Biomechanical study on the treatment of intertrochanteric fracture of A3.3 type with medial sustainable nail and proximal femoral anti-rotation nail.
10.12200/j.issn.1003-0034.2020.12.014
- Author:
Shao-Bo NIE
1
;
Jian-Tao LI
1
;
Yan-Peng ZHAO
1
;
Zhe ZHAO
1
;
Bao-Zhang ZHU
1
;
Yun-Chao YAN
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.
- Publication Type:Journal Article
- Keywords:
Biomechanical study;
Intramedullary nail;
Medial support;
Trochanteric fractures
- MeSH:
Biomechanical Phenomena;
Bone Nails;
Bone Screws;
Femur;
Fracture Fixation, Intramedullary;
Hip Fractures/surgery*;
Humans
- From:
China Journal of Orthopaedics and Traumatology
2020;33(12):1161-1165
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:A3 intertrochanteric fracture is an extremely unstable fracture, which is often treated with intramedullary nail, but the implant failure is common due to the posterior medial fragment cannot be reconstructed. A new medial sustainable nail (MSN-Ⅱ) which can reconstruct the femoral medial support by sustainable screw was introduced in this study. The mechanical effect was verified by biomechanical experiment.
METHODS:The loss medial support model of intertrochanteric fracture (A3) was made by artificial Sawbones model, fixed with MSN-Ⅱ and PFNA-Ⅱ, underwent axial loading and axial failure tests. The axial stiffness, yield load, displacement of head-neck fragment and torsional angle of fracture site of these nails were recorded and compared for biomechanical differences. The effect of early reconstruction of medial support with MSN-Ⅱ was determined.
RESULTS:The axial stiffness, yield load, the displacement of head and neck fragment when the axial load was 1 800 N and torsional angle of the fracture site after the axial failure test of MSN-Ⅱ were (222.76 ±62.46) N /mm, (4 241.71 ±847.42) N, (11.51 ±0.62) mm, (1.71 ±0.10)° respectively, while the PFNA -Ⅱ was (184.58±40.59) N /mm, (3 058.76±379.63) N, (16.15±1.36) mm, (2.52±0.26)°respectively. The difference between the two groups was statistically significant.
CONCLUSION:The axial stiffness of MSN-Ⅱ is better than that of PFNA-Ⅱ. The MSN-Ⅱ can bear more loads when fixed A3.3 intertrochanteric fracture and has greater axial and rotational stability. It is an effective means to reconstruct the medial support of A3 intertrochanteric fracture.
