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Finite Element Analysis of Fracture Fixation

  • Biomechanics (J Nyman and C Hernandez, Section Editors)
  • Published:
Current Osteoporosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Fracture fixation aims to provide stability and promote healing, but remains challenging in unstable and osteoporotic fractures with increased risk of construct failure and nonunion. The first part of this article reviews the clinical motivation behind finite element analysis of fracture fixation, its strengths and weaknesses, how models are developed and validated, and how outputs are typically interpreted. The second part reviews recent modeling studies of the femur and proximal humerus, areas with particular relevance to fragility fractures.

Recent Findings

There is some consensus in the literature around how certain modeling aspects are pragmatically formulated, including bone and implant geometries, meshing, material properties, interactions, and loads and boundary conditions. Studies most often focus on predicted implant stress, bone strain surrounding screws, or interfragmentary displacements. However, most models are not rigorously validated.

Summary

With refined modeling methods, improved validation efforts, and large-scale systematic analyses, finite element analysis is poised to advance the understanding of fracture fixation failure, enable optimization of implant designs, and improve surgical guidance.

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Funding

GSL, HW, and JSR were supported by the National Institute of Biomedical Imaging and Bioengineering (1R01EB029207-01). DM and PV were supported by the AO Foundation via the AOTRAUMA Network (Grant No.: AR 2018/01).

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Authors and Affiliations

  1. Department of Orthopaedics and Rehabilitation, Pennsylvania State University, Hershey, PA, USA

    Gregory S. Lewis, Hwabok Wee & J. Spence Reid

  2. AO Research Institute Davos, Davos, Switzerland

    Dominic Mischler & Peter Varga

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GSL receives research support for an unrelated project from Arthrex Inc. GSL and JSR are co-inventors on the patent: “Individualized preoperative planning system and method.” JSR and GSL have received materials for a biomechanical research project from Depuy Synthes (Johnson and Johnson). JSR is consultant for Depuy Synthes (Johnson and Johnson) and Osteocentric, and stockholder for ROMtech. None of the above indirectly related interests has influenced the present paper. No other competing interests are present.

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Lewis, G.S., Mischler, D., Wee, H. et al. Finite Element Analysis of Fracture Fixation. Curr Osteoporos Rep 19, 403–416 (2021). https://doi.org/10.1007/s11914-021-00690-y

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