Finite element analysis of two nonanatomic reductions of Pauwels Ⅲ subcapital femoral fractures fixation
ZHENG Xiang, XU Jin-huang, HUANG jian-rong
Chinese Journal of Clinical Anatomy ›› 2017, Vol. 35 ›› Issue (6) : 665-670.
Finite element analysis of two nonanatomic reductions of Pauwels Ⅲ subcapital femoral fractures fixation
Objective To explore and compare the biomechanical properties of two nonanatomic reductions of Pauwels Ⅲ subcapital femoral fractures fixation using finite element analysis, therefore to provide theoretic reference for clinic application. Methods Using a CT scan from a 25-year-old healthy male femur and the measuring data of a PH Nail (Physiological Hip Nail) and screws, positive buttress reduction and negative buttress reduction models of Pauwels Ⅲ subcapital femoral fracture fixation were developed using finite element soft wares. The maximum displacement of the fracture sites, the maximum Von Mises strain on femur, the maximum von Mises stress on implants were compared under two loading conditions simulating “stance” and “walking” respectively. Results The maximum displacement of the fracture sites of two models under “stance” and “walking” conditions were 0.87 mm and 1.38 mm, 1.27 mm and 1.98 mm, respectively. The maximum Von Mises strains on femur were 1.77e-2 and 2.47e-2, 1.89e-2 and 2.12e-2, respectively. The maximum von Mises stresses on implants were 304.47 Mpa and 359.03 Mpa, 362.24 Mpa and 391.52 Mpa, respectively. Conclusions The reduction of positive buttress has better biomechanical properties than negative buttress under the same loading conditions for Pauwels Ⅲ subcapital femoral fracture fixation. Results of this study support the Yechiel Gotfried theory for Pauwels Ⅲ subcapital femoral fracture fixation from a biomechanical perspective.
Subcapital femoral fracture / Nonanatomic reduction / Positive buttress / Negative buttress / Finite element analysis
[1] Hawks MA, Kim H, Strauss J, et al. Does a trochanteric lag screw improve fixation of vertically oriented femoral neck fractures A biomechanical analysis in cadaveric bone [J]. Clin Biomech, 2013, 28(8): 886-891.
[2] Mittal R, Banerjee S. Proximal femoral fractures: Principles of management and review of literature[J]. J Clin Orthop Trauma, 2012, 3 (1):15-23.
[3] van Vust AB. Femoral neck non-unions: How do l do it [J] ? Injury, 2007, 38 (Suppl 2): S51-54.
[4] Stacey SC, Renninger CH, Hak D, et al. Tips and tricks for ORIF of displaced femoral neck fractures in the young adult patient[J]. Eur J Orthop Surg Traumatol, 2016, 26(4):355-363.
[5] Nagi ON，Dhillon MS. Management of neglected/uninvited fractures of the femoral neck in young adults[J]. Current Orthopedics, 2003,17(5):394-402.
[6] Ehlinger M, Moser T, Adam P, et al. Early prediction of femoral head avascular necrosis following neck fracture[J]. Orthop Traumatol Surg Res, 2011,97(1):79-88.
[7] Gotfried Y. The Gotfried (Nonanatomic, Closed) Reduction of Unstable Subcapital Femoral Fractures[J]. Techniques in Orthopaedics, 2014, 29(4):194-96
[8] Gotfried Y, Kovalenko S, Fuchs D. Nonanatomical reduction of displaced subcapital femoral fractures (Gotfried reduction) [J]. J Orthop Trauma, 2013, 27(11): e254-e259.
[9] 樊黎霞, 丁光兴, 费王华, 等. 基于CT图像的长管骨有限元材料属性研究及实验验证[J]. 医用生物力学, 2012, 28(1):102-108.
[10]Tupis TM, Altman GT, Altman DT, et al. Femoral bone strains during antegrade nailing: A comparison of two entry points with identical nails using finite element analysis[J]. Clin Biomech, 2012, 27(4): 354-359.
[11]Saqib N, Cerianne P, Tim F, et al. Finite element analysis modelling of proximal femoral fractures, including post-fixation periprosthetic fractures[J]. Injury, 2013, 44 (6):791-795.
[12] Mahaisavariya B, Sitthiseripratip K, Suwanprateeb J. Finite element study of the proximal femur with retained trochanteric gamma nail and after removal of nail. [J]. Injury, 2006, 37 (8):778-785.
[13]Mei J, Liu S, Jia G, et al. Finite element analysis of the effect of cannulated screw placement and drilling frequency on femoral neck fracture fixation[J]. Injury, 2014, 45(12):342-348.
[14]Chen DW, Lin C, Hu C, et al. Finite element analysis of different repair methods of Vancouver B1 periprosthetic fractures after total hip arthroplasty[J]. Injury, 2012, 43(7): 1061-65.
[15]Sim E, Freimuller W, Reiter TJ. Finite element analysis of the stress distributions in the proximal end of the femur after stabilization of a pertrochanteric model fracture: a comparison of two implants[J]. Injury, 1995, 26(7): 445-449.
[16]Sabalic S, Kodvanj J, Pavic A. Comparative study of three models of extra-articular distal humerus fracture osteosynthesis using the finite element method on an osteoporotic computational model[J]. Injury, 2013, 44 (Suppl 3): S56-S61.
[17]Hambli R, Lespessailles E, Benhamou C. Integrated remodeling-to-fracture finite element model of human proximal femur behavior[J]. J Mech Behav Biomed Mater, 2013, 17(1): 89-106.
[18]Disegi JA, Eschbach L. Strainless steel in bone surgery[J]. Injury, 2004, 31(Suppl 4): D2-6.
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