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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2022

Open Access 01-12-2022 | Fracture Healing | Research article

Comparison of femoral mechanics before and after internal fixation removal and the effect of sclerosis on femoral stress: a finite element analysis

Authors: Yang Liu, Wenjie Song, Haoran Liang, Chaoxin Li, Wenjie Niu, Huifeng Shao, Yuze Wang, Ziquan Yang, Pengcui Li, Xiaogang Wu, Yong He, Xiaochun Wei, Wangping Duan

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

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Abstract

Background

Femoral neck fractures are a common traumatic injury. The removal of the internal fixation remains controversial, especially in terms of mechanical stability. Moreover, collapsed necrosis of the femoral head continues to occur after fracture healing. We believe that sclerotic cancellous bone (SCB) formation around the screw is associated with femoral head necrosis. We aimed to compare mechanical features before and after implant removal and determine the effect of SCB formation on stress distribution.

Methods

Cylindrical cancellous bone sections were collected from a relatively normal region and an SCB region of a necrotic femoral head, and their elastic moduli were measured. Four femoral finite element models were developed: a) femoral neck fracture healing with implants, b) fracture healing without implants, c) sclerosis around the screw with implants, and d) sclerosis around the screw without implants.

Results

The maximum von Mises peak stresses of models a and b were 66.643 MPa and 63.76 MPa, respectively, and were concentrated in the upper lateral femur. The main stress was scattered at the lowest screw tail, femoral calcar region, and lateral femur shaft. Moreover, coronal plane strain throughout the screw paths near the femoral head in models a and b was mostly in the range of 1000–3000 με. The maximum stress concentrations in models c and d were located at the lower femoral head and reached 91.199 MPa and 78.019 MPa, respectively.

Conclusions

The stresses in the sclerotic model around the cannulated screws are more concentrated on the femoral head than in the healing model without sclerotic bone. The overall stresses in the healing femoral neck fracture model were essentially unchanged before and after removal of the internal fixation.
Appendix
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Metadata
Title
Comparison of femoral mechanics before and after internal fixation removal and the effect of sclerosis on femoral stress: a finite element analysis
Authors
Yang Liu
Wenjie Song
Haoran Liang
Chaoxin Li
Wenjie Niu
Huifeng Shao
Yuze Wang
Ziquan Yang
Pengcui Li
Xiaogang Wu
Yong He
Xiaochun Wei
Wangping Duan
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-022-05888-4

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