Predicting femoral bone strength after cephalomedullary nail removal with FE models using pre-operative CT scans

Abstract

Cephalomedullary nailing is frequently used to treat per- and subtrochanteric fractures of the proximal femur. After fracture healing, patients sometimes request nail removal due to persistent pain or irritation. However, removing the nail leaves a large void in the bone, which poses a considerable risk of re-fracture at the femoral neck. Pre-operative prediction of fracture risk would help to make an informed decision about nail removal and to estimate the required post-operative care. This study investigated whether patient-specific finite element (FE) models created from pre-operative CT scans can predict femoral bone strength after nail removal. Experimental data of femora after nail removal were used to evaluate the accuracy of the models.