Biomechanical Analysis of a Modified Proximal Femoral Nail in the Management of Reverse Obliquity Intertrochanteric Fractures: A Finite Element Study from East India

Dr. Bighnesh Dash, Dr. Hatia Marandi

Abstract: Background: Reverse obliquity intertrochanteric fractures (ROIFs) remain one of the most challenging proximal femoral fractures to stabilize, and the ideal fixation method continues to be debated. To address this, a modified proximal femoral nail (MPFN) was designed with the intention of enhancing stability in such fracture configurations. Methods: This study, conducted in East India between February 2023 and March 2025, utilized finite element modeling to evaluate the biomechanical performance of the MPFN compared with two widely used intramedullary implants: the Proximal Femoral Nail Antirotation (PFNA) and the InterTAN nail. An AO/OTA 31-A3.1 ROIF model was reconstructed using Mimics software. Each implant was virtually applied, and the models were subjected to axial, bending, and torsional loading. Stress distribution and displacement patterns were analyzed under physiologic load conditions. Results: The MPFN model demonstrated a more favorable stress distribution than PFNA and InterTAN under an axial load of 2,100 N. Bone stresses were significantly lower in the MPFN construct compared to the other two systems. Displacement analysis showed a 12.6% reduction with the MPFN relative to PFNA under axial load. Similar biomechanical superiority of the MPFN was observed under bending and torsional stresses. Conclusion: Among the three fixation systems tested, the modified proximal femoral nail exhibited the most favorable biomechanical properties, followed by the InterTAN and PFNA. These findings suggest that the MPFN may provide a biomechanically reliable alternative for treating reverse obliquity intertrochanteric fractures in the East Indian population. Clinical Relevance: The superior biomechanical stability of the MPFN may translate into reduced implant failure, improved fracture healing, and better functional outcomes for patients with reverse obliquity intertrochanteric fractures.

Keywords: reverse obliquity intertrochanteric fracture, modified proximal femoral nail, finite element analysis, biomechanics, intramedullary fixation, East India

How to Cite?: Dr. Bighnesh Dash, Dr. Hatia Marandi, "Biomechanical Analysis of a Modified Proximal Femoral Nail in the Management of Reverse Obliquity Intertrochanteric Fractures: A Finite Element Study from East India", Volume 14 Issue 12, December 2025, International Journal of Science and Research (IJSR), Pages: 654-662, https://www.ijsr.net/getabstract.php?paperid=SR251208173034, DOI: https://dx.doi.org/10.21275/SR251208173034