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New fixation method for Pauwels type III femoral neck fracture: a finite element analysis of sliding hip screw, L-shaped, and L-shaped with medial plate

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Objective

In this study, we aimed to evaluate the biomechanical behavior of three fixations for Pauwels type III fractures (sliding hip screw (SHS), L-shaped, and L-shaped with medial plate), by finite element analysis (FEM).

Methods

Three internal fixators were developed to treat Pauwels type III fracture by finite elements: SHS; L-shaped; and L-shaped with medial plate. Under the same conditions, localized and total vertical fracture displacement, maximum and minimum principal and von Mises stresses were evaluated.

Results

The localized and total vertical displacement evaluated for the SHS, L-shaped, and L-shaped with medial plate were 0.15 mm, 0.17 mm, and 0.07 mm (localized), and 4.52 mm, 6.97 mm, and 6.83 mm (total), respectively. The maximum values obtained in the upper region of the femoral neck for the internal fixations were 1.43 MPa, 1.29 MPa, and 1.24 MPa, and the minimum values obtained in the lower region of the femoral neck were  − 0.73 MPa,  − 1.09 MPa, and  − 1.03 MPa, respectively. The maximum Von Mises peak stress values were 6.35 MPa, 10.7 MPa, and 16.2 MPa for the fixation models using the SHS, L-shaped, and L-shaped with medial plate, respectively.

Conclusion

The present FEM analysis showed that SHS yields better results in terms of total vertical displacements, maximum distribution, and Von Mises peak stresses reduction. On the other hand, the L-shaped construction plus a medial plate decreases localized vertical displacements and maximum principal distribution when compared to the SHS and L-shaped constructions. These results demonstrate that both constructions, SHS and L-shaped plus a medial plate, are biomechanically efficient for the fixation of Pauwels type III femoral neck fractures.

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Authors and Affiliations

  1. Regional Hospital of the City of Gama, Brasilia, Distrito Federal, Brazil

    Anderson Freitas, Ricardo Lourenço Bontempo & Frank Anderson Ramos Azevedo

  2. Research and Education Institute of the Orthopedics and Specialized Medicine Hospital (IPE - H O M E) , SGAS Quadra 613- Conjunto C , Brasília, Distrito Federal, 70200-730, Brazil

    Anderson Freitas & Fabrício Reichert Barin

  3. Department of Orthopedics and Anesthesiology, São Paulo University, (FMRP/USP), São Paulo, Brazil

    Leonardo Rigobello Battaglion

  4. Galeão Air Force Hospital – , Rio de Janeiro, Brazil

    Marcos Noberto Giordano

  5. Orthopedics and Traumatology Service, Nova Monteiro - Miguel Couto Municipal Hospital, Rio de Janeiro, Brazil

    Vincenzo Giordano

Authors
  1. Anderson Freitas
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  2. Ricardo Lourenço Bontempo
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  3. Frank Anderson Ramos Azevedo
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  4. Leonardo Rigobello Battaglion
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  5. Marcos Noberto Giordano
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  6. Fabrício Reichert Barin
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  7. Vincenzo Giordano
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Correspondence to Fabrício Reichert Barin.

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Freitas, A., Bontempo, R.L., Azevedo, F.A.R. et al. New fixation method for Pauwels type III femoral neck fracture: a finite element analysis of sliding hip screw, L-shaped, and L-shaped with medial plate. Eur J Orthop Surg Traumatol 31, 1069–1075 (2021). https://doi.org/10.1007/s00590-020-02824-x

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  • DOI: https://doi.org/10.1007/s00590-020-02824-x

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