Computational simulation of cephalomedullary nailing in the osteoporotic Asian femur and clinical implications

Chon, Chang Soo; Kim, Joon‐Woo; Sohn, Hong Gyoo; Jung, Gu-Hee

doi:10.1016/j.injury.2021.11.035

Cited by 1 publication

(3 citation statements)

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“…6,[14][15][16][17][18][19] Consequently, exploring the PCT not only sheds light on the pathogenesis of hip fractures but also aids in refining the criteria for evaluating the effectiveness of implant selection. 20,21 Despite numerous attempts to map the distribution of PCT within the proximal femur, the conventional visual extraction method for identifying trabecular columns has been criticized for its substantial spatial deviation errors, casting doubts on its reliability. 8,11,14,[22][23][24][25] A significant challenge in assessing and quantifying PCT distribution lies in the unique nature of trabecular structures-no two are exactly alike.…”

Section: Introductionmentioning

confidence: 99%

“…Nonetheless, the primary compressive trabeculae (PCT)—a dense column of trabecular bone extending from the superior aspect of the femoral head to the medial cortex of the femoral neck—remains relatively preserved and is deemed the principal load‐bearing structure that links the femoral head with the femoral neck 6,14–19 . Consequently, exploring the PCT not only sheds light on the pathogenesis of hip fractures but also aids in refining the criteria for evaluating the effectiveness of implant selection 20,21 …”

Section: Introductionmentioning

confidence: 99%

“… 6 , 14 , 15 , 16 , 17 , 18 , 19 Consequently, exploring the PCT not only sheds light on the pathogenesis of hip fractures but also aids in refining the criteria for evaluating the effectiveness of implant selection. 20 , 21 …”

Section: Introductionmentioning

confidence: 99%

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Quantitative Analysis of Primary Compressive Trabeculae Distribution in the Proximal Femur of the Elderly

Xu,

Li,

Zhang

et al. 2024

Orthopaedic Surgery

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ObjectiveAs osteoporosis progresses, the primary compressive trabeculae (PCT) in the proximal femur remains preserved and is deemed the principal load‐bearing structure that links the femoral head with the femoral neck. This study aims to elucidate the distribution patterns of PCT within the proximal femur in the elderly population, and to assess its implications for the development and optimization of internal fixation devices used in hip fracture surgeries.MethodsThis is a retrospective cohort study conducted from March 2022 to April 2023. A total of 125 patients who underwent bilateral hip joint CT scans in our hospital were enrolled. CT data of the unaffected side of the hip were analyzed. Key parameters regarding the PCT distribution in the proximal femur were measured, including the femoral head's radius (R), the neck‐shaft angle (NSA), the angle between the PCT‐axis and the head–neck axis (α), the distance from the femoral head center to the PCT‐axis (δ), and the lengths of the PCT's bottom and top boundaries (L‐bottom and L‐top respectively). The impact of gender differences on PCT distribution patterns was also investigated. Student's t‐test or Mann–Whitney U test were used to compare continuous variables between genders. The relationship between various variables was investigated through Pearson's correlation analysis.ResultsPCT was the most prominent bone structure within the femoral head. The average NSA, α, and δ were 126.85 ± 5.85°, 37.33 ± 4.23°, and 0.39 ± 1.22 mm, respectively, showing no significant gender differences (p > 0.05). Pearson's correlation analysis revealed strong correlations between α and NSA (r = −0.689, p < 0.001), and R and L‐top (r = 0.623, p < 0.001), with mild correlations observed between δ and NSA (r = −0.487, p < 0.001), and R and L‐bottom (r = 0.427, p < 0.001). Importantly, our study establishes a method to accurately localize PCT distribution in true anteroposterior (AP) radiographs of the hip joint, facilitating precise screw placement in proximal femur fixation procedures.ConclusionOur study provided unprecedented insights into the distribution patterns of PCT in the proximal femur of the elderly population. The distribution of PCT in the proximal femur is predominantly influenced by anatomical and geometric factors, such as NSA and femoral head size, rather than demographic factors like gender. These insights have crucial implications for the design of internal fixation devices and surgical planning, offering objective guidance for the placement of screws in hip fracture treatments.

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