Pipkin Type-II Femoral Head Fracture – A Biomechanical Evaluation by the Finite-Element Method^[*]

Abstract

Objective To evaluate the biomechanical capacity of two forms of fixation for Pipkin type-II fractures, describing the vertical fracture deviation, the maximum and minimum principal stresses, and the Von Mises equivalent stress in the syntheses used.

Materials and Methods Two internal fasteners were developed to treat Pipkin type-II fractures through finite elements: a 3.5-mm cortical screw and a Herbert screw. Under the same conditions, the vertical fracture deviation, the maximum and minimum principal stresses, and the Von Mises equivalent stress in the syntheses used were evaluated.

Results The vertical displacements evaluated were of 1.5 mm and 0.5 mm. The maximum principal stress values obtained in the upper region of the femoral neck were of 9.7 KPa and 1.3 Kpa, and the minimum principal stress values obtained in the lower region of the femoral neck were of -8.7 KPa and -9.3 KPa. Finally, the peak values for Von Mises stress were of 7.2 GPa and 2.0 GPa for the fixation models with the use of the 3.5-mm cortical screw and the Herbert screw respectively.

Conclusion The fixation system with the Herbert screw generated the best results in terms of reduction of vertical displacement, distribution of the maximum principal stress, and the peak Von Mises equivalent stress, demonstrating mechanical superiority compared to that of the 3.5-mm cortical screw in the treatment of Pipkin type-II fractures.

Keywords

femoral head - hip fractures - bone screws

Financial Support

The authors declare that they have received no financial support from public, commercial, or non-profit sources pertaining to the conduction of the present study.

^* Work developed at Instituto de Pesquisa e Ensino, Hospital Ortopédico e Medicina Especializada (IPE-HOME), Brasília, Distrito Federal, Brazil.

Publication History

Received: 16 January 2022

Accepted: 26 July 2022

Article published online:
03 October 2022

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