1
|
Arias-Blanco A, Marco M, Giner E, Larraínzar-Garijo R, Miguélez MH. Experimental and numerical analysis of the influence of intramedullary nail position on the cut-out phenomenon. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 240:107734. [PMID: 37517184 DOI: 10.1016/j.cmpb.2023.107734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/13/2023] [Accepted: 07/24/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND AND OBJECTIVE Proximal femur fractures, colloquially known as hip fractures, are a common pathology with increasing incidence in the last years due to the enhanced ageing population. Regarding the extracapsular fracture, the treatment for this pathology consists of a fixation of the fragments using an osteosynthesis device, mainly the intramedullary nail. This repairing method implies several complications, which may include the failure of the fixation device, frequently occurring due to the "cut-out" mechanism. The present work focuses on the study of how the position of the cephalic screw, which should be fixed during surgery, affects the cut-out risk. Through experimental tests and numerical models some variables that can be critical for the cut-out phenomenon are analysed. METHODS This study has been carried out through a numerical model based on the finite element method and experimental tests. The digital image correlation technique has been used in experimental tests to measure displacements on the femoral surface with the objective of numerical model validation. Some basic daily activities with different intramedullary nail positions have been analysed through the numerical model, considering variables that can induce the cut-out complication. RESULTS The results show how the intramedullary nail position clearly influences the cut-out risk, showing that displacements in the upper, anterior and posterior direction increase the cut-out risk, while displacement in the lower direction endangers the intramedullary nail itself. Thus, the centred position is the one which reduces the cut-out risk. CONCLUSIONS This work supposes an improvement in the knowledge of the cut-out phenomenon thanks to the combination of experimental testing and validated numerical models. The effects of different intramedullary nail positions in the femoral head are studied, including a novelty variable as torque, which is critical for the structural integrity of the fixation. The main conclusion of the work is the determination of the central intramedullary nail position as the most favourable one for decreasing the cut-out risk.
Collapse
Affiliation(s)
- A Arias-Blanco
- Department of Mechanical Engineering, Universidad Carlos III de Madrid, Spain
| | - M Marco
- Department of Mechanical Engineering, Universidad Carlos III de Madrid, Spain.
| | - E Giner
- Institute of Mechanical and Biomechanical Engineering (I2MB), Department of Mechanical and Materials Engineering, Universitat Politècnica de València, Spain
| | - R Larraínzar-Garijo
- Service of Orthopaedic Surgery and Traumatology, University Hospital Infanta Leonor, Universidad Complutense de Madrid, Spain
| | - M H Miguélez
- Department of Mechanical Engineering, Universidad Carlos III de Madrid, Spain
| |
Collapse
|
2
|
Li J, Yin P, Li J, Zhao Z, Zhao J, Cui X, Lyu H, Zhang L, Tang P. Novel slide compression anatomic plates of the femoral neck for treating unstable femoral neck fracture: A biomechanical study. J Orthop Res 2022; 41:1088-1096. [PMID: 36116025 DOI: 10.1002/jor.25447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 08/01/2022] [Accepted: 09/14/2022] [Indexed: 02/04/2023]
Abstract
To compare the biomechanical stability of slide compression anatomic plates of the femoral neck, cannulated compression screws and dynamic hip screws with derotation screws for stabilizing unstable femoral neck fractures (Pauwels angle = 70°). Pauwels III femoral neck fractures were created on 45 Sawbones femurs and randomly assigned to three implant groups (1:1:1). The biomechanical stability of all Sawbones in each treatment group was evaluated with three tests. First, in the static loading test, the load-displacement curve, vertical stiffness (load/vertical displacement [N/mm]) and 5 mm failure load were recorded. Second, in the incremental cyclic loading test (700, 1000, and 1400 N), the cyclic-displacement curve and the displacement of the fragments were recorded. Third, in the torsion test, the torsional rigidity, maximum torque, and torsional angle corresponding to the maximum torque were recorded. The static compression test showed that slide compression anatomic place-femoral neck (SCAP-FN) had the largest vertical stiffness (275 ± 11 N/mm, p < 0.01) and 5 mm failure load (1232 ± 156, p < 0.01). The cyclic loading test showed that SCAP-FN had the lowest change in displacement after 30000 cycles of loading. The torsional stiffness and the maximum torque followed the order SCAP-FN > dynamic hip screw systems (DHS) + derotational screw (DS) > CCS, and the torsional angle corresponding to the maximum torque followed the order SCAP-FN < DHS + DS < CCS. The SCAP-FN construct provides stiffness and stability compared with other standard fixation techniques (3CS and DHS + DS). The fixation strategy of SCAP-FN might be sufficient for clinical use, indicating studies in the human body are warranted.
Collapse
Affiliation(s)
- Jia Li
- Department of Orthopedics, Fourth Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopaedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Pengbin Yin
- Department of Orthopedics, Fourth Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopaedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Jiantao Li
- Department of Orthopedics, Fourth Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopaedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Zhe Zhao
- School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Jingxin Zhao
- Department of Orthopedics, Fourth Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopaedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Xiang Cui
- Department of Orthopedics, Fourth Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopaedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Houchen Lyu
- Department of Orthopedics, Fourth Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopaedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Licheng Zhang
- Department of Orthopedics, Fourth Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopaedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Peifu Tang
- Department of Orthopedics, Fourth Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopaedics, Sports Medicine & Rehabilitation, Beijing, China
| |
Collapse
|
3
|
Beyond the pedicle screw-a patent review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:1553-1565. [PMID: 35380271 DOI: 10.1007/s00586-022-07193-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This review provides an overview of the patent literature on posteriorly placed intrapedicular bone anchors. Conventional pedicle screws are the gold standard to create a fixation in the vertebra for spinal fusion surgery but may lack fixation strength, especially in osteoporotic bone. The ageing population demands new bone anchors that have an increased fixation strength, that can be placed safely, and, if necessary, can be removed without damaging the surrounding tissue. METHODS The patent search was conducted using a classification search in the Espacenet patent database. Only patents with a Cooperative Patent Classification of A61B17/70 or A61B17/7001 concerning spinal positioners and stabilizers were eligible for inclusion. The search query resulted in the identification of 731 patents. Based on preset inclusion criteria, a total of 56 unique patents on different anchoring methods were included, reviewed and categorized in this study. RESULTS Five unique fixation methods were identified; (1) anchors that use threading, (2) anchors that utilize a curved path through the vertebra, (3) anchors that (partly) expand, (4) anchors that use cement and (5) anchors that are designed to initiate bone ingrowth. Of the anchor designs included in this study, eight had a corresponding commercial product, six of which were evaluated in clinical trials. CONCLUSION This review provides insights into worldwide patented intrapedicular bone anchors that aim to increase the fixation strength compared to the conventional pedicle screw. The identified anchoring methods and their working principles can be used for clinical decision-making and as a source of inspiration when designing novel bone anchors.
Collapse
|
4
|
Fuse Y, Zenke Y, Okimoto N, Yoshioka T, Yamanaka Y, Kawasaki M, Terayama H, Sakai A. Biomechanical comparison of lag screw and non-spiral blade fixation of a novel femoral trochanteric nail in an osteoporotic bone model. Sci Rep 2022; 12:782. [PMID: 35039574 PMCID: PMC8764022 DOI: 10.1038/s41598-022-04844-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/03/2022] [Indexed: 12/05/2022] Open
Abstract
There is no consensus regarding the advantages of the lag screw type over the blade type for treating femoral trochanteric fractures. We aimed to investigate whether non-spiral blade (Conventional-Blade, Fid-Blade) nails provide better biomechanical fixation than lag screws in a severe osteoporotic bone model. Different severities of osteoporotic cancellous bone were modelled using polyurethane foam blocks of three densities (0.24, 0.16, and 0.08 g/cm3). Three torsional tests were performed using each component for each density of the polyurethane block, and the maximum torque was recorded; subsequently, the energy required to achieve 30° rotation was calculated. Using a push-in test, the maximum force was recorded, and the energy required to achieve 4-mm displacement was calculated. For 0.08-g/cm3 density, the peak torques to achieve 30° rotation, energy required to achieve 30° rotation, peak force to achieve 4-mm displacement, and energy required to achieve 4-mm displacement were significantly greater for Conventional-Blade and Fid-Blade than those for Lag Screw. The fixation stability of the blade-type Magnum nail component is better than that of the lag screw type under any test condition. The blade-type nail component may have better fixation stability than the lag screw type in a severe osteoporotic bone model.
Collapse
Affiliation(s)
- Yoshifumi Fuse
- Department of Orthopaedic Surgery, Saka Midorii Hospital, 6-28-1, Midorii, Asaminami-Ku, Hiroshima Shi, Hiroshima Ken, 731-0103, Japan.
| | - Yukichi Zenke
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyusyu-shi, Fukuoka, 807-8555, Japan
| | - Nobukazu Okimoto
- Okimoto Clinic, 185-4, Yutakamachi Kubi, Kure Shi, Hiroshima Ken, 734-0304, Japan
| | - Toru Yoshioka
- Department of Orthopaedic Surgery, Shimura Hospital, 3-13, Funairimachi, Naka Ku, Hiroshima Shi, Hiroshima Ken, 730-0841, Japan
| | - Yoshiaki Yamanaka
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyusyu-shi, Fukuoka, 807-8555, Japan
| | - Makoto Kawasaki
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyusyu-shi, Fukuoka, 807-8555, Japan
| | - Hiroshi Terayama
- Department of Orthopaedic Surgery, Saka Midorii Hospital, 6-28-1, Midorii, Asaminami-Ku, Hiroshima Shi, Hiroshima Ken, 731-0103, Japan
| | - Akinori Sakai
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyusyu-shi, Fukuoka, 807-8555, Japan
| |
Collapse
|
5
|
Fletcher JWA, Sommer C, Eckardt H, Knobe M, Gueorguiev B, Stoffel K. Intracapsular Femoral Neck Fractures-A Surgical Management Algorithm. ACTA ACUST UNITED AC 2021; 57:medicina57080791. [PMID: 34440996 PMCID: PMC8400014 DOI: 10.3390/medicina57080791] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 01/04/2023]
Abstract
Background and Objectives: Femoral neck fractures are common and constitute one of the largest healthcare burdens of the modern age. Fractures within the joint capsule (intracapsular) provide a specific surgical challenge due to the difficulty in predicting rates of bony union and whether the blood supply to the femoral head has been disrupted in a way that would lead to avascular necrosis. Most femoral neck fractures are treated surgically, aiming to maintain mobility, whilst reducing pain and complications associated with prolonged bedrest. Materials and Methods: We performed a narrative review of intracapsular hip fracture management, highlighting the latest advancements in fixation techniques, generating an evidence-based algorithm for their management. Results: Multiple different fracture configurations are encountered within the category of intracapsular hip fractures, with each pattern having different optimal surgical strategies. Additionally, these injuries typically occur in patients where further procedures due to operative complications are associated with a considerable increase in mortality, highlighting the need for choosing the correct index operation. Conclusions: Factors such as pathological causes for the fracture, pre-existing symptomatic osteoarthritis, patient’s physiological age and fracture displacement all need to be considered when choosing optimal management.
Collapse
Affiliation(s)
- James W. A. Fletcher
- AO Research Institute Davos, 7270 Davos, Switzerland;
- Department for Health, University of Bath, Bath BA2 7AY, UK
- Correspondence:
| | | | - Henrik Eckardt
- University Hospital Basel, 4052 Basel, Switzerland; (H.E.); (K.S.)
| | - Matthias Knobe
- Department of Orthopaedics and Trauma Surgery, Lucerne Cantonal Hospital, 6000 Lucerne, Switzerland;
| | | | - Karl Stoffel
- University Hospital Basel, 4052 Basel, Switzerland; (H.E.); (K.S.)
| |
Collapse
|
6
|
Raleigh JS, Filliquist B, Kapatkin AS, Chou PY, Marcellin-Little DJ, Garcia TC, Jacques KL, Stover SM. Influence of interlocking thread screws to repair simulated adult canine humeral condylar fractures. Vet Surg 2021; 50:1237-1249. [PMID: 33959975 DOI: 10.1111/vsu.13655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 04/14/2021] [Accepted: 04/26/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the influence of interlocking screw threads on the biomechanical properties of repaired canine humeral condylar fractures. STUDY DESIGN Ex vivo biomechanical study. SAMPLE POPULATION Thirty-six humeral condyles. METHODS Simulated fractures of the lateral aspect of the humeral condyle were stabilized by a 3.5 mm interlocking thread screw (ITS) or 3.5 mm buttress thread screw placed in lag (BTS-L) or positional fashion (BTS-P) and axially loaded at a walk, trot, 2-mm displacement, and failure cycles. Compact flute drill bits (CFBs) were used for ITS constructs and standard flute drill bits (SFB) for BTS constructs. The effects of bit type on drilling parameters and screw type on screw insertion properties and fragment stability were assessed. RESULTS CFB produced a 6°C greater temperature increase (p = .042) and required 20 N higher torque (p = .003) than SFB. Insertional torque was greater for ITS than BTS-P (p = .001) and BTS-L (p = .001). Condylar fragment rotation at failure was lower in ITS (lsmean ± SE, 8.3° ± 1.9°) than BTS-L constructs (14.5° ± 2.3°, p = .011). ITS resisted greater loads (1503 ± 105 N) than BTS-P (1189 ± 99 N, p = .038) but not BTS-L (1249 ± 123 N, p = .121) constructs. CONCLUSION Biomechanical performance of constructs was improved with ITS rather than BTS fixation. CLINICAL SIGNIFICANCE ITS can be considered for stabilization of humeral condylar fractures in adult dogs.
Collapse
Affiliation(s)
- Joseph S Raleigh
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Barbro Filliquist
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Amy S Kapatkin
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Po Yen Chou
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Denis J Marcellin-Little
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Tanya C Garcia
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Kevin L Jacques
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Susan M Stover
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| |
Collapse
|
7
|
Griffin XL, Achten J, O'Connor HM, Cook JA, Costa ML. Effect on health-related quality of life of the X-Bolt dynamic plating system versus the sliding hip screw for the fixation of trochanteric fractures of the hip in adults: the WHiTE Four randomized clinical trial. Bone Joint J 2021; 103-B:256-263. [PMID: 33390029 PMCID: PMC7954151 DOI: 10.1302/0301-620x.103b.bjj-2020-1404.r1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS Surgical treatment of hip fracture is challenging; the bone is porotic and fixation failure can be catastrophic. Novel implants are available which may yield superior clinical outcomes. This study compared the clinical effectiveness of the novel X-Bolt Hip System (XHS) with the sliding hip screw (SHS) for the treatment of fragility hip fractures. METHODS We conducted a multicentre, superiority, randomized controlled trial. Patients aged 60 years and older with a trochanteric hip fracture were recruited in ten acute UK NHS hospitals. Participants were randomly allocated to fixation of their fracture with XHS or SHS. A total of 1,128 participants were randomized with 564 participants allocated to each group. Participants and outcome assessors were blind to treatment allocation. The primary outcome was the EuroQol five-dimension five-level health status (EQ-5D-5L) utility at four months. The minimum clinically important difference in utility was pre-specified at 0.075. Secondary outcomes were EQ-5D-5L utility at 12 months, mortality, residential status, mobility, revision surgery, and radiological measures. RESULTS Overall, 437 and 443 participants were analyzed in the primary intention-to-treat analysis in XHS and SHS treatment groups respectively. There was a mean difference of 0.029 in adjusted utility index in favour of XHS with no evidence of a difference between treatment groups (95% confidence interval -0.013 to 0.070; p = 0.175). There was no evidence of any differences between treatment groups in any of the secondary outcomes. The pattern and overall risk of adverse events associated with both treatments was similar. CONCLUSION Any difference in four-month health-related quality of life between the XHS and SHS is small and not clinically important. There was no evidence of a difference in the safety profile of the two treatments; both were associated with lower risks of revision surgery than previously reported. Cite this article: Bone Joint J 2021;103-B(2):256-263.
Collapse
Affiliation(s)
- Xavier L. Griffin
- Department of Trauma and Orthopaedic Surgery, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Barts Health NHS Trust, London, UK
| | - Juul Achten
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Heather Marie O'Connor
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Centre for Statistics in Medicine, University of Oxford, Oxford
| | - Jonathan A. Cook
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Centre for Statistics in Medicine, University of Oxford, Oxford
| | - Matt L. Costa
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - on behalf of the WHiTE Four Investigators
- Department of Trauma and Orthopaedic Surgery, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Barts Health NHS Trust, London, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Centre for Statistics in Medicine, University of Oxford, Oxford
| |
Collapse
|
8
|
Nie S, Li M, Ji H, Li Z, Li W, Zhang H, Licheng Z, Tang P. Biomechanical comparison of medial sustainable nail and proximal femoral nail antirotation in the treatment of an unstable intertrochanteric fracture. Bone Joint Res 2020; 9:840-847. [PMID: 33275035 PMCID: PMC9021899 DOI: 10.1302/2046-3758.912.bjr-2020-0284.r1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
AIMS Restoration of proximal medial femoral support is the keystone in the treatment of intertrochanteric fractures. None of the available implants are effective in constructing the medial femoral support. Medial sustainable nail (MSN-II) is a novel cephalomedullary nail designed for this. In this study, biomechanical difference between MSN-II and proximal femoral nail anti-rotation (PFNA-II) was compared to determine whether or not MSN-II can effectively reconstruct the medial femoral support. METHODS A total of 36 synthetic femur models with simulated intertrochanteric fractures without medial support (AO/OTA 31-A2.3) were assigned to two groups with 18 specimens each for stabilization with MSN-II or PFNA-II. Each group was further divided into three subgroups of six specimens according to different experimental conditions respectively as follows: axial loading test; static torsional test; and cyclic loading test. RESULTS The mean axial stiffness, vertical displacement, and maximum failure load of MSN-II were 258.47 N/mm (SD 42.27), 2.99 mm (SD 0.56), and 4,886 N (SD 525.31), respectively, while those of PFNA-II were 170.28 N/mm (SD 64.63), 4.86 mm (SD 1.66), and 3,870.87 N (SD 552.21), respectively. The mean torsional stiffness and failure torque of MSN-II were 1.72 N m/° (SD 0.61) and 16.54 N m (SD 7.06), respectively, while those of PFNA-II were 0.61 N m/° (SD 0.39) and 6.6 N m (SD 6.65), respectively. The displacement of MSN-II in each cycle point was less than that of PFNA-II in cyclic loading test. Significantly higher stiffness and less displacement were detected in the MSN-II group (p < 0.05). CONCLUSION The biomechanical performance of MSN-II was better than that of PFNA-II, suggesting that MSN-II may provide more effective mechanical support in the treatment of unstable intertrochanteric fractures. Cite this article: Bone Joint Res 2020;9(12):840-847.
Collapse
Affiliation(s)
- Shaobo Nie
- Department of Orthopaedics, First Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Ming Li
- Department of Orthopaedics, First Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Hui Ji
- Department of Anesthesia and Operation Center, Chinese PLA General Hospital, Beijing, China
| | - Zhirui Li
- Department of Orthopaedics, First Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Wenwen Li
- Department of Orthopaedics, First Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Hao Zhang
- Department of Orthopaedics, First Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Zhang Licheng
- Department of Orthopaedics, First Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Peifu Tang
- Department of Orthopaedics, First Medical Center, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, China
| |
Collapse
|