are less. The concept of TAD describes the position of lag screw within the femoral head and was shown to be highly predictive of fixation failure by screw cut out (18) .…”
Section: Discussionmentioning
confidence: 99%
“…As for the joint force of the hip and muscle, one-legged standing condition was simulated. A load of 2400 N was applied to the femoral head at an angle of 16°relative to the femoral axis, and a load of 1200 N was applied to the greater trochanter at an angle of 21° [24,25]. With regard to the prosthesis implant model, the interface state after the stable bone ingrowth was simulated, and the degrees of freedom of the prosthesis-bone interface node were coupled.…”
Section: Materials Properties and Application Of Loadmentioning
confidence: 99%
“…Many clinical studies have evaluated the blade position immediately after surgery and after a follow-up period to identify statistical relations between the post-surgical position and the risk of cut-out [6][7][8][9][10]. Computational studies using the finite element method have also been used to find which blade positions lead to less bone damage [5,[11][12][13][14][15][16]. Considering static analyses of stress or strain, and maximum principal stress or strain criteria as a measure of the risk of cut-out, Arias-Blanco et al [5,16], Goffin et al [11], Celik et al [12], and Lee et al [13] investigated the influence of different anterior-posterior and superior-inferior blade positions on the risk of cut-out.…”
Section: Introductionmentioning
confidence: 99%
“…Computational studies using the finite element method have also been used to find which blade positions lead to less bone damage [5,[11][12][13][14][15][16]. Considering static analyses of stress or strain, and maximum principal stress or strain criteria as a measure of the risk of cut-out, Arias-Blanco et al [5,16], Goffin et al [11], Celik et al [12], and Lee et al [13] investigated the influence of different anterior-posterior and superior-inferior blade positions on the risk of cut-out. Two primary factors set these studies apart: the implants considered, which included the Proximal Femoral Nail Anti-rotation (PFNA) implant by Synthes (Oberdof, Switzerland) [5,16], the Omega3 Compression Hip Screw by Stryker Osteosynthesis (Schoenkirchen, Germany) [11], the Dynamic Hip Screw by Tipsan Tibbi Aletler (Bornova, Turkey) [12], and the Asia Anatomic Anteversion Hip Nail by A Plus Biotechnology (New Taipei City, Taiwan) [13]; and the fractures considered, which included a stable fracture classified as 31-A1 in the Müller AO classification system [5,13,16] and an unstable 31-A2 fracture, with an intrusion distance of 30% [11,12].…”
Section: Introductionmentioning
confidence: 99%