Lateral drill holes decrease strength of the femur: an observational study using finite element and experimental analyses

Journal of Orthopaedic Surgery and Research

Zbigniew H Stachurski¹  Shankar Kalyanasundaram¹  Paul N Smith³  Jennie M Scarvell²  Melanie J Fox¹ 

[1] Department of Engineering, Australian National University, Canberra, ACT 0200, Australia;Trauma and Orthopaedic Research Unit, Canberra Hospital, Woden, ACT 2606, Australia;Australian National University Medical School, Australian National University, Canberra, ACT 0200, Australia

关键词: Materials testing;    Mechanical;    Stress;    Finite element analysis;    Intramedullary fixation;    Internal fracture fixation;    Femur fracture;   

Others  :  814421
DOI  :  10.1186/1749-799X-8-29

 received in 2012-10-22, accepted in 2013-08-12,  发布年份 2013

【 摘 要 】

Background

Internal fixation of femoral fractures requires drilling holes through the cortical bone of the shaft of the femur. Intramedullary suction reduces the fat emboli produced by reaming and nailing femoral fractures but requires four suction portals to be drilled into the femoral shaft. This work investigated the effect of these additional holes on the strength of the femur.

Methods

Finite element analysis (FEA) was used to calculate compression, tension and load limits which were then compared to the results from mechanical testing. Models of intact femora and fractured femora internally fixed with intramedullary nailing were generated. In addition, four suction portals, lateral, anterior and posterior, were modelled. Stresses were used to calculate safety factors and predict fatigue. Physical testing on synthetic femora was carried out on a universal mechanical testing machine.

Results

The FEA model for stresses generated during walking showed tensile stresses in the lateral femur and compression stresses in the medial femur with a maximum sheer stress through the neck of the femur. The lateral suction portals produced tensile stresses up to over 300% greater than in the femur without suction portals. The anterior and posterior portals did not significantly increase stresses. The lateral suction portals had a safety factor of 0.7, while the anterior and posterior posts had safety factors of 2.4 times walking loads. Synthetic bone subjected to cyclical loading and load to failure showed similar results. On mechanical testing, all constructs failed at the neck of the femur.

Conclusions

The anterior suction portals produced minimal increases in stress to loading so are the preferred site should a femur require such drill holes for suction or internal fixation.

【 授权许可】

   
2013 Fox et al.; licensee BioMed Central Ltd.

【 图 表 】

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