A Model to Evaluate Pauwels Type III Femoral Neck Fractures

Document Type

Article

Publication Date

1-10-2018

Publication Title

Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine

Abstract

While many femoral neck fractures can be reliably treated with surgical intervention, Pauwels III femoral neck fractures in the young adult population continue to be a challenging injury, and there is no consensus on optimal treatment. As such, there are past and ongoing biomechanical studies to evaluate the fixation provided by different constructs for this inherently unstable fracture. While many investigations rely on cadavers to evaluate the biomechanical performance of a construct, significant inter-subject variability can confound the analysis. Biomechanical femur analogs are being used more frequently due to more consistent mechanical properties; however, they have not been stringently evaluated for morphology or suitability for instrumentation. This study sought to determine the variability among composite femoral analogs as well as consistently create a Pauwels III injury and instrument the analogs without the need for fluoroscopic guidance. In total, 24 fourth-generation composite femoral analogs were evaluated for femoral height, neck–shaft angle, anteversion, and cortical thickness. A method was developed to simulate a Pauwels III fracture and to prepare three different constructs: an inverted triangle of cannulated screws, a sliding hip screw, and a hybrid inverted triangle with cannulated screws and a sliding hip screw. Radiographs were utilized to evaluate the variation in implant position. All but one of the morphological parameters varied by

Volume

232

Issue

3

First Page

310

Last Page

317

DOI

10.1177/0954411917752972

ISSN

ISSN: 0954-4119 and eISSN: 2041-3033

Rights

Copyright © 2019 by Institution of Mechanical Engineers

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