Affiliations: [a] Department Orthopädie und Traumatologie, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany | [b] Institut für Statik und Dynamik der Luft- und Raumfahrtkonstruktionen, Universität Stuttgart, Stuttgart, Germany | [c] LASSO Ingenieurgesellschaft, Leinfelden-Echterdingen, Germany | [d] Berufsgenossenschaftliche Unfallklinik, Eberhard-Karls-Universität Tübingen, Tübingen, Germany | [x] Mechanical Engineering Faculty, Laboratory for Materials Technology, University of Applied Science, Regensburg, Germany | [y] University Clinic, Department of Traumatology, Regensburg, Germany
Correspondence:
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Address for correspondence: Department Orthopädie und Traumatologie, Albert-Ludwigs-Universität Freiburg, Hugstetterstr. 55, D-79106 Freiburg, Germany. Tel.: +49 761 270 2764; Fax: +49 761 270 2520; E-mail: helwig@ch11.ukl.uni-freiburg.de.
Abstract: Static analysis with finite element of a realistic femur nail bone-implant system in a typical proximal femoral fracture under physiological load bearing situations provides results for stress, displacement and strain. The question to be answered is, if simulation with the finite element analysis is able to explain biomechanically clinical observed patterns of failure. Surface-Reconstruction with CT database of a proximal femur and reconstruction with CT based density data was done. Next steps were to unite the bone structure with the Proximal Femoral Nail and to model two relevant fractures (31-A2.2 and A2.3 according AO). After modelling of geometry, isotropic material behaviour and load application numeric calculation of the femur-nail system with FE-software was performed. FE simulation mainly shows an axial dislocation of the femoral head screw with nearly no dislocation of the antirotation screw. This so-called z-effect therefore means: (1) Tilting of the proximal main fragment around the sagittal axis between the screws and (2) relative movement of both screws in the frontal plane. Relative movement of the two screws against each other could be the reason for implant failure, the so called cut out. Furthermore simulation shows different gliding of the screws explaining the so called z-telescoping. The analyzed stress patterns have to be relativized, because isotropic material behaviour of cancellous bone was assumed. Further examinations for this issue are necessary.
