Biomechanical analysis of four internal fixations for Pauwels Ⅲ femoral neck fractures with defects.
10.12200/j.issn.1003-0034.2023.03.012
- Author:
Zhi-Hao SU
1
,
2
;
Hong-Li TAN
3
;
Zi-Huan XU
1
,
2
;
Peng-Fei LI
1
,
2
;
Yong-Qin WANG
1
,
2
;
Shuang LI
4
;
Ming NI
5
,
6
Author Information
1. School of Health Science and Engineering, Shanghai University of Technology, Shanghai 200093, China
2. Department of Orthopaedics, Shanghai Pudong New Area People's Hospital, Shanghai 201299, China.
3. Department of Rehabilitation, Haian Hospital of Traditional Chinese Medicine in Jiangsu Province, Haian 226600, Jiangsu, China.
4. Department of Orthopaedics, Shanghai Pudong New Area People's Hospital, Shanghai 201299, China.
5. Department of Orthopaedics, Shanghai Pudong New Area People's Hospital, Shanghai 201299, China
6. Department of Orthopaedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
- Publication Type:Journal Article
- Keywords:
Bone defect;
Femoral neck fracture;
Femoral neck system;
Finite element analysis;
Medial buttress plate
- MeSH:
Humans;
Femoral Neck Fractures/surgery*;
Fracture Fixation, Internal/methods*;
Bone Screws;
Bone Plates;
Biomechanical Phenomena;
Finite Element Analysis
- From:
China Journal of Orthopaedics and Traumatology
2023;36(3):255-261
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the biomechanical characteristics of different internal fixations for Pauwels type Ⅲ femoral neck fracture with defect, and provide reference for the treatment of femoral neck fracture.
METHODS:Three-dimensional (3D) finite element models of femoral neck fractures were established based on CT images, including fracture and fracture with defects. Four internal fixations were simulated, namely, inverted cannulated screw(ICS), ICS combined with medial buttress plate, the femoral neck system (FNS) and FNS combined with medial buttress plate. The von Mises stress, model stiffness and fracture displacements of fracture models under 2 100 N axial loads were measured and compared.
RESULTS:When femoral neck fracture was fixed by ICS and FNS, the peak stress was mainly concentrated on the surface of the screw near the fracture line, and the peak stress of FNS is higher than that of ICS;When the medial buttress plate was combined, the peak stress was increased and transferred to medial buttress plate, with more obvious of ICS fixation. For the same fracture model, the stiffness of FNS was higher than that of ICS. Compared with femoral neck fracture with defects, fracture model showed higher stiffness in the same internal fixation. The use of medial buttress plate increased model stiffness, but ICS increased more than FNS. The fracture displacement of ICS model exceeded that of FNS.
CONCLUSION:For Pauwels type Ⅲ femoral neck fracture with defects, FNS had better biomechanical properties than ICS. ICS combined with medial buttress plate can better enhance fixation stability and non-locking plate is recommended. FNS had the capability of shear resistance and needn't combine with medial buttress plate.
