[Stability after obtaining cancellous bone from the greater trochanter].

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Human anatomy

Context:

• Cancellous bone harvesting from the greater trochanter is a common clinical procedure.
• Femoral stability is crucial for load-bearing capacity.
• Previous studies have not fully quantified the impact of bone harvesting on trochanteric stability.

Purpose:

• To evaluate the effect of cancellous bone removal from the greater trochanter on femoral stability.
• To compare the fracture incidence and patterns in femurs with and without bone harvesting.
• To assess the influence of cortical window shape on stress concentration and fracture risk.

Summary:

• Testing on 40 human femurs revealed that removing cancellous bone from the greater trochanter significantly reduced trochanteric stability (p < 0.05).
• Femurs with harvested bone showed a higher rate of subtrochanteric and pertrochanteric fractures compared to intact femurs.
• Cutting a round cortical window, instead of a square one of equal area, reduced the number of fractures crossing the window by half (p < 0.05), mitigating stress concentration.

Impact:

• Findings suggest that cancellous bone harvesting from the greater trochanter compromises femoral integrity.
• The study recommends using round cortical windows to minimize iatrogenic fracture risk during bone harvesting.
• It advises prioritizing alternative bone graft sites, such as the ilium, when possible.