Finite element analysis of distal femoral locking plate and minimally invasive internal fixation system in different motion states

doi:10.3969/j.issn.2095-4344.2016.35.010

Abstract

Abstract:

BACKGROUND: Traditional distal femoral fixation plate screw breakage is relatively common. Designing good anatomical and attached fixation system is the key for clinical application.

OBJECTIVE: To perform finite element analysis in two states of motion of the minimally invasive distal femoral fixation system, compare stress distribution of different parts in the same fixed way, different fixed methods and the same fixed parts of different motion states.

METHODS: Imaging data of a 34-year-old male patient weighing 68 kg with 33-C1 type fracture of distal femur were selected. CT data were input into Mimics 16.0 for reconstruction. PRO-E software was used to establish minimally invasive internal fixation system with distal femoral locking plate. Data were introduced into reconstructed models of distal femur fracture in Mimics for grid division. Data were introduced into Ansys products 11.0 to construct finite element model, fix the surface of distal femur, and loaded 340 N on greater trochanter of femur. Stress distribution of each plate, screw hole and screw tail was analyzed in each group. Stress at the same region was compared in flexion and extension movement states.

RESULTS AND CONCLUSION: (1) Finite element models of anatomic locking plate for distal femur fracture fixation were successfully established, totally 43 536 units, 41 256 nodes. (2) With the steel segment gradually down (S1-S5), the stress gradually increased. A1-A5 with the increase in the number of screws, the stress gradually increased, but A6 suddenly decreased. (3) According to the cloud atlas of stress, these were well distributed except A1. From distal end to extremity of screw, the stress of screws increased. Among corresponding segments, significant differences in stress around the nail holes and steel segment stress were detected. Moreover, the steel stress was greater than the stress of corresponding segment of screw hole. (4) Results suggest that using anatomical locking plate and minimally invasive internal fixation system for distal femur fracture in a variety of fixed modes and moving conditions, the stress of each part is less than the yield strength of the titanium alloy screw, so the fixed system will not produce instantaneous deformation or fracture.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Femoral Fractures, Finite Element Analysis, Internal Fixators, Surgical Procedures, Minimally Invasive, Tissue Engineering

CLC Number:

R318

Hao Ting, Wang Xing-guo, Li Xiao-he. Finite element analysis of distal femoral locking plate and minimally invasive internal fixation system in different motion states[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(35): 5237-5243.

Figures/Tables 2

References

[1] Höntzsch D, Blauth M, Attal R,et al.Angle-stable fixation of intramedullary nails using the Angular Stable Locking System® (ASLS). Oper Orthop Traumatol. 2011;23(5):387-396.
[2] Ehlinger M, Adam P, Arlettaz Y,et al. Minimally-invasive fixation of distal extra-articular femur fractures with locking plates: limitations and failures. Orthop Traumatol Surg Res. 2011;97(6):668-674.16:28 2016-9-6
[3] Nayak RM, Koichade MR, Umre AN,et al.Minimally invasive plate osteosynthesis using a locking compression plate for distal femoral fractures. J Orthop Surg (Hong Kong).2011;19(2):185-190.
[4] Malviya A, Reed MR, Partington PF. Acute primary total knee arthroplasty for peri-articular knee fractures in patients over 65 years of age.Injury.2011;42(11):1368-1371.
[5] Lopes JB, Figueiredo CP, Caparbo VF,et al. Osteoporotic fractures in the Brazilian community- dwelling elderly: prevalence and risk factors. J Clin Densitom. 2011;14(3):359-366.
[6] [6] Weil YA, Rivkin G, Safran O,et al. The outcome of surgically treated femur fractures associated with long-term bisphosphonate use. J Trauma. 2011;71(1): 186-190.
[7] Hierholzer C, von Rüden C, Pötzel T, et al. Outcome analysis of retrograde nailing and less invasive stabilization system in distal femoral fractures: A retrospective analysis. Indian J Orthop. 2011;45(3): 243-250.
[8] Shih KS, Hsu CC, Hsu TP. A biomechanical investigation of the effects of static fixation and dynamization after interlocking femoral nailing: A finite element study. J Trauma. 2012;72(2):E46-E53.
[9] Salas C, Mercer D, DeCoster TA, et al. Experimental and probabilistic analysis of distal femoral periprosthetic fracture: a comparison of locking plate and intramedullary nail fixation. Part A: experimental investigation. Comput Methods Biomech Biomed Engin. 2011;14(2):157-164.
[10] Han QT, Wang YJ, Tang HW. Biomechanical comparison of three methods of internal fixation for distal femoral fractures. Zhongguo Gu Shang. 2010; 23(8):601-604.
[11] Efstathopoulos N, Nikolaou VS, Xypnitos FN, et al.Investigation on the distal screw of a trochanteric intramedullary implant (Fi-nail) using a simplified finite element model. Injury. 2010;41(3):259-265.
[12] Chang CY, Rupp JD, Reed MP, et al.Predicting the effects of muscle activation on knee, thigh, and hip injuries in frontal crashes using a finite-element model with muscle forces from subject testing and musculoskeletal modeling. Stapp Car Crash J. 2009; 53:291-328.
[13] Bougherara H, Zdero R, Miric M, et al.The biomechanics of the T2 femoral nailing system: a comparison of synthetic femurs withfinite element analysis. Proc Inst Mech Eng H. 2009;223(3):303-314.
[14] Chen SH, Yu TC, Chang CH, et al. Biomechanical analysis of retrograde intramedullary nail fixation in distal femoral fractures. Knee. 2008;15(5):384-389.
[15] Mann KA, Lee J, Arrington SA, et al.Predicting distal femur bone strength in a murine model of tumor osteolysis. Clin Orthop Relat Res. 2008;466(6): 1271-1278.
[16] Shih KS, Tseng CS, Lee CC, et al.Influence of muscular contractions on the stress analysis of distal femoral interlocking nailing. Clin Biomech(Bristol, Avon). 2008;23(1):38-44.
[17] Mahaisavariya B, Sitthiseripratip K, Suwanprateeb J. Finite element study of the proximal femur with retained trochanteric gamma nail and after removal of nail. Injury. 2006;37(8):778-785.
[18] Cegoñino J, García Aznar JM, Doblaré M, et al. A comparative analysis of different treatments for distal femur fractures using the finite element method. Comput Methods Biomech Biomed Engin. 2004;7(5): 245-256.
[19] Dubov A, Kim SY, Shah S, et al.The biomechanics of plate repair of periprosthetic femur fractures near the tip of a total hip implant: the effect of cable-screw position. Proc Inst Mech Eng H. 2011;225(9):857-865.
[20] Shah S, Kim SY, Dubov A, et al.The biomechanics of plate fixation of periprosthetic femoral fractures near the tip of a total hip implant: cables, screws, or both? Proc Inst Mech Eng H. 2011;225(9):845-856.
[21] Wilson LJ, Richards CJ, Irvine D, et al. Irvine D,Risk of periprosthetic femur fracture after anterior cortical bone windowing: a mechanical analysis of short versus long cemented stems in pigs. Acta Orthop. 2011;82(6): 674-678.
[22] Chen SH, Tai CL, Yu TC, et al. Modified fixations for distal femur fractures following total knee arthroplasty: a biomechanical and clinical relevance study. Knee Surg Sports Traumatol Arthrosc. 2016. [Epub ahead of print]
[23] Filardi V.The healing stages of an intramedullary implanted tibia: A stress strain comparative analysis of the calcification process.J Orthop. 2015;12(Suppl 1):S51-61.
[24] Yoshimoto K, Nakashima Y, Nakamura A, et al. Neck fracture of femoral stems with a sharp slot at the neck: biomechanical analysis.J Orthop Sci. 2015;20(5):881-887.
[25] Li L, Yu M, Ma R, et al.Initial Stability of Subtrochanteric Oblique Osteotomy in Uncemented Total Hip Arthroplasty: A Preliminary Finite Element Study. Med Sci Monit. 2015;21:1969-1975.
[26] Märdian S, Schaser KD, Duda GN, et al. Working length of locking plates determines interfragmentary movement in distal femur fracturesunder physiological loading. Clin Biomech (Bristol, Avon). 2015;30(4): 391-396.
[27] Zhang J, Ebraheim N, Li M, et al.External fixation using locking plate in distal tibial fracture: a finite element analysis.Eur J Orthop Surg Traumatol. 2015;25(6): 1099-1104.
[28] Leonidou A, Moazen M, Lepetsos P, et al. The biomechanical effect of bone quality and fracture topography on locking plate fixation in periprosthetic femoral fractures. Injury. 2015;46(2):213-217.
[29] Mahaisavariya B, Chantarapanich N, Riansuwan K, et al. Prevention of excessive medialisation of trochanteric fracture by a buttress screw: a novel methodand finite element analysis. J Med Assoc Thai. 2014;97 Suppl 9:S127-132.
[30] Martelli S, Pivonka P, Ebeling PR. Femoral shaft strains during daily activities: Implications for atypical femoral fractures. Clin Biomech (Bristol, Avon). 2014; 29(8):869-876.
[31] Tan CO, Battaglino RA, Doherty AL, et al.Adiponectin is associated with bone strength and fracture history in paralyzed men with spinal cord injury.Osteoporos Int. 2014;25(11):2599-2607.
[32] Sun ZH, Liu YJ, Li H. Femoral stress and strain changes post-hip, -knee and -ipsilateral hip/knee arthroplasties: a finiteelement analysis. Orthop Surg. 2014;6(2):137-144.
[33] Tran TN, Warwas S, Haversath M, et al.Experimental and computational studies on the femoral fracture risk for advanced core decompression.Clin Biomech (Bristol, Avon). 2014;29(4):412-417.
[34] Kimura G, Onishi E, Kawanabe K, et al.Characteristic loosening of the distally straight cylindrical femoral stem. J Orthop Sci. 2014;19(3):437-442.
[35] Shih KS, Hsu CC, Hsu TP, et al. Biomechanical analyses of static and dynamic fixation techniques of retrograde interlocking femoralnailing using nonlinear finite element methods.Comput Methods Programs Biomed. 2014;113(2):456-464.
[36] Edwards WB, Schnitzer TJ, Troy KL.Bone mineral and stiffness loss at the distal femur and proximal tibia in acute spinal cord injury.Osteoporos Int. 2014;25(3): 1005-1015.
[37] Erhardt JB, Khoo PP, Stoffel KK, et al.Periprosthetic fractures around polished collarless cemented stems: the effect of stem design on fracture pattern.Hip Int. 2013;23(5):459-464.
[38] Chen SH, Chiang MC, Hung CH, et al.Finite element comparison of retrograde intramedullary nailing and locking plate fixation with/without an intramedullary allograft for distal femur fracture following total knee arthroplasty.Knee. 2014;21(1):224-231.