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  

作　　者：Shao-Bo Nie Yan-Peng Zhao Jian-Tao Li Zhe Zhao Zhuo Zhang Li-Cheng Zhang Pei-Fu Tang 

机构地区：[1]Department of Orthopaedics,The First Medical Center,Chinese PLA General Hospital,Beijing 100853,China [2]Department of Orthopedics,the Fourth Medical Centre,Chinese PLA General Hospital,Beijing 100853,China [3]Department of Orthopaedics,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China

出　　处：《Chinese Medical Journal》2020年第22期2682-2687,共6页中华医学杂志（英文版）

基　　金：This work was supported by a grant from the Capital Health Research and Development of Special Grants(No.2016-1-5012)。

摘　　要：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.Conclusions: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.

关 键 词：Finite-element analysis Inter-trochanteric fracture Proximal femoral nail anti-rotation 

分 类 号：R687.3[医药卫生—骨科学]