A small but significant fraction of screw placement in the proximal femur for hip fractures results in iatrogenic fractures associated with the screw hole . There is evidence that the failure occurs under fatigue, and it is likely that those individuals experiencing failure have greater stresses in the proximal femur as dictated by key morphometric variables, such as cortical thickness and bone size. Finite element analysis (FEA) could greatly facilitate fracture risk assessment in the presurgical phase by predicting the local stresses, however, executing FEM in a patient customized fashion would be costly, time consuming, and technically difficult for surgeons to perform.
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