Mário Augusto Ferreira Cruz, Leonardo Rigobello Battaglion, José Batista Volpon
{"title":"弹性髓内钉治疗小儿股骨粗隆下骨折:生物力学研究。","authors":"Mário Augusto Ferreira Cruz, Leonardo Rigobello Battaglion, José Batista Volpon","doi":"10.1590/1413-785220233102e260008","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the stability provided by two flexible intramedullary nails (FINs) in a simulation of fractures at the proximal levels in pediatric femur models.</p><p><strong>Methods: </strong>Two FINs were inserted in 18 synthetic models of pediatric femurs. Fractures were simulated at one of three levels, and the models were divided into the following groups (n=6): diaphysis (control), subtrochanteric and trochanteric. Flex-compression tests were performed with force up to 85 N. Relative stiffness and the average deformation was obtained. Torsion tests were performed by rotating the proximal fragment until 20°, to obtain the average torque.</p><p><strong>Results: </strong>At flex-compression, the set's average relative stiffness and average deformations were: 54.360x10<sup>3</sup> N/m and 1.645 mm in the control group, respectively. In the subtrochanteric group, the relative stiffness was 31.415x10<sup>3</sup> N/m (-42.2%) and the deformation was 2.424 mm (+47.3%) (p<0.05). For the trochanteric group, the relative stiffness was 30.912x10<sup>3</sup> N/m (+43.1%) and the deformation was 2.508 mm (+52.4%) (p<0.05). In torsion, the average torque was 1.410 Nm in the control group; 1.116 Nm in the subtrochanteric group (-20.8%), and 2.194 Nm in the trochanteric group (+55.6%) (p<0.05).</p><p><strong>Conclusion: </strong>FINs do not seem to be biomechanically competent for the treatment of proximal femoral fractures. Level of Evidence I; Therapeutic Studies - Investigating the results of treatment.</p>","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":null,"pages":null},"PeriodicalIF":0.5000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10263443/pdf/","citationCount":"0","resultStr":"{\"title\":\"FLEXIBLE INTRAMEDULLARY NAILS IN PEDIATRIC SUBTROCHANTERIC FEMUR FRACTURE: BIOMECHANICAL STUDY.\",\"authors\":\"Mário Augusto Ferreira Cruz, Leonardo Rigobello Battaglion, José Batista Volpon\",\"doi\":\"10.1590/1413-785220233102e260008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Evaluate the stability provided by two flexible intramedullary nails (FINs) in a simulation of fractures at the proximal levels in pediatric femur models.</p><p><strong>Methods: </strong>Two FINs were inserted in 18 synthetic models of pediatric femurs. Fractures were simulated at one of three levels, and the models were divided into the following groups (n=6): diaphysis (control), subtrochanteric and trochanteric. Flex-compression tests were performed with force up to 85 N. Relative stiffness and the average deformation was obtained. Torsion tests were performed by rotating the proximal fragment until 20°, to obtain the average torque.</p><p><strong>Results: </strong>At flex-compression, the set's average relative stiffness and average deformations were: 54.360x10<sup>3</sup> N/m and 1.645 mm in the control group, respectively. In the subtrochanteric group, the relative stiffness was 31.415x10<sup>3</sup> N/m (-42.2%) and the deformation was 2.424 mm (+47.3%) (p<0.05). For the trochanteric group, the relative stiffness was 30.912x10<sup>3</sup> N/m (+43.1%) and the deformation was 2.508 mm (+52.4%) (p<0.05). In torsion, the average torque was 1.410 Nm in the control group; 1.116 Nm in the subtrochanteric group (-20.8%), and 2.194 Nm in the trochanteric group (+55.6%) (p<0.05).</p><p><strong>Conclusion: </strong>FINs do not seem to be biomechanically competent for the treatment of proximal femoral fractures. Level of Evidence I; Therapeutic Studies - Investigating the results of treatment.</p>\",\"PeriodicalId\":55563,\"journal\":{\"name\":\"Acta Ortopedica Brasileira\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.5000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10263443/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Ortopedica Brasileira\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1590/1413-785220233102e260008\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Ortopedica Brasileira","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1590/1413-785220233102e260008","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
FLEXIBLE INTRAMEDULLARY NAILS IN PEDIATRIC SUBTROCHANTERIC FEMUR FRACTURE: BIOMECHANICAL STUDY.
Objective: Evaluate the stability provided by two flexible intramedullary nails (FINs) in a simulation of fractures at the proximal levels in pediatric femur models.
Methods: Two FINs were inserted in 18 synthetic models of pediatric femurs. Fractures were simulated at one of three levels, and the models were divided into the following groups (n=6): diaphysis (control), subtrochanteric and trochanteric. Flex-compression tests were performed with force up to 85 N. Relative stiffness and the average deformation was obtained. Torsion tests were performed by rotating the proximal fragment until 20°, to obtain the average torque.
Results: At flex-compression, the set's average relative stiffness and average deformations were: 54.360x103 N/m and 1.645 mm in the control group, respectively. In the subtrochanteric group, the relative stiffness was 31.415x103 N/m (-42.2%) and the deformation was 2.424 mm (+47.3%) (p<0.05). For the trochanteric group, the relative stiffness was 30.912x103 N/m (+43.1%) and the deformation was 2.508 mm (+52.4%) (p<0.05). In torsion, the average torque was 1.410 Nm in the control group; 1.116 Nm in the subtrochanteric group (-20.8%), and 2.194 Nm in the trochanteric group (+55.6%) (p<0.05).
Conclusion: FINs do not seem to be biomechanically competent for the treatment of proximal femoral fractures. Level of Evidence I; Therapeutic Studies - Investigating the results of treatment.
期刊介绍:
A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.