Cannulated vs solid screws in the distal block of a lateral condylar plate does not change distal femur fracture strain - 19/08/26

Doi : 10.1016/j.otsr.2026.104859

Gregory R. Roytman ^a,^b,^c,⁎ , Louise Atadja ^a, Motasem Salameh ^a, Brad J. Yoo ^a, Steven M. Tommasini ^a,^c, Daniel H. Wiznia ^a,^d, Brianna R. Fram ^a

^a Orthopaedics and Rehabilitation, Yale University School of Medicine, 47 College Place, New Haven, CT 06510, United States of America

^b VA Connecticut Healthcare System, Veterans Health Administration, 950 Campbell Ave, West Haven, CT 06516, United States of America

^c Biomedical Engineering, Yale University School of Engineering and Applied Science, 17 Hillhouse Avenue, New Haven, CT 06520, United States of America

^d Mechanical Engineering and Materials Science, Yale University School of Engineering and Applied Science, 17 Hillhouse Avenue, New Haven, CT 06520, United States of America

^⁎ Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 19 August 2026

Abstract

Introduction

Distal femur fractures are common in the geriatric population with a concurrent high risk of mortality. When treating these injuries, surgeons consider interfragmentary strain at the fracture site an important variable due to its large influence on the potential for fracture healing. The lateral condylar plate is a common implant used to fix distal femur fractures. Modulating different properties of the lateral condylar plate has the potential to change the interfragmentary strain. Our primary research question was therefore whether fracture-site strain in osteoporotic distal femur fractures stabilized with lateral condylar plates was significantly different with solid versus cannulated distal block screws during axial loading. We hypothesized that cannulated screws or solid screws used in the distal fracture fragment may affect fracture site strain.

Methods

We performed finite element analysis of a femur model with concurrent synthetic femur validation of cannulated screws and solid screws in the distal fracture fragment (n = 5 trials each). The cortical bone and trabecular bone sections of the virtual femur were split into two different sections with unique material properties. Femur constructs were loaded vertically axially with body weight (80 kg patient with 784 N), both in the finite element analysis and synthetic femur trials. Differences between cannulated and solid screw groups were assessed.

Results

The finite element simulations were determined to be valid, with no significant difference between the finite element analysis and synthetic femur trials in the cannulated screw scenarios (p = 0.076) or the solid screw scenarios (p = 0.25). In both the synthetic femur trials and finite element analysis trials, we found no significant difference between the cannulated screw and solid screw scenarios (p = 0.96).

Conclusion

No difference in distal femur fracture interfragmentary strain was found between lateral condylar plates with solid and cannulated screws in the distal block during axial loading.