The Effect of Cannulated Screw Placement Angle in the Management of Femoral Neck Fracture

Abstract:

Fixation with cannulated screw was widely accepted for management of femoral neck fracture. However, the angle of placement cannulated screw for management of femoral neck fracture still controversial. The present study aims to investigate the mechanical behavior of the cannulated screws with two different angles of placements which are 135^o and 150^o in inverted triangular configuration for management of femoral neck fracture via finite element method. Therefore, the 3D model of a proximal femur consist of femoral neck fracture was constructed from CT data images using medical image processing software. The von Mises stress distributions on the cannulated screws were compared between each screw angle placement. The result showed that the cannulated screws in inverted triangle with 135^o of placement angle have better stress distributions than 150^o placement angle.

• Periodical: Advanced Materials Research (Volume 845)
• Pages: 216-220
• DOI: https://doi.org/10.4028/www.scientific.net/AMR.845.216
• Online since: December 2013
• Authors: Muhammad Farhan Ishak*, Mohammed Rafiq Abdul Kadir, Habibollah Harun, Shaifuzain Abdul Rahman
• Keywords: Cannulated Screw, Femoral Neck Fracture, Finite Element Analysis (FEA)

References

[1] J. -J. Yang, L. -C. Lin, K. -H. Chao, S. -Y. Chuang, C. -C. Wu, T. -T. Yeh, and Y. -T. Lian, Risk Factors for Nonunion in Patients with Intracapsular Femoral Neck Fractures Treated with Thre Cannulated Screws Placed in Either a Triangle or an Inverted Triangle Configuration, Journal of Bone & Joint Surgery, vol. 95-A, pp.61-69, (2013).

DOI: 10.2106/jbjs.k.01081

[2] T. -W. Huang, W. -H. Hsu, K. -T. Peng, and C. -Y. Lee, Effect of integrity of the posterior cortex in displaced femoral neck fractures on outcome after surgical fixation in young adults, Injury, vol. 42, pp.217-222, (2011).

DOI: 10.1016/j.injury.2010.10.005

[3] J. W. Oakey, M. D. Stover, H. D. Summers, M. Sartori, R. M. Havey, and A. G. Patwardhan, Does screw configuration affect subtrochanteric fracture after femoral neck fixation?, Clinical Orthopaedics and Related Research, pp.302-306, (2006).

DOI: 10.1097/01.blo.0000188557.65387.fc

[4] E. Walker, D. P. Mukherjee, A. L. Ogden, K. K. Sadasivan, and J. A. Albright, A Biomechanical Study of Simulated Femoral Neck Fracture Fixation by Cannulated Screws: Effects of Placement Angle and Number of screws, The America Journal of Orthopedic, vol. 36, pp.680-684, (2007).

[5] O. Filipov, Biplane double-supported screw fixation (F-technique): a method of screw fixation at osteoporotic fractures of the femoral neck, European Journal of Orthopaedic Surgery & Traumatology, vol. 21, pp.539-543, 2011/10/01 (2011).

DOI: 10.1007/s00590-010-0747-9

[6] C. A. Bout, D. M. Cannegieter, and J. W. Juttmann, Percutaneous cannulated screw fixation of femoral neck fractures: the three point principle, Injury, vol. 28, pp.135-139, (1997).

DOI: 10.1016/s0020-1383(96)00161-1

[7] M. R. b. A. Kadir, Interface Micromotion in Cementless Hip Protheses, Doctor of Philosophy, Biomechanic Imperial College London, Imperial College London, (2005).

[8] W. -P. Chen, C. -L. Tai, C. -H. Shih, P. -H. Hsieh, M. -C. Leou, and M. S. Lee, Selection of fixation devices in proximal femur rotational osteotomy: clinical complications and finite element analysis, Clinical Biomechanics, vol. 19, pp.255-262, (2004).

DOI: 10.1016/j.clinbiomech.2003.12.003

[9] P. J. Nowotarski, B. Ervin, B. Weatherby, J. Pettit, R. Goulet, and B. Norris, Biomechanical analysis of a novel femoral neck locking plate for treatment of vertical shear Pauwel's type C femoral neck fractures, Injury, vol. 43, pp.802-806, (2012).

DOI: 10.1016/j.injury.2011.09.012

[10] T. V. Ly and M. F. Swiontkowski, Treatment of Femoral Neck Fractures in Young Adults, Journal of Bone & Joint Surgery, vol. 90-A, pp.2254-266, (2008).

[11] R. Mittal and S. Banerjee, Proximal femoral fractures: Principles of management and review of literature, Journal of Clinical Orthopaedics and Trauma, vol. 3, pp.15-23, (2012).

DOI: 10.1016/j.jcot.2012.04.001

[12] M. J. Parker and S. M. Ali, Short versus long thread cannulated cancellous screws for intracapsular hip fractures: A randomised trial of 432 patients, Injury, vol. 41, pp.382-384, (2010).

DOI: 10.1016/j.injury.2009.10.008

[13] S. M. Ali, S. Haleem, and M. J. Parker, Short- versus long-thread cannulated screws for intracapsular hip fractures: A randomised trial of 432 patients, Injury Extra, vol. 39, p.202, (2008).

DOI: 10.1016/j.injury.2007.11.405

[14] S. Sowmianarayanan, A. Chandrasekaran, and R. K. Kumar, Finite element analysis of a subtrochanteric fractured femur with dynamic hip screw, dynamic condylar screw, and proximal femur nail implants-a comparative study, Proc Inst Mech Eng H, vol. 222, pp.117-27, Jan (2008).

DOI: 10.1243/09544119jeim156

[15] V. Tan, K. L. Wong, C. T. Born, R. Harten, and W. G. DeLong, Two-Screw Femoral Neck Fracture Fixation: A Biomechanical Analysis of 2 Different Configuration, The America Journal of Orthopedic, vol. 36, pp.481-485, (2007).