Abstract
Abstract. Intertrochanteric femoral fractures are serious traumas among elderly patients. In these patients, external fixator is a preferable method for the fixation of fractures. Therefore, this study was planned to compare the parallel and convergent proximal schanz screw placement of pertrochanteric fixator in the intertrochanteric femoral fractures with respect to biomechanical forces that stabilize the fracture line and to present their clinical importance. A commercial finite element based program, AnsysWorkbench was used to investigate the biomechanical parameters of the femoral intertrochanteric fractures and different placement of implants. The von Mises stress, von Mises strain and shear stress on the proximal and distal surface of the fracture line were lower in the convergent pertrochanteric fixator. Proximal schanz screws in convergent configuration pertrochanteric fixator had greater stress and strain values than proximal schanz screws in parallel configuration pertrochanteric fixator. The distance between the proximal schanz screws on the fracture line was measured as 12 mm in convergent configuration pertrochanteric fixator, and as 3.5 mm in parallel configuration pertrochanteric fixator. The angle between the proximal schanz screws in the convergent configuration was measured as 12.88°. The effect of convergent and parallel configuration pertrochanteric fixators on axial loading demonstrated that convergent configuration pertrochanteric fixator was safer in this respect.
Highlights
Intertrochanteric femoral fractures (ITFs) are generally associated with low energy traumas among elderly patients and with high energy traumas among young patients
Our aim was biomechanically to investigate the effectiveness of Pertrochanteric Fixators (PTFs) applied with two different configurations of schanz screws inserted to the femoral head in ITFs
The Von Mises stress, strain and shear stress values on the upper and lower surfaces of the fracture line were found to be lower in convergent configuration PTF in comparison to parallel configuration PTF (Figs. 3 and 4)
Summary
Intertrochanteric femoral fractures (ITFs) are generally associated with low energy traumas among elderly patients and with high energy traumas among young patients. In elderly patients, and depending on age-related concomitant conditions such as osteoporosis, these fractures can lead to high morbidity and mortality rates. For this reason, ITFs are considered among the difficult-to-treat group of fractures (Healey and Msorman, 1993; Laskin et al, 1979). For elderly patients with these concurrent conditions, the administration as well as the duration of anesthesia involves certain risks (Christodoulou and Sdrenias, 2000). For this reason, it is generally described that treatment procedures involving external fixation methods should be preferred for such patients. External fixation methods ensure treatment with minimal surgical trauma and blood loss, and a short duration of anesthesia and surgery
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