Comput Methods Programs Biomed - Biomechanical analyses of static and dynamic fixation techniques of retrograde interlocking femoral nailing using nonlinear finite element methods.

Tópicos

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Resumo

Femoral shaft fractures can be treated using retrograde interlocking nailing systems; however, fracture nonunion still occurs. Dynamic fixation techniques, which remove either the proximal or distal locking screws, have been used to solve the problem of nonunion. In addition, a surgical rule for dynamic fixation techniques has been defined based on past clinical reports. However, the biomechanical performance of the retrograde interlocking nailing systems with either the traditional static fixation technique or the dynamic fixation techniques has not been investigated by using nonlinear numerical modeling. Three-dimensional nonlinear finite element models were developed, and the implant strength, fixation stability, and contact area of the fracture surfaces were evaluated. Three types of femoral shaft fractures (a proximal femoral shaft fracture, a middle femoral shaft fracture, and a distal femoral shaft fracture) fixed by three fixation techniques (insertion of all the locking screws, removal of the proximal locking screws, or removal of the distal locking screws) were analyzed. The results showed that the static fixation technique resulted in sufficient fixation stability and that the dynamic fixation techniques decreased the failure risk of the implant and produced a larger contact area of the fracture surfaces. The outcomes of the current study could assist orthopedic surgeons in comprehending the biomechanical performances of both static and dynamic fixation techniques. In addition, the surgeons could also select a fixation technique based on the specific patient situation using the numerical outcomes of this study.

Resumo Limpo

femor shaft fractur can treat use retrograd interlock nail system howev fractur nonunion still occur dynam fixat techniqu remov either proxim distal lock screw use solv problem nonunion addit surgic rule dynam fixat techniqu defin base past clinic report howev biomechan perform retrograd interlock nail system either tradit static fixat techniqu dynam fixat techniqu investig use nonlinear numer model threedimension nonlinear finit element model develop implant strength fixat stabil contact area fractur surfac evalu three type femor shaft fractur proxim femor shaft fractur middl femor shaft fractur distal femor shaft fractur fix three fixat techniqu insert lock screw remov proxim lock screw remov distal lock screw analyz result show static fixat techniqu result suffici fixat stabil dynam fixat techniqu decreas failur risk implant produc larger contact area fractur surfac outcom current studi assist orthoped surgeon comprehend biomechan perform static dynam fixat techniqu addit surgeon also select fixat techniqu base specif patient situat use numer outcom studi

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