Novel Design of Minimal Incision Double Oblique Device for Osteosynthesis (DODO) of Hip: Results of an In-silico Study Based on the Femur Morphometrics of the Northeast (NE) Indian population

Hip fractures account for a large proportion of hospitalization among the trauma cases. Low cost, simple technique, easy removal, and high rate of the bone union makes extramedullary (EM) fixation techniques a preferred choice. A close-fit bone and plate are essential for the success of such implantation. Various studies have found femur morphometry being related to regional features and social differences. Most of the available commercial implants are developed based on the data of the Caucasian population. In the herein study, a novel design, Double Oblique Device for Osteosynthesis of hip (DODO), is proposed while considering the regional morphometry of the Northeast (NE) population of India. This study employs finite element (FE) analysis to compare the biomechanical outcome of the new device with that of proximal femoral locking plate (PFLP) and variable angle dynamic hip screw (VA-DHS) on a femur having an Evans type-I intertrochanteric fracture. The stress shielding was substantially high for the PFLP and VA-DHS in the distal bone fragment (lateral aspect) and for DODO in the femoral head. The difference in axial displacement between the post-implanted DODO-fixed femur and its respective intact femur was predicted to be almost the same as that of PFLP-fixed femur and its respective intact femur. The computational results found the new device to be a viable alternative to the conventional plating techniques, especially for the NE population of India, and predicted better to comparable biomechanical characteristics.