Medial support nail and proximal femoral nail antirotation in the treatment of reverse obliquity inter-trochanteric fractures (Arbeitsgemeinschaft fur Osteosynthesfrogen/Orthopedic Trauma Association 31-A3.1): a finite-element analysis.

Autor:	Nie SB; Department of Orthopaedics, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China., Zhao YP; Department of Orthopedics, the Fourth Medical Centre, Chinese PLA General Hospital, Beijing 100853, China., Li JT; Department of Orthopaedics, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China., Zhao Z; Department of Orthopaedics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China., Zhang Z; Department of Orthopaedics, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China., Zhang LC; Department of Orthopaedics, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China., Tang PF; Department of Orthopaedics, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.
Jazyk:	angličtina
Zdroj:	Chinese medical journal [Chin Med J (Engl)] 2020 Nov 20; Vol. 133 (22), pp. 2682-2687.
DOI:	10.1097/CM9.0000000000001031
Abstrakt:	Background: The reverse obliquity inter-trochanteric fracture is a distinct fracture pattern that is mechanically different from most inter-trochanteric fractures and the optional treatment of it is still controversial. The purpose of this study was to compare differences in the efficacy of a novel nail (medial support nail [MSN-II]) and proximal femoral nail anti-rotation (PFNA-II) in the treatment of reverse obliquity inter-trochanteric fractures (Arbeitsgemeinschaft fur Osteosynthesfrogen/Orthopedic Trauma Association [AO/OTA] 31-A3.1) using finite-element analysis. Methods: Modeling software was used to establish a three-dimensional model of MSN-II and PFNA-II and an A3.1 inter-trochanteric fracture model. Abaqus software was used to implement different force loads to compare finite-element biomechanical parameters such as the maximum stress in implant and the displacement of fracture site. Results: The femoral stress, implant stress and fracture site displacement of MSN-II was less than that of PFNA-II. The results indicated that the maximal femoral stress was 581 MPa for PFNA-II and 443 MPa for the MSN-II. The maximum stress values in the PFNA-II and MSN-II models were 291 and 241 MPa, respectively. The maximal displacements of the fracture site were 1.47 and 1.16 mm in the PFNA-II and MSN-II models, respectively. Conclusion: Compared with PFNA-II for inter-trochanteric fracture (AO/OTA 31-A3.1), MSN-II which was designed with a triangular stability structure can provide better biomechanical stability. The MSN-II may be a feasible option for the treatment of reverse obliquity inter-trochanteric fracture.
Databáze:	MEDLINE
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