Finite Element Analysis of Mechanical Characteristics of Internal Fixation for Treatment of Proximal Femoral Osteolytic Lesions in Children
Objectives Clinically, it is very difficult to prevent pathological fracture caused by high recurrence rate of osteolytic disease of proximal femur in children. At present, there is no consensus in clinical studies of which internal fixation method can significantly reduce the probability of recurre...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-02-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13591 |
| _version_ | 1797936711161872384 |
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| author | Yi‐chen Wang Dan Yang Li‐hua Zhao Bo Xiao Qi‐chao Ma Liang‐chao Dong Xiang Li Yu‐guo Zhang Zi‐ming Zhang Yi Luo |
| author_facet | Yi‐chen Wang Dan Yang Li‐hua Zhao Bo Xiao Qi‐chao Ma Liang‐chao Dong Xiang Li Yu‐guo Zhang Zi‐ming Zhang Yi Luo |
| author_sort | Yi‐chen Wang |
| collection | DOAJ |
| description | Objectives Clinically, it is very difficult to prevent pathological fracture caused by high recurrence rate of osteolytic disease of proximal femur in children. At present, there is no consensus in clinical studies of which internal fixation method can significantly reduce the probability of recurrence of pathological fracture. The study aims to research the mechanical properties of different internal fixations in the treatment of osteolytic lesions of proximal femur in children by finite element analysis, and to find out the optimal treatment. Methods Based on finite element analysis, the osteolytic disease models of the femoral neck and intertrochanter in a child (8‐year‐old, boy) were established respectively, and different internal fixation models (plate and titanium elastic intramedullary nails, TENs) were assembled. For the osteolytic lesion of the femoral neck: model A1 was assembled with a plate; model A2 with two TENs crossing the physis; model A3 with two TENs without crossing the physis. And for pertrochanteric osteolytic lesion: model B1 was assembled with a plate, model B2 with two TENs crossing the physis and model B3 with two TENs without crossing the physis. The Eccentric bearing load, torsional restraintal restraint of calcar femorale and composite load were analyzed for each models. Results When the yield strain of each model is reached, the stress concentration points are located in the proximal and distal femoral calcar. In the model of femoral neck lesions, the failure load of model A1 and model A2 are the same (1250 N), and the failure load of model A3 (980 N) is significantly lower than that of the former two; in the model of intertrochanteric lesions, the failure load of model B2 is the largest (1350 N), and the failure load of model B1 (1220 N) is lower than that of model B3 (1260 N), but both are smaller than that of model B2. Conclusion Through finite element analysis, TENs through the epiphyseal plate, is found to be the better internal fixation method for femoral neck lesions and intertrochanteric lesions under two different working conditions. The results of clinical correlation study provide new biomechanical information for orthopedic doctors to consider different treatment options for osteolytic lesions of proximal femur. |
| first_indexed | 2024-04-10T18:33:34Z |
| format | Article |
| id | doaj.art-d29e8b3109c546889f39b9c8fc560f1e |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-10T18:33:34Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-d29e8b3109c546889f39b9c8fc560f1e2023-02-02T02:44:50ZengWileyOrthopaedic Surgery1757-78531757-78612023-02-0115262863810.1111/os.13591Finite Element Analysis of Mechanical Characteristics of Internal Fixation for Treatment of Proximal Femoral Osteolytic Lesions in ChildrenYi‐chen Wang0Dan Yang1Li‐hua Zhao2Bo Xiao3Qi‐chao Ma4Liang‐chao Dong5Xiang Li6Yu‐guo Zhang7Zi‐ming Zhang8Yi Luo9Department of Orthopedics, Shanghai Children's Hospital, School of medicine Shanghai Jiao Tong University Shanghai ChinaDepartment of Orthopedics, Shanghai Children's Hospital, School of medicine Shanghai Jiao Tong University Shanghai ChinaDepartment of Orthopedics, Shanghai Children's Hospital, School of medicine Shanghai Jiao Tong University Shanghai ChinaDepartment of Orthopedics, Shanghai Children's Hospital, School of medicine Shanghai Jiao Tong University Shanghai ChinaDepartment of Orthopedics, Shanghai Children's Hospital, School of medicine Shanghai Jiao Tong University Shanghai ChinaDepartment of Orthopedics, Shanghai Children's Hospital, School of medicine Shanghai Jiao Tong University Shanghai ChinaSchool of Mechanical Engineering Shanghai Jiao Tong University Shanghai ChinaDepartment of Orthopedics, Shanghai Children's Hospital, School of medicine Shanghai Jiao Tong University Shanghai ChinaDepartment of Orthopedics, Shanghai Children's Hospital, School of medicine Shanghai Jiao Tong University Shanghai ChinaDepartment of Orthopedics, Shanghai Children's Hospital, School of medicine Shanghai Jiao Tong University Shanghai ChinaObjectives Clinically, it is very difficult to prevent pathological fracture caused by high recurrence rate of osteolytic disease of proximal femur in children. At present, there is no consensus in clinical studies of which internal fixation method can significantly reduce the probability of recurrence of pathological fracture. The study aims to research the mechanical properties of different internal fixations in the treatment of osteolytic lesions of proximal femur in children by finite element analysis, and to find out the optimal treatment. Methods Based on finite element analysis, the osteolytic disease models of the femoral neck and intertrochanter in a child (8‐year‐old, boy) were established respectively, and different internal fixation models (plate and titanium elastic intramedullary nails, TENs) were assembled. For the osteolytic lesion of the femoral neck: model A1 was assembled with a plate; model A2 with two TENs crossing the physis; model A3 with two TENs without crossing the physis. And for pertrochanteric osteolytic lesion: model B1 was assembled with a plate, model B2 with two TENs crossing the physis and model B3 with two TENs without crossing the physis. The Eccentric bearing load, torsional restraintal restraint of calcar femorale and composite load were analyzed for each models. Results When the yield strain of each model is reached, the stress concentration points are located in the proximal and distal femoral calcar. In the model of femoral neck lesions, the failure load of model A1 and model A2 are the same (1250 N), and the failure load of model A3 (980 N) is significantly lower than that of the former two; in the model of intertrochanteric lesions, the failure load of model B2 is the largest (1350 N), and the failure load of model B1 (1220 N) is lower than that of model B3 (1260 N), but both are smaller than that of model B2. Conclusion Through finite element analysis, TENs through the epiphyseal plate, is found to be the better internal fixation method for femoral neck lesions and intertrochanteric lesions under two different working conditions. The results of clinical correlation study provide new biomechanical information for orthopedic doctors to consider different treatment options for osteolytic lesions of proximal femur.https://doi.org/10.1111/os.13591BiomechanicsFemurFinite Element AnalysisInternal FixationOsteolytic Lesions |
| spellingShingle | Yi‐chen Wang Dan Yang Li‐hua Zhao Bo Xiao Qi‐chao Ma Liang‐chao Dong Xiang Li Yu‐guo Zhang Zi‐ming Zhang Yi Luo Finite Element Analysis of Mechanical Characteristics of Internal Fixation for Treatment of Proximal Femoral Osteolytic Lesions in Children Orthopaedic Surgery Biomechanics Femur Finite Element Analysis Internal Fixation Osteolytic Lesions |
| title | Finite Element Analysis of Mechanical Characteristics of Internal Fixation for Treatment of Proximal Femoral Osteolytic Lesions in Children |
| title_full | Finite Element Analysis of Mechanical Characteristics of Internal Fixation for Treatment of Proximal Femoral Osteolytic Lesions in Children |
| title_fullStr | Finite Element Analysis of Mechanical Characteristics of Internal Fixation for Treatment of Proximal Femoral Osteolytic Lesions in Children |
| title_full_unstemmed | Finite Element Analysis of Mechanical Characteristics of Internal Fixation for Treatment of Proximal Femoral Osteolytic Lesions in Children |
| title_short | Finite Element Analysis of Mechanical Characteristics of Internal Fixation for Treatment of Proximal Femoral Osteolytic Lesions in Children |
| title_sort | finite element analysis of mechanical characteristics of internal fixation for treatment of proximal femoral osteolytic lesions in children |
| topic | Biomechanics Femur Finite Element Analysis Internal Fixation Osteolytic Lesions |
| url | https://doi.org/10.1111/os.13591 |
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