**Author details**

Orlin Filipov *Department of Orthopaedics, Vitosha Hospital, Sofia, Bulgaria* 

### **9. References**

92 Injury and Skeletal Biomechanics

type Pauwels III.

**8. Conclusion** 

fixation.

**Author details** 

Orlin Filipov

sometimes leads to cutting of the DHS-screw through the soft cancellous bone of the femoral head with migration of the implant in proximal direction, accompanied by displacement in varus of the fracture; (3.) Increase of the percentage of aseptic necrosis with fixation with DHS, compared to the screw fixation. (4.) In the presence of osteoporosis, the compression upon the fracture, created by the DHS-screw is very weak, compared to the three cancellous screws,

*Proximal femoral locking plates*. These implants represent a modification of the traditional methods for fixation with cancellous screws, placed almost parallel in the cancellous bone of the femoral neck. Here the screws are fixed in the plate at the level of the lateral cortex, which solves the problem with the fragile lateral cortex of the greater trochanter and creates a stable construction. However it fixes the fracture statically, not allowing creation of compression, because of the locking of the screws and also lacks the sliding-phenomenon,

Intramedullary nails. In the presence of femoral neck fracture, combined with other fracture, located in a lower segment of femur, at present we use different types of intramedullary

Other alternative types of implants, most of which have only historical significance, are the 130° blade-plates. Their inconvenience is that they cannot create compression as the screw systems and having at the same time imperfections with their outdated surgical technique. However, having a fixed angle the blade-plate ensure excellent fixation of the fracture regarding the varus stress and torsion and combined with one additional screw is probably the most effective method for fixation in fracture with vertical fracture line –

The provision of two steady supporting points for the implants and the obtuse angle at which they are positioned, allows transferring of the body weight successfully from the head fragment onto the diaphysis, owing to the strength of the screws, with the patient's bone quality being of least significance. The position of the screws allows them to slide under stress at minimum risk of displacement. The achieved results with the BDSF-method in terms of fracture consolidation are far more successful than the results with conventional fixation methods. The BDSF-method ensures reliable fixation, early rehabilitation and excellent long-term outcomes, even in non-cooperative patients. BDSF is mainly addressed to patients, who have contraindications for arthroplasty, as well as for conventional screw

which fix in the head subchondrally in three different points.

which is helpful for the process of healing.

systems of the type of the reconstructive nail and PFN.

*Department of Orthopaedics, Vitosha Hospital, Sofia, Bulgaria* 

	- [15] Tidermark J, Ponzer S, Svensson O, Söderqvist A, Törnkvist H (2003) Internal fixation compared with total hip replacement for displaced femoral neck fractures in the elderly. J Bone Joint Surg. Br 85-B(3): 380-388

**Chapter 6** 

© 2012 Patel and Goswami, licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2012 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

**Comparison of Intracranial Pressure** 

**– Validation of Computational Model** 

Traumatic brain injury (TBI) is a leading cause of death in the United States. The brain is among the most essential organs of the human body. From a mechanical stand point, different scenarios where a head comes in contact with a media has evolved a number of integrated protection devices. The scalp and skull, but also to a certain extent the pressurized subarchnoidal space and the dura matter, are the natural protections for the brain. However, these structures are not adapted to the dynamic loading conditions involved in modern road and sports accidents as well as blast injury scenarios. The consequence of this extreme loading is often moderate-to-severe TBI [1-15]. Injuries to the head constitute one of the major causes of death. Brain injury disables or kills someone in the United States every two and half minutes [2]. The annual hospitalization and rehabilitation cost has been estimated to be \$33 billion per year in the US alone [14]. In the United States TBI is a leading cause of death for persons under age 45 [15]. TBI occurs every 15 seconds, see Figure 1. Approximately 5 million Americans currently suffer some form of TBI disability. The leading causes of TBI are motor vehicle accidents, falls, sports injuries and from blast injuries [12]. Thus, preventing these head injuries

will not only enhance safety and quality of life but also save healthcare dollars.

of human head subject to impact loadings [3].

Over the last 40 years, biomechanical research has been gaining attention to fully understand the mechanism of the head injury. Understanding and thus protecting the brain from injury. This can only be achieved by: 1) understanding mechanics of the impact and 2) the biomechanical response of the head to a variety of the loading conditions [2]. A costeffective alternative method using the finite element modeling was used to investigate TBI

A brief review of TBI performed below and injury parameters compiled for model validation.

and reproduction in any medium, provided the original work is properly cited.

**by Lateral and Frontal Impacts** 

Aalap Patel and Tarun Goswami

http://dx.doi.org/10.5772/50368

**1. Introduction** 

Additional information is available at the end of the chapter

Aalap Patel and Tarun Goswami

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/50368
