A Biomechanical Study Area of Cannulated Screw Fixation for Femoral Neck Fracture in Cadaveric
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Abstract
Objective : To study the area of cannulated screw in femoral neck whether it will cause the biomechanical effect to femoral neck in terms of strength and stability or not and to consider the procedure to position the screws with multiple screw fixation method to gain appropriate placement and stable strength according to principle of biomechanics.
Material and methods : 24 cadaveric femurs were brought to do an osteotomy at the center of the femoral neck with 60 degree to the horizontal (Pauwel II) by using Image J photo analyzing program to calculate the cross-sectional area of femoral neck and defined screw placement in the form of an inverted triangle in three different positions by dividing the screw area of femoral neck in 3 different areas which were the area A, B and C. Reduction and fixation done with Cannulated screw No. 6.0. The femur was tested with mechanical test (Instron series IX) to analyze Axial stiffness, Axial load to failure, Axial Failure Displacement and Axial failure energy. This data was collected and interpreted.
Results : Femoral neck fracture fixation by using a multiple screw fixation method with cannulated screw, was divided screw area in femoral neck into 3 areas which are area A (4.19 cm.2), area B (2.64 cm.2) and area C (1.35 cm.2). It found that area A which was the most covered areas in femur had a better biomechanical effect than area B and C which were less covered area in femur, respectively. Biomechanical effect in area B was better than area C in Axial stiffness, Axial load to failure, Axial failure displacement and Axial failure energy and there was a statistically significant difference.
Conclusion : The result of femoral neck fracture fixation by using a multiple screw fixation method with a cannulated screw which its placement was in the form of an inverted triangle showed that the more screw placement covers the femoral neck area the more it causes a biomechanical effect and the most stability after the operation.
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