Influence of the biomechanical evaluation of rupture using two shapes of same intramedullary implant after proximal interphalangeal joint arthrodesis to correct the claw/hammer pathology: A finite element study.

Autor: Bayod-López J; Applied Mechanics and Bioengineering Group (AMB), Aragon Institute of Engineering Research (I3A), Centro de Investigación Biomédica en Red CIBER-BBN, Spain, Universidad de Zaragoza, Zaragoza, Spain., Becerro-de-Bengoa-Vallejo R; Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain., Prados-Frutos JC; Department of Medical Specialties and Public Health, IDIBO Group (High Performance Group in Research and Development of Biomaterials in Dentistry), Rey Juan Carlos University, Madrid, Spain., Losa-Iglesias M; Facultad de CC de la Salud, Universidad Rey Juan Carlos, Madrid, Spain., López-López D; Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, Ferrol, Spain., Prados-Privado M; Department Continuum Mechanics and Structural Analysis, Higher Polytechnic School,, Carlos III University, Leganes, Madrid, Spain.
Jazyk: angličtina
Zdroj: International wound journal [Int Wound J] 2024 Aug; Vol. 21 (8), pp. e70014.
DOI: 10.1111/iwj.70014
Abstrakt: We used finite element analysis to study the mechanical stress distribution of a new intramedullary implant used for proximal interphalangeal joint (PIPJ) arthrodesis (PIPJA) to surgically correct the claw-hammer toe deformity that affects 20% of the population. After geometric reconstruction of the foot skeleton from claw toe images of a 36-year-old male patient, two implants were positioned, in the virtual model, one neutral implant (NI) and another one 10° angled (10°AI) within the PIPJ of the second through fourth HT during the toe-off phase of gait and results were compared to those derived for the non-surgical foot (NSF). A PIPJA was performed on the second toe using a NI reduced tensile stress at the proximal phalanx (PP) (45.83 MPa) compared to the NSF (59.44 MPa; p < 0.001). When using the 10°AI, the tensile stress was much higher at PP and middle phalanges (MP) of the same toe, measuring 147.58 and 160.58 MPa, respectively, versus 59.44 and 74.95 MPa at corresponding joints in the NSF (all p < 0.001). Similar results were found for compressive stresses. The NI reduced compressive stress at the second PP (-65.12 MPa) compared to the NSF (-113.23 MPa) and the 10°AI (-142 MPa) (all p < 0.001). The von Mises stresses within the implant were also significantly lower when using NI versus 10°AI (p < 0.001). Therefore, we do not recommend performing a PIPJA using the 10°AI due to the increase in stress concentration primarily at the second PP and MP, which could promote implant breakage.
(© 2024 The Author(s). International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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