Stability of the femoral neck and internal fixation with bone cement and steel plate after curettage for benign proximal femoral lesions
10.3969/j.issn.2095-4344.2501
- Author:
Zhaoxin YANG
1
Author Information
1. Department of Orthopedic Trauma, Affiliated Hospital of Chengde Medical College
- Publication Type:Journal Article
- Keywords:
Benign lesion;
Curettage;
Defect;
Finite element;
Mechanical analysis;
Proximal femur;
Steel plate
- From:
Chinese Journal of Tissue Engineering Research
2020;24(12):1841-1846
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: For benign bone tumor patients, the life cycle is long. To reduce the incidence of complications and improve the quality of life after surgery through surgery is the common goal of physicians. The quality of life of patients can be increased through discussing the operation mode and prognosis of benign tumor patients, choosing the reasonable operation mode, predicting and reducing the risk of secondary fracture. OBJECTIVE: To analyze the femoral neck force after different surgical methods using finite element technique in the analysis of benign proximal femoral lesions, and to assess the stability of the femoral neck and the risk of fracture after different surgical procedures for cases with a wide range of lesions. METHODS: According to preoperative CT data of lesion sites in 10 subjects with benign tumor of proximal femur, three-dimensional model of internal fixation with bone cement and steel plate after focal curettage (group A) and three-dimensional model of treating with bone cement after focal curettage (group B) were set in this study. Finite element technique was used to simulate the maximum force of the femoral neck when walking. The stress peaks of the femoral neck were compared after surgery between the two groups. The risk of fracture at this location was assessed. Patients signed the informed consent. This study was approved by the Ethics Committee of Chengde Medical College. RESULTS AND CONCLUSION: (1) The stress was significantly lower in the group A than in the group B (P=0.007 < 0.05). (2) The local stress of the model was reasonable in the group A. Ten patients were operated with the protocol of the group A. An additional 17 patients with proximal femur benign lesions who met the requirements but refused to enter the finite element experiment were treated with the surgical program of the group A. (3) The patients were followed up for 14-42 months. During the follow-up, no new fracture was found in the operation area, and the internal fixation device was firm without fracture. At 12 months postoperatively, the mean Musculoskeletal Tumor Society score of all patients was (26.12±2.28). (4) The finite element technology for simulating the stress evaluation and postoperative follow-up verified that the treatment of proximal femur benign tumor with bone cement and steel plate internal fixation after curettage is more reasonable and effective. The scheme can effectively reduce the risk of secondary fracture and enhance the stability in the surgical area.
