Abstract
Objective To compare the biomechanical effects of the proximal femoral reconstruction nail antirotation(PFRNA),designed by our research group,with the proximal femoral nail antirotation(PFNA)in the treatment of intertrochanteric femoral fractures combined with lateral wall fractures using finite element analysis,and to evaluate the efficacy of PFRNA fixation.Methods The CT data of a normal male femur were imported into software to extract a standard femoral model,which was then segmented to create a fracture model.The PFRNA and PFNA models were designed in the software and assembled with the fracture model.Finally,the fracture-fixation models were imported into analysis software for biomechanical evaluation.Results Under a 600 N vertical load:In the PFNA group,the maximum displacements of the femur,internal fixation device,and fracture fragment were 2.544 0 mm,2.432 9 mm,and 2.169 4 mm.In the PFRNA group,these values were 2.075 5 mm,1.985 3 mm,and 1.759 2 mm,respectively.The peak von Mises stresses in the femur,internal fixation device,and fracture fragment for the PFNA group were 75.292 3 MPa,75.292 0 MPa,and 12.254 0 MPa,respectively.For the PFRNA group,these stresses were 47.675 0 MPa,47.675 0 MPa,and 7.148 4 MPa,respectively.The displacement of the lateral wall fracture line and intertrochanteric fracture line along the x,y,and z axes in the PFNA group was(-1.530 1 mm,-1.127 1 mm,0.165 5 mm)and(-1.272 9 mm,-1.379 4 mm,0.011 6 mm),respectively.In the PFRNA group,the displacement of the lateral wall fracture line and intertrochanteric fracture line along the x,y,and z axes was(-1.010 3 mm,-1.153 0 mm,0.110 3 mm)and(-0.773 1 mm,-1.308 7 mm,0.034 1 mm),respectively.Conclusion Under simulated bipedal standing conditions,FEA demonstrated that the PFRNA model outperformed PFNA in femoral/implant displacement,stress distribution,and fracture line stability.PFRNA provides effective fixation for both intertrochanteric fractures and concomitant lateral wall fractures.关键词
股骨粗隆间骨折/外侧壁/股骨近端防旋髓内钉/有限元分析/内固定/生物力学现象Key words
Intertrochanteric femoral fracture/Lateral wall/Proximal femoral nail antirotation/Finite element analysis/Internal fixation/Biomechanical phenomena分类
医药卫生
