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| Finite element analysis of proximal femoral nail anti-rotation with different length in the treatment of type A3.3 femoral intertrochanteric fracture in elderly |
| CHEN Xinmin1 JIANG Teng1 YANG Wei1 ZHENG Liqin2 LIN Ziling2 TU Shijie1 |
1.Department of Traumatic Orthopedics, Fengcheng Hospital of Traditional Chinese Medicine, Jiangxi Province, Fengcheng 331100, China;
2.Department of Traumatic Orthopedics, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Province, Guangzhou 510405, China |
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Abstract Objective To investigate the optimal length of proximal femoral nail anti-rotation for the treatment of type A3.3 femoral intertrochanteric fracture in elderly by using finite element method. Methods Based on one patient volunteer′s hip CT data in Fengcheng Hospital of Traditional Chinese Medicine, Jiangxi Province imported into Mimics 19.0 and Geomagic 2017 softwares and obtained proximal femur model after processed. Then the model was imported into Solidworks 2017 software to simulate A3.3 type fracture and assembled with different length of proximal femoral nail anti-rotation getting model A (short nail), B (middle nail), and C (long nail) respectively. The models were imported into Abaqus 2016 software one by one in step format to set material parameters and boundary conditions, etc. and then the calculation was carried out. The Von Mises cloud pictures were checked and the whole femur stress, internal fixation stress, fracture gap size and inversion angle of head-neck bone fragment were observed. Results The overall stress of femur in model B was the minimum, that in model C was the maximum, and that in model A was the center. Proximal femoral nail anti-rotation was the main supporting structure of head and neck bone fracture, and beared most of the stress. The stress peak was located at the connection between spiral blade and main nail, and the secondary peak was located at the entry point of external femoral wall. The fracture gap size and inversion angle of head-neck bone fragment were inversely proportional to the length of the main nail, model A had the smallest fracture gap size and inversion angle of head-neck bone fragment, model C had the largest, and model B had the middle. Conclusion The application of the short length proximal femoral nail anti-rotation in the treatment of type A3.3 femoral intertrochanteric fracture in the elderly has a smaller fracture gap size, a more stable fracture end and a better biomechanical effect.
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