Finite element analysis of two cephalomedullary nails in treatment of elderly reverse obliquity intertrochanteric fractures: zimmer natural nail and proximal femoral nail antirotation-ΙΙ
Abstract Background More elderly patients are suffering from intertrochanteric fractures. However, the choice of internal fixation is still controversial, especially in the treatment of unstable intertrochanteric fracture; thus, previous implants continue to be improved, and new ones are being devel...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-12-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-019-1468-3 |
| _version_ | 1798034760075837440 |
|---|---|
| author | Jian Chen Jian-xiong Ma Ying Wang Hao-hao Bai Lei Sun Yan Wang Bin Lu Ben-chao Dong Ai-xian Tian Xin-long Ma |
| author_facet | Jian Chen Jian-xiong Ma Ying Wang Hao-hao Bai Lei Sun Yan Wang Bin Lu Ben-chao Dong Ai-xian Tian Xin-long Ma |
| author_sort | Jian Chen |
| collection | DOAJ |
| description | Abstract Background More elderly patients are suffering from intertrochanteric fractures. However, the choice of internal fixation is still controversial, especially in the treatment of unstable intertrochanteric fracture; thus, previous implants continue to be improved, and new ones are being developed. The purpose of our study was to compare the biomechanical advantages between the zimmer natural nail (ZNN) and proximal femoral nail antirotation-II (PFNA-II) in the treatment of elderly reverse obliquity intertrochanteric fractures. Methods A three-dimensional finite element was applied for reverse obliquity intertrochanteric fracture models (AO31-A3.1) fixed with the ZNN or PFNA-II. The distribution, peak value and position of the von Mises stress and the displacement were the criteria for comparison between the two groups. Results The stresses of the internal fixation and femur in the ZNN model were smaller than those in the PFNA-II model, and the peak values of the two groups were 364.8 MPa and 171.8 MPa (ZNN) and 832.3 MPa and 1795.0 MPa (PFNA-II). The maximum amount of displacement of the two groups was similar, and their locations were the same, i.e., in the femoral head vertex (3.768 mm in the ZNN model and 3.713 mm in the PFNA-II model). Conclusions The displacement in the two models was similar, but the stresses in the implant and bone were reduced with the ZNN. Therefore, the ZNN implant may provide biomechanical advantages over PFNA-II in reverse obliquity intertrochanteric fractures, as shown through the finite element analysis. These findings from our study may provide a reference for the perioperative selection of internal fixations. |
| first_indexed | 2024-04-11T20:48:47Z |
| format | Article |
| id | doaj.art-f57fe794fa2d46b9b200d95635c90c66 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T20:48:47Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-f57fe794fa2d46b9b200d95635c90c662022-12-22T04:03:57ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2019-12-011411810.1186/s13018-019-1468-3Finite element analysis of two cephalomedullary nails in treatment of elderly reverse obliquity intertrochanteric fractures: zimmer natural nail and proximal femoral nail antirotation-ΙΙJian Chen0Jian-xiong Ma1Ying Wang2Hao-hao Bai3Lei Sun4Yan Wang5Bin Lu6Ben-chao Dong7Ai-xian Tian8Xin-long Ma9Department of Orthopedics, Tianjin Medical University General HospitalInstitute of Orthopedics, Tianjin Hospital, Tianjin UniversityInstitute of Orthopedics, Tianjin Hospital, Tianjin UniversityInstitute of Orthopedics, Tianjin Hospital, Tianjin UniversityInstitute of Orthopedics, Tianjin Hospital, Tianjin UniversityInstitute of Orthopedics, Tianjin Hospital, Tianjin UniversityInstitute of Orthopedics, Tianjin Hospital, Tianjin UniversityInstitute of Orthopedics, Tianjin Hospital, Tianjin UniversityInstitute of Orthopedics, Tianjin Hospital, Tianjin UniversityDepartment of Orthopedics, Tianjin Medical University General HospitalAbstract Background More elderly patients are suffering from intertrochanteric fractures. However, the choice of internal fixation is still controversial, especially in the treatment of unstable intertrochanteric fracture; thus, previous implants continue to be improved, and new ones are being developed. The purpose of our study was to compare the biomechanical advantages between the zimmer natural nail (ZNN) and proximal femoral nail antirotation-II (PFNA-II) in the treatment of elderly reverse obliquity intertrochanteric fractures. Methods A three-dimensional finite element was applied for reverse obliquity intertrochanteric fracture models (AO31-A3.1) fixed with the ZNN or PFNA-II. The distribution, peak value and position of the von Mises stress and the displacement were the criteria for comparison between the two groups. Results The stresses of the internal fixation and femur in the ZNN model were smaller than those in the PFNA-II model, and the peak values of the two groups were 364.8 MPa and 171.8 MPa (ZNN) and 832.3 MPa and 1795.0 MPa (PFNA-II). The maximum amount of displacement of the two groups was similar, and their locations were the same, i.e., in the femoral head vertex (3.768 mm in the ZNN model and 3.713 mm in the PFNA-II model). Conclusions The displacement in the two models was similar, but the stresses in the implant and bone were reduced with the ZNN. Therefore, the ZNN implant may provide biomechanical advantages over PFNA-II in reverse obliquity intertrochanteric fractures, as shown through the finite element analysis. These findings from our study may provide a reference for the perioperative selection of internal fixations.https://doi.org/10.1186/s13018-019-1468-3Finite element analysis (FEA)Reverse obliquity intertrochanteric fractureFracture fixationZimmer natural nail (ZNN)Proximal femoral nail antirotation-II (PFNA-II) |
| spellingShingle | Jian Chen Jian-xiong Ma Ying Wang Hao-hao Bai Lei Sun Yan Wang Bin Lu Ben-chao Dong Ai-xian Tian Xin-long Ma Finite element analysis of two cephalomedullary nails in treatment of elderly reverse obliquity intertrochanteric fractures: zimmer natural nail and proximal femoral nail antirotation-ΙΙ Journal of Orthopaedic Surgery and Research Finite element analysis (FEA) Reverse obliquity intertrochanteric fracture Fracture fixation Zimmer natural nail (ZNN) Proximal femoral nail antirotation-II (PFNA-II) |
| title | Finite element analysis of two cephalomedullary nails in treatment of elderly reverse obliquity intertrochanteric fractures: zimmer natural nail and proximal femoral nail antirotation-ΙΙ |
| title_full | Finite element analysis of two cephalomedullary nails in treatment of elderly reverse obliquity intertrochanteric fractures: zimmer natural nail and proximal femoral nail antirotation-ΙΙ |
| title_fullStr | Finite element analysis of two cephalomedullary nails in treatment of elderly reverse obliquity intertrochanteric fractures: zimmer natural nail and proximal femoral nail antirotation-ΙΙ |
| title_full_unstemmed | Finite element analysis of two cephalomedullary nails in treatment of elderly reverse obliquity intertrochanteric fractures: zimmer natural nail and proximal femoral nail antirotation-ΙΙ |
| title_short | Finite element analysis of two cephalomedullary nails in treatment of elderly reverse obliquity intertrochanteric fractures: zimmer natural nail and proximal femoral nail antirotation-ΙΙ |
| title_sort | finite element analysis of two cephalomedullary nails in treatment of elderly reverse obliquity intertrochanteric fractures zimmer natural nail and proximal femoral nail antirotation ιι |
| topic | Finite element analysis (FEA) Reverse obliquity intertrochanteric fracture Fracture fixation Zimmer natural nail (ZNN) Proximal femoral nail antirotation-II (PFNA-II) |
| url | https://doi.org/10.1186/s13018-019-1468-3 |
| work_keys_str_mv | AT jianchen finiteelementanalysisoftwocephalomedullarynailsintreatmentofelderlyreverseobliquityintertrochantericfractureszimmernaturalnailandproximalfemoralnailantirotationii AT jianxiongma finiteelementanalysisoftwocephalomedullarynailsintreatmentofelderlyreverseobliquityintertrochantericfractureszimmernaturalnailandproximalfemoralnailantirotationii AT yingwang finiteelementanalysisoftwocephalomedullarynailsintreatmentofelderlyreverseobliquityintertrochantericfractureszimmernaturalnailandproximalfemoralnailantirotationii AT haohaobai finiteelementanalysisoftwocephalomedullarynailsintreatmentofelderlyreverseobliquityintertrochantericfractureszimmernaturalnailandproximalfemoralnailantirotationii AT leisun finiteelementanalysisoftwocephalomedullarynailsintreatmentofelderlyreverseobliquityintertrochantericfractureszimmernaturalnailandproximalfemoralnailantirotationii AT yanwang finiteelementanalysisoftwocephalomedullarynailsintreatmentofelderlyreverseobliquityintertrochantericfractureszimmernaturalnailandproximalfemoralnailantirotationii AT binlu finiteelementanalysisoftwocephalomedullarynailsintreatmentofelderlyreverseobliquityintertrochantericfractureszimmernaturalnailandproximalfemoralnailantirotationii AT benchaodong finiteelementanalysisoftwocephalomedullarynailsintreatmentofelderlyreverseobliquityintertrochantericfractureszimmernaturalnailandproximalfemoralnailantirotationii AT aixiantian finiteelementanalysisoftwocephalomedullarynailsintreatmentofelderlyreverseobliquityintertrochantericfractureszimmernaturalnailandproximalfemoralnailantirotationii AT xinlongma finiteelementanalysisoftwocephalomedullarynailsintreatmentofelderlyreverseobliquityintertrochantericfractureszimmernaturalnailandproximalfemoralnailantirotationii |