Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (3): 329-333.doi: 10.3969/j.issn.2095-4344.2942

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Mechanical stability of medial support nail in treatment of severe osteoporotic intertrochanteric fracture

Nie Shaobo1, 2, Li Jiantao1, 2, Sun Jien3, Zhao Zhe4, Zhao Yanpeng1, 2, Zhang Licheng1, 2, Tang Peifu1, 2   

  1. 1Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, China; 2National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing 100853, China; 3Shandong WeiGao Orthopedic Material Limited liability Company, Weihai 264200, Shandong Province, China; 4Beijing Tsinghua Changgung Hospital, Beijing 102218, China
  • Received:2020-03-10 Revised:2020-03-14 Accepted:2020-04-15 Online:2021-01-28 Published:2020-11-16
  • Contact: Tang Peifu, Chief physician, Professor, Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, China; National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing 100853, China
  • About author:Nie Shaobo, Doctoral candidate, Attending physician, Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, China; National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing 100853, China
  • Supported by:
    the Capital Health Development Research Project, No. 2016-1-5012

Abstract: BACKGROUND: The medial support nail restored the triangular stable structure of the proximal femur through the reconstruction of the medial femoral support. The early finite element analysis and biomechanics showed that the stability of the nail was better than that of the commonly used proximal femoral nail antirotation, but the specific performance in the model of severe osteoporosis was unknown.
OBJECTIVE: To compare the biomechanical differences between medial support nail and proximal femoral nail antirotation in the treatment of severe osteoporotic intertrochanteric fractures without medical support.
METHODS: The medial unsupported intertrochanteric fracture model was made of artificial bone with severe osteoporosis. Axial and torsional failure experiments were conducted after the medial support nail and the proximal femoral nail antirotation were respectively fixed, and the axial stiffness and torsional stiffness of the two under axial and torsional loads were recorded.
RESULTS AND CONCLUSION: (1) Axial failure experiment showed that the ultimate load  yield load and axial stiffness of the medial support nail group were all greater than those of the proximal femoral nail antirotation group, but there was no significant difference between the two groups (P  > 0.05). (2) The torsional failure experiment showed that the torsional stiffness of the medial support nail group was higher than that of the proximal femoral nail antirotation group (P < 0.05). (3) The findings confirmed that the mechanical stability of the medial support nail, especially torsion resistance, is better than that of the proximal femoral nail antirotation, which may be a good choice for the treatment of severe osteoporotic intertrochanteric fracture.

Key words: bone, screw, intramedullary nail, femur, intertrochanteric fracture, medial support, biomechanics, osteoporosis

CLC Number: