Finite element analysis of femoral intertrochanteric fracture treated with intramedullary nail with different lateral wall classifications

doi:10.12307/2023.649

Abstract

Abstract: BACKGROUND: At present, there is a controversy on the internal fixation for the femoral intertrochanteric fracture with fracture of lateral wall. The main method is the proximal femoral nail antirotation. The biomechanical study of intramedullary fixation for femoral intertrochanteric fracture with different lateral wall classifications is less.
OBJECTIVE: To compare the biomechanical characteristics of proximal femoral nail antirotation in the treatment of femoral intertrochanteric fracture with different lateral wall classifications by finite element analysis, and to explore the influence of lateral wall on the internal fixation of femoral intertrochanteric fracture.
METHODS: A healthy elderly female patient was selected. A 3D finite element model of proximal femur and proximal femoral nail antirotation was established by using Mimics 21.0, Geomagic Wrap, Creo 6.0 and Abaqus 2020 software according to the CT scanning data of proximal femur. The proximal femoral nail antirotation assembly model was established by simulating lateral wall stable, dangerous and ruptured intertrochanteric fractures. The Von Mises stress and displacement distributions of three models of internal fixation were observed under the same load in static and walking conditions.
RESULTS AND CONCLUSION: (1) The maximum Von Mises stress and displacement of A3.3 type intertrochanteric fracture were the largest under dynamic state; the maximum Von Mises stress was about twice of type A2.3, and 2.7 times of type A1.3; the maximum Von Mises displacement was about 1.5 times of type A2.3 and 3 times of type A1.3, and there was no significant difference among the various types under static state. (2) The Von Mises stress A3.3 at femoral neck, fracture end and main nail was larger than that of A1.3 and A2.3 under dynamic and static states, especially at main nail. (3) The Von Mises displacements of femoral head, femoral neck, fracture end, lateral wall, medial wall, main nail and spiral blade in A3.3 type were larger than that in A1.3 and A2.3 types; the change was not obvious under static state. (4) These results suggest that the integrity of the lateral wall can reduce the internal fixation stress, make the stress and displacement distribution more reasonable, and help to maintain the stability of intertrochanteric fracture.

Key words: femoral intertrochanteric fracture, lateral wall classification, intramedullary nail, Von Mises stress, finite element analysis, dynamic load

CLC Number:

Zhou Long, Wang Liang, Xu Rui, Bao Yidong, He Shuangjian, Xu Xibin. Finite element analysis of femoral intertrochanteric fracture treated with intramedullary nail with different lateral wall classifications[J]. Chinese Journal of Tissue Engineering Research, 2023, 27(29): 4652-4657.

Figures/Tables 6

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