Nail breakage of proximal femoral nail anti-rotation for treating intertrochanteric fracture: construction and validation of finite element simulation model

doi:10.12307/2021.271

Abstract

Abstract: BACKGROUND: Nail breakage of proximal femoral nail anti-rotation is one of the severe implant failure that must be revised. At present, the biomechanical causes for the nail breakage are mostly inferred from metal fatigue; however, there is still no direct research or method to prove the mechanical mechanism of nail breakage. Therefore, to construct a finite element model of proximal femoral nail anti-rotation in treating intertrochanteric fracture and to realize the visualization of nail breakage are of great significance in studying the failure mechanism.
OBJECTIVE: To simulate biomechanical process of the nail breakage of proximal femoral nail anti-rotation in treating intertrochanteric fracture.
METHODS: Femoral CT data of a hip fracture patient, who was hospitalized in Department of Traumatic Orthopedics, First Affiliated Hospital of Guangzhou University of Chinese Medicine, were imported into Mimics 19.0 and polished in Geomagic Studio software to reconstruct a three-dimensional finite element model of proximal femur. The proximal femoral nail anti-rotation model was created in SolidWorks based on the specification and matched with the polished femoral model according to the surgical protocol. The proximal femoral nail anti-rotation intramedullary nail was fixed to the proximal femur, and the assembly model of the femur and proximal femoral nail anti-rotation intramedullary nail was established. The component including proximal femoral nail anti-rotation and proximal femur was meshed as tetrahedron and constructed as AO-31A1.3 type fracture (2018 version) in Hypermesh software. After material contents (including critical fatigue parameter of implants and biomechanical material parameter of femur), loading, boundary condition and friction coefficient were completed, the K file was finally solved in LS-DYNA.
RESULTS AND CONCLUSION: (1) Crack first appeared on the weakness on the blade hole of nail. (2) The maximal Von Mises stress of nail reached 412 MPa before breakage. During the crack propagation, stress concentrated at the intersection between nail and helical blade, locking bolt and nail. Stress distributed around the head-neck part and the insertion point of the great trochanter on femur. The maximal Von Mises stress of femur during the nail breakage was 248.3 MPa. (3) The tip of helical blade and the femoral head varus in the coronal plane, and being the most displaced parts. (4) The validation results suggest that this model can effectively simulate the nail breakage of proximal femoral nail anti-rotation in treating intertrochanteric fracture. The weak part of nail was the critical area of stress concentration and destruction.

Key words: bone, hip, fracture, intertrochanteric fracture, proximal femoral nail anti-rotation, nail breakage, biomechanics, finite element analysis

CLC Number:

Xu Long, Zeng Zhanpeng, Chen Zijie, Zhang Yan, Lin Ziling, . Nail breakage of proximal femoral nail anti-rotation for treating intertrochanteric fracture: construction and validation of finite element simulation model[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(30): 4839-4844.

Figures/Tables 6

References

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