Medial support nail and proximal femoral nail antirotation in the treatment of reverse obliquity inter-trochanteric fractures (Arbeitsgemeinschaft fur Osteosynthesfrogen/Orthopedic Trauma Association 31-A3.1): a finite-element analysis.
10.1097/CM9.0000000000001031
- Author:
Shao-Bo NIE
1
;
Yan-Peng ZHAO
2
;
Jian-Tao LI
1
;
Zhe ZHAO
3
;
Zhuo ZHANG
1
;
Li-Cheng ZHANG
1
;
Pei-Fu TANG
1
Author Information
1. Department of Orthopaedics, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.
2. Department of Orthopedics, the Fourth Medical Centre, Chinese PLA General Hospital, Beijing 100853, China.
3. Department of Orthopaedics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
- Publication Type:Journal Article
- MeSH:
Bone Nails;
Femur;
Finite Element Analysis;
Fracture Fixation, Intramedullary;
Hip Fractures/surgery*;
Humans;
Treatment Outcome
- From:
Chinese Medical Journal
2020;133(22):2682-2687
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:The reverse obliquity inter-trochanteric fracture is a distinct fracture pattern that is mechanically different from most inter-trochanteric fractures and the optional treatment of it is still controversial. The purpose of this study was to compare differences in the efficacy of a novel nail (medial support nail [MSN-II]) and proximal femoral nail anti-rotation (PFNA-II) in the treatment of reverse obliquity inter-trochanteric fractures (Arbeitsgemeinschaft fur Osteosynthesfrogen/Orthopedic Trauma Association [AO/OTA] 31-A3.1) using finite-element analysis.
METHODS:Modeling software was used to establish a three-dimensional model of MSN-II and PFNA-II and an A3.1 inter-trochanteric fracture model. Abaqus software was used to implement different force loads to compare finite-element biomechanical parameters such as the maximum stress in implant and the displacement of fracture site.
RESULTS:The femoral stress, implant stress and fracture site displacement of MSN-II was less than that of PFNA-II. The results indicated that the maximal femoral stress was 581 MPa for PFNA-II and 443 MPa for the MSN-II. The maximum stress values in the PFNA-II and MSN-II models were 291 and 241 MPa, respectively. The maximal displacements of the fracture site were 1.47 and 1.16 mm in the PFNA-II and MSN-II models, respectively.
CONCLUSION:Compared with PFNA-II for inter-trochanteric fracture (AO/OTA 31-A3.1), MSN-II which was designed with a triangular stability structure can provide better biomechanical stability. The MSN-II may be a feasible option for the treatment of reverse obliquity inter-trochanteric fracture.
