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Traditional and bionic dynamic hip screw fixation for the treatment of intertrochanteric fracture: a finite element analysis.
International Orthopaedics ( IF 2.7 ) Pub Date : 2020-01-11 , DOI: 10.1007/s00264-019-04478-9
Yunwei Cun 1, 2 , Chenhou Dou 1 , Siyu Tian 1 , Ming Li 1 , Yanbin Zhu 1 , Xiaodong Cheng 1, 2 , Wei Chen 1, 2
Affiliation  

PURPOSE The dynamic hip screw (DHS) is widely used for fixing intertrochanteric femur fractures. A porous bionic DHS was developed recently to avoid the stress concentration and risk of post-operative complications associated with titanium alloy DHSs. The purpose of this study was to compare the effects of traditional titanium alloy, bionic titanium alloy, and bionic magnesium alloy DHS fixation for treatment of intertrochanteric fractures using finite element analysis. METHODS A three-dimensional model of the proximal femur was established by human computed tomography images. An intertrochanteric fracture was created on the model, which was fixed using traditional and porous bionic DHS, respectively. The von Mises stress, maximum principal stress, and minimum principal stress were calculated to evaluate the effect of bone ingrowth on stress distribution of the proximal femur after fixation. RESULTS Stress concentration of the bionic DHS model was lower compared with traditional DHS fixation models. The von Mises stress, maximum principal stress, and minimum principal stress distributions of bionic magnesium alloy DHS models improved, along with simulation of the bone healing process and magnesium alloy degeneration, assumed to biodegrade completely 12 months post-operatively. The distribution of maximum principal stress in the secondary tension zone of the bionic DHS model was close to the intact bone. In the minimum principal stress, the region of minimum stress value less than - 10 MPa was significantly improved compared with traditional DHS models. CONCLUSION The bionic magnesium alloy DHS implant can improve the stress distribution of fractured bone close to that of intact bone while reducing the risk of post-operative complications associated with traditional internal fixations.

中文翻译:

传统和仿生动力髋螺钉固定治疗股骨转子间骨折:有限元分析。

目的动力髋螺钉(DHS)被广泛用于固定股骨粗隆间骨折。最近开发了一种多孔仿生DHS,以避免应力集中以及与钛合金DHS相关的术后并发症的风险。本研究的目的是使用有限元分析方法比较传统钛合金,仿生钛合金和仿生镁合金DHS固定治疗股骨转子间骨折的效果。方法利用人体计算机断层扫描图像建立股骨近端的三维模型。在模型上创建了股骨转子间骨折,分别使用传统的和多孔的仿生DHS固定。von Mises应力,最大主应力,计算最小主应力,以评估骨长入对固定后股骨近端应力分布的影响。结果仿生DHS模型的应力集中度低于传统DHS固定模型。仿生镁合金DHS模型的von Mises应力,最大主应力和最小主应力分布得到改善,并模拟了骨愈合过程和镁合金变性,并假设它们在术后12个月会完全生物降解。在仿生DHS模型的第二拉伸区域中,最大主应力的分布接近完整的骨骼。在最小主应力下,与传统DHS模型相比,最小应力值小于-10 MPa的区域得到了显着改善。
更新日期:2020-01-13
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