Energy Required for Fracture in Synthetic Proximal Femoral Models After Synthesis Material Removal: a Biomechanical Study Using Cannulated Screws, Dynamic Hip Screws, and Proximal Femoral Nails^[*]

Abstract

Objective The present study aims to identify the energy required for synthetic proximal femoral fracture after removal of three implant types: cannulated screws, dynamic hip screws (DHS), and proximal femoral nail (PFN).

Methods Twenty-five synthetic proximal femur bones were used: 10 were kept intact as the control group (CG), 5 were submitted to the placement and removal of 3 cannulated screws in an inverted triangle configuration (CSG), 5 were submitted to the placement and removal of a dynamic compression screw (DHSG), and 5 were submitted to the placement and removal of a proximal femur nail (PFNG). All samples were biomechanically analyzed simulating a fall on the greater trochanter using a servo-hydraulic machine to determine the energy (in Joules [J]) required for fracture.

Results All samples presented basicervical fractures. The energy required for fracture was 7.1 J, 6.6 J, 6 J, and 6.7 J for the CG, CSG, DHSG and PFNG, respectively. There was no statistically significant difference (considering a 95% confidence interval) in energy among the study groups (p = 0.34).

Conclusion There was no statistically significant difference in the energy required to cause a synthetic proximal femoral fracture after removing all three implant types and simulating a fall over the greater trochanter.

Keywords

hip - hip fractures - fracture fixation - device removal

^* This study was developed by the Orthopedics and Traumatology Department, Hospital Regional do Gama, Brasília, DF, and Instituto de Pesquisa e Ensino do Hospital Ortopédico e Medicina Especializada (IPE-HOME), Brasília, DF, Brazil.

Publication History

Received: 17 February 2020

Accepted: 16 September 2020

Article published online:
31 March 2021

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