长髓内钉与短髓内钉治疗反向转子前骨折:生物力学研究

IF 1.7 4区 医学 Q3 ENGINEERING, BIOMEDICAL Medical Engineering & Physics Pub Date : 2024-08-13 DOI:10.1016/j.medengphy.2024.104230
Gilles Udin , Lore Hoffmann , Fabio Becce , Olivier Borens , Alexandre Terrier
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引用次数: 0

摘要

对于治疗反向转子前骨折的首选植入物,目前还没有确切的证据。我们对不同骨质的反向转子前骨折进行了有限元模拟,并比较了长短髓内钉在生理负荷下的稳定性。对于每种变量组合,我们都计算了骨折部位的微动、骨应变和植入应力。骨折表面的平均微动以及绝对和相对骨折表面的微动>150 µm,短钉略低(分别为8%、3%和3%)。骨折远端延伸对稳定性有负面影响,内侧的微动增加。超过 1% 的骨应变不受钉子长度的影响。这项模拟研究表明,对于所研究的反向转子前骨折模式,长钉没有任何益处,骨折部位的微动、骨应变和植入应力都相似。
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Long vs short intramedullary nails for reverse pertrochanteric fractures: A biomechanical study

There is currently no definitive evidence for the implant of choice for the treatment of reverse pertrochanteric fractures. Here, we aimed to compare the stability provided by two implant options: long and short intramedullary nails.

We performed finite element simulations of different patterns of reverse pertrochanteric fractures with varying bone quality, and compared the short vs long nail stabilization under physiological loads. For each variable combination, the micromotions at the fracture site, bone strain, and implant stress were computed.

Mean micromotions at the fracture surface and absolute and relative fracture surface with micromotions >150 µm were slightly lower with the short nail (8%, 3%, and 3%, respectively). The distal fracture extension negatively affected the stability, with increasing micromotions on the medial side. Bone strain above 1 % was not affected by the nail length. Fatigue stresses were similar for both implants, and no volume was found above the yield and ultimate stress in the tested conditions.

This simulation study shows no benefit of long nails for the investigated patterns of reverse pertrochanteric fractures, with similar micromotions at the fracture site, bone strain, and implant stress.

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来源期刊
Medical Engineering & Physics
Medical Engineering & Physics 工程技术-工程:生物医学
CiteScore
4.30
自引率
4.50%
发文量
172
审稿时长
3.0 months
期刊介绍: Medical Engineering & Physics provides a forum for the publication of the latest developments in biomedical engineering, and reflects the essential multidisciplinary nature of the subject. The journal publishes in-depth critical reviews, scientific papers and technical notes. Our focus encompasses the application of the basic principles of physics and engineering to the development of medical devices and technology, with the ultimate aim of producing improvements in the quality of health care.Topics covered include biomechanics, biomaterials, mechanobiology, rehabilitation engineering, biomedical signal processing and medical device development. Medical Engineering & Physics aims to keep both engineers and clinicians abreast of the latest applications of technology to health care.
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