{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:15:06Z","timestamp":1789020906057,"version":"build-2803163510"},"reference-count":73,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Migration and cut\u2010out are commo n failures observed in internal fixation of intertrochanteric fractures. This study compares the performance of four typical devices under dynamic loading using benchtop and computer\u2010simulated fracture models. The dynamic hip screw (DHS), Gamma3, proximal femoral nail anti\u2010rotation (PFNA\u2010II), and TFN\u2010Advanced (TFNA) were inserted into a solid rigid 10 pounds per cubic foot (PCF) polyurethane bone foam mimicking a reduced unstable intertrochanteric fracture model. Static and dynamic loading tests using a double\u2010peak loading curve based on natural walking gait were conducted. The blade devices had higher resistance to the onset of implant migration under physical dynamic loading in comparison to the screw devices. However, as dynamic loading progressed, no implant showed clear superior performance. Mesh\u2010free simulations of the physical tests were then conducted to visualize stress and failure patterns within the bone foam during migration and cut\u2010out, using an experimentally validated porous foam material model. The mean concordance correlation coefficient between load to cut\u2010out for the physical and simulated tests was 0.953 and 0.858 under static and dynamic loading, respectively. Under simulated dynamic loading, the volumes of yielding and failed bone foam were 15%, 32%, and 25% higher for Gamma3, PFNA\u2010II, and TFNA than for DHS, suggesting that devices with similar forces at cut\u2010out may produce relatively large differences in the volume of damaged bone tissue. Accurate simulation of material damage during dynamic loading may offer a useful alternative method for differentiating device performance in support of clinical decision\u2010making around implant selection.<\/jats:p>","DOI":"10.1002\/jor.70159","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T02:56:03Z","timestamp":1770778563000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of the Dynamic Cut\u2010Out Failure Modes of Common Proximal Femoral Fixation Devices Using a Mesh\u2010Free Computational Method"],"prefix":"10.1002","volume":"44","author":[{"given":"Erica Ueda","family":"Boles","sequence":"first","affiliation":[{"name":"Lifespans Ltd. Hong Kong China"},{"name":"Department of Orthopaedics &amp; Traumatology, LKS Faculty of Medicine The University of Hong Kong Hong Kong China"},{"name":"School of Biomedical Engineering The University of Hong Kong Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sloan","family":"Kulper","sequence":"additional","affiliation":[{"name":"Lifespans Ltd. Hong Kong China"},{"name":"Department of Orthopaedics &amp; Traumatology, LKS Faculty of Medicine The University of Hong Kong Hong Kong China"},{"name":"School of Biomedical Engineering The University of Hong Kong Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Whiffin","sequence":"additional","affiliation":[{"name":"Lifespans Ltd. Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1798-3379","authenticated-orcid":false,"given":"Marilyn Janice","family":"Oentaryo","sequence":"additional","affiliation":[{"name":"Lifespans Ltd. Hong Kong China"},{"name":"Department of Orthopaedics &amp; Traumatology, LKS Faculty of Medicine The University of Hong Kong Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Schneider","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgeon Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frankie","family":"Leung","sequence":"additional","affiliation":[{"name":"Lifespans Ltd. Hong Kong China"},{"name":"Department of Orthopaedics &amp; Traumatology, LKS Faculty of Medicine The University of Hong Kong Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3827-0351","authenticated-orcid":false,"given":"Christian X.","family":"Fang","sequence":"additional","affiliation":[{"name":"Lifespans Ltd. Hong Kong China"},{"name":"Department of Orthopaedics &amp; Traumatology, LKS Faculty of Medicine The University of Hong Kong Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/515197"},{"key":"e_1_2_7_3_1","article-title":"Internal Fixation Implants for Intracapsular Hip Fractures in Adults","volume":"4","author":"Parker M. J.","year":"2001","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-004-1702-6"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-006-0172-4"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00004148"},{"key":"e_1_2_7_7_1","unstructured":"WHO.2003.Prevention and Management of Osteoporosis: Report of a WHO Scientific Group. WHO Technical Report World Health Organization."},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.6.785"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000029384"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-023-05138-9"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0251894"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-020-02031-8"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0020-1383(89)90120-4"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2021.01.011"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.52312\/jdrs.2022.800"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-020-02193-5"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-20717-2"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcma.2017.04.007"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1123\/japa.19.4.373"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453678809149419"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12938-019-0663-0"},{"issue":"5","key":"e_1_2_7_23_1","first-page":"899","article-title":"Stable Fixation of Intertrochanteric Fractures: A Biomechanical Evaluation","volume":"56","author":"Kaufer H.","year":"1974","journal-title":"Journal of Bone & Joint Surgery"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.12671\/jkfs.2018.31.3.79"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/351936"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2006.06.008"},{"key":"e_1_2_7_27_1","unstructured":"T.Issa \u201cMechanical Testing and Material Modelling of Rigid Polyurethane Foam a Bone Surrogate \u201d (thesis Queen's University 2023)."},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.21236"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v9.i22.6343"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-69783-9"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2019.01.008"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.13497"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11071885"},{"key":"e_1_2_7_34_1","unstructured":"X.Huang B.Yu Y.Gu andZ.Li 2017 Biomechanical Comparison of Dynamic Hip Screw and Gamma Nail for the Treatment of Unstable Trochanteric Fractures: A Finite Element Study 7867\u20137874 www.ijcem.com\/."},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-018-1011-y"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/cnm.70093"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e29671"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2021.111473"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2023.1279067"},{"key":"e_1_2_7_40_1","unstructured":"S.Li G.\u2010X.Sun S.\u2010M.Chang et al.2017. Simulated Postoperative Weight\u2010Bearing After Fixation of a Severe Osteoporotic Intertrochanteric Fracture 8544\u20138554 p www.ijcem.com\/."},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2011.11.013"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10237-012-0434-3"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1086\/112164"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1115\/1.1431547"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.23734"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2024.106679"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2024.106443"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.2140\/jomms.2012.7.265"},{"key":"e_1_2_7_49_1","first-page":"213","volume-title":"Biodental Engineering III: Proceedings of the 3rd International Conference on Biodental Engineering (BIODENTAL 2014)","author":"Belinha J.","year":"2014"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2024.106412"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0067958"},{"issue":"7","key":"e_1_2_7_52_1","first-page":"1058","article-title":"The Value of the Tip\u2010Apex Distance in Predicting Failure of Fixation of Peritrochanteric Fractures of the Hip","volume":"77","author":"Baumgaertner M. R.","year":"1995","journal-title":"Journal of Bone & Joint Surgery"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200407000-00006"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.orthres.2005.05.002.1100230614"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0170048"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0155612"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.05.034"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2011.07.006"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31821852ed"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.22522"},{"key":"e_1_2_7_61_1","first-page":"143","volume-title":"Computational Inelasticity","author":"Simo J. C.","year":"1998"},{"key":"e_1_2_7_62_1","unstructured":"ASTM International.2021. ASTM F1839\u201008(2021) Specification for Rigid Polyurethane Foam for use as a Standard Material for Testing Orthopaedic Devices and Instruments.13.01:1\u20136 ASTM International."},{"key":"e_1_2_7_63_1","unstructured":"GPL Software.2025.CloudCompare http:\/\/www.cloudcompare.org\/."},{"key":"e_1_2_7_64_1","doi-asserted-by":"publisher","DOI":"10.2307\/2532051"},{"key":"e_1_2_7_65_1","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.25.2000150"},{"key":"e_1_2_7_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2010.08.003"},{"issue":"11","key":"e_1_2_7_67_1","first-page":"1487","article-title":"The Effect of Shortening and Varus Collapse of the Femoral Neck on Function After Fixation of Intracapsular Fracture of the Hip: A Multi\u2010Centre Cohort Study","volume":"90","author":"Zlowodzki M.","year":"2008","journal-title":"Journal of Bone and Joint Surgery. British Volume"},{"key":"e_1_2_7_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30066-1"},{"key":"e_1_2_7_69_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.21236"},{"key":"e_1_2_7_70_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10856-010-4024-6"},{"key":"e_1_2_7_71_1","doi-asserted-by":"publisher","DOI":"10.1515\/bmt-2024-0158"},{"key":"e_1_2_7_72_1","doi-asserted-by":"publisher","DOI":"10.1177\/09544119221092842"},{"key":"e_1_2_7_73_1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2024.1482165"},{"key":"e_1_2_7_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2024.106379"}],"container-title":["Journal of Orthopaedic Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jor.70159","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jor.70159","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jor.70159","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:10:08Z","timestamp":1779286208000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jor.70159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":73,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/jor.70159"],"URL":"https:\/\/doi.org\/10.1002\/jor.70159","archive":["Portico"],"relation":{},"ISSN":["0736-0266","1554-527X"],"issn-type":[{"value":"0736-0266","type":"print"},{"value":"1554-527X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"2025-07-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70159"}}