Comparative Pull-Out Performances of Cephalomedullary Nail with Screw and Helical Blade According to Femur Bone Densities

This paper mainly examines the fixation performances of the cephalomedullary nail for the incidence of intertrochanteric (IT) fracture to guide the appropriate fixations with respect to the bone density in terms of a biomechanical perspective. It is substantially important to guide which types of fixation are applied during the operation since it tends to induce the backout or migration of the helical blade and screw according to weight and bone density. Biomedical polyurethane (PUR) foam blocks for simulating human bone are adopted with two grades of densities to simulate a normal person and an elderly person who has osteoporosis. Tensile and compression tests are conducted to analyze the tensile-compression anisotropy of PUR foams. Pull-out performances of screw and helical blades are evaluated from experimental perspectives, which are supported by comparison with the results of finite element method analysis. The clamping force of the screw is higher than the helical blade, about 177% in normal foam density and 198% in low foam density. After physical evaluation of the critical pull-out fixation force of screw and helical blade, we have suggested that stable fixation is guaranteed when the pull-out force is larger than projected force.