Femoral Shaft Fractures Treated by Intramedullary Interlocked Nailing

Analysis of the Impact of Configuration of the Stabilisation System for Femoral Diaphyseal Fractures on the State of Stresses and Displacements

Introduction

The treatment of femoral diaphyseal fractures by intramedullary nailing has become a common procedure in orthopaedic surgery. The purpose of this numerical simulation was to present how the changes in configuration of the stabilisation system can affect the stress and displacement state in the bone tissue and implanted device.

Material and Methods

The numerical comparison of the stabilisation variants for the type 32-A2 femoral diaphyseal fracture (according to the AO classification) performed by using the Charfix2 (ChM®) anatomical nail locked in a number of chosen ways. The displacement and the stress distributions both in the bone and implant were obtained and analysed by computational simulation.

Results

In all models, there was the same characteristic distribution, which shows there were minimal rotational movements of the bone around the anatomical axis. In all cases, stress concentrations were generated in the nail material in the area of the fracture gap.

Conclusions

The obtained results indicate that there is a visible advantage to one-plane distal stabilisation in the reduction of stresses regardless of the type of proximal stabilisation. The results of calculations indicate that the use of proximal stabilisation with a neck screw reduces the possibility of damage to the implant.