Finite element analysis of different internal fixation methods for the treatment of Pauwels type III femoral neck fracture

Lin, Tao; Yang, Peng; Xu, Jingjing; Wei, Qiushi; Zhou, Guangquan; He, Wei; Zhang, Qingwen

doi:10.1016/j.biopha.2019.108658

Cited by 64 publications

(57 citation statements)

References 23 publications

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“…The elastic modulus of cortical bone was set to 16,800 MPa, and Poisson's ratios to 0.3 [14]. The elastic modulus and Poisson's ratio of the trabecular bone were set to 840 MPa and 0.2 [15].…”

Section: Materials Parameter Settingsmentioning

confidence: 99%

Effects of proximal fibular osteotomy on stress changes in mild knee osteoarthritis with varus deformity: a finite element analysis

et al. 2020

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Background: Many previous studies lack sufficient quantitative evidences about changes in biomechanical properties of the knee in response to proximal fibular osteotomy (PFO). Therefore, the aim of this study was to compare the preoperative and postoperative effects of PFO on mechanical stresses in the knee joint and provide with a biomechanical basis for PFO in the treatment of mild knee osteoarthritis (KOA) with varus deformity. Methods: A total of 10 patients suffering mild KOA with varus deformity were enrolled in this study. Their image data from computerized tomography (CT) and magnetic resonance imaging (MRI) were used for finite element models, and PFO models were established. Static structural analysis was carried out using ABAQUS to compare the von Mises stress distribution and values of the maximal von Mises stress of femoral cartilage, meniscuses, tibial cartilages, and tibial plateau before and after surgery. Results: The stress distribution in the cortical bone of the tibial plateau showed that stresses were transferred from the anterior medial area to the posterior medial area after PFO. Values of the maximal von Mises stress in femoral cartilage, medial meniscus, medial tibial cartilage, and tibial plateau after surgery were significantly lower than the preoperative values, with statistically significant differences (P < 0.05). Postoperative values of the maximal von Mises stress of lateral meniscus and lateral tibial cartilage were significantly higher than the preoperative ones, with statistically significant differences (P < 0.05). Conclusion: PFO could reduce the stresses in the medial compartment of the knee joint with stress pathways transferring from the anterior medial area to the posterior medial area of the tibial plateau. Therefore, PFO is recommended for the treatment of mild KOA with varus deformity featuring favorably pain-relieving effects.

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Section: Materials Parameter Settingsmentioning

confidence: 99%

Effects of proximal fibular osteotomy on stress changes in mild knee osteoarthritis with varus deformity: a finite element analysis

et al. 2020

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“…In another femoral neck cadaver study, Basso et al 34 found that the combination of one locking plate with three common cancellous screws reduced the magnitude of micromovement of the femoral neck and prevented rotation of the bone surrounding the proximal fracture. Several nite element analyses have indicated that a medial support plate can effectively resist the shear force of a Pauwels III femoral neck fracture and create an excellent mechanical environment for fracture healing 21,35 . In a clinical study, Ye et al 36 also explored three cannulated screws augmented with a medial buttress plate for the treatment of Pauwels type III femoral neck fractures, and their results showed that this surgical method improved the fracture healing rate.…”

Section: Discussionmentioning

confidence: 99%

Finite element analysis of a new internal fixation implant for Pauwels type III femoral neck fractures

Fan¹,

Su²,

Zhou³

et al. 2020

Preprint

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Background The optimal treatment strategy for Pauwels type III femoral neck fractures remains controversial. A new internal fixation femoral neck system (FNS) for the treatment of femoral neck fractures was developed, and we compared the mechanical efficiency of the internal fixation FNS with that of two cannulated screw configurations for the treatment of Pauwels type III femoral neck fractures. Method: In this study, we constructed models of Pauwels type III femoral neck fractures with angles of 50°, 60°, and 70°. Moreover, a fixation model with the FNS and two fixation models with cannulated screws were developed. Under two axial loads, 1400 N and 2100 N, the von Mises stress distributions, maximum von Mises stress, and displacements of the femur and internal fixation components were measured for each fracture group. Result The maximum von Mises stress of internal fixation in the three models was mostly located near the fracture line, and the femoral head region closest to the femoral calcar experienced the maximum amount of stress. As the Pauwels angle and axial loads increased, the stress and displacement of the proximal femoral head and internal fixation component increased in each group. Compared with cannulated screw configurations, the internal fixation FNS showed lower values of peak stress at the femoral head and smaller displacements of the femur and internal implant in the treatment of Pauwels type III femoral neck fractures with Pauwels angles of 50°, 60°, and 70°. Conclusion The newly developed internal fixation FNS provided improved biomechanical stability for the treatment of Pauwels type III femoral neck fractures, which indicated that the internal fixation FNS may be a new option for the treatment of vertical femoral neck fractures.

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“…First, the maximum displacement of the fracture end of the model was measured. Second, four models' von Mises Stress (VMS) distribution and peak VMS of both the xation plates and the internal xation system were observed [20]. These parameters were used to capture the mechanical factors involved in the xation stability and fracture healing [21].…”

Section: Evaluation Criteria Of the Systemmentioning

confidence: 99%

Finite element analysis of different locking-plate fixation methods for the treatment of ulna head fracture

Zhang

Shao

Yang

et al. 2020

Preprint

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Background: Ulnar head fractures are increasingly higher with the growing proportion of the elderly in the population. Failure to achieve stable anatomic reduction of ulna head fracture may lead to the DRUJ dysfunction and nonunion of distal radius. Due to the lack of the postoperative reporting outcomes and the biomechanical studies, it has not been well established about the optimal management of the comminuted distal ulna head fracture. This study aimed to explain the advantages and disadvantages of the ulnar-side locking plate fixation, compared with the dorsal-side one, and its screws arrangement in the treatment of the ulnar head fracture by using finite element analysis. Methods: FE models of the ulnar head fracture and the models of ulnar-side locking plate and dorsal-side plate with two or three distal screws was constructed. In order to simulate forces acting on the ulnar and the osteosynthesis material during daily-life activity in subjects who underwent reconstructive surgery, we applied three loading conditions to each model, viz. axial compression 20N, 50N, and torsion moments 1Nm. Under these conditions, values of the von Mises Stress (VMS) distribution of the implant, peak VMS, and model displacement were investigated. Results: Both the stress values and model displacement of ulnar-side plate were lower than those of dorsal-side plate. When adding a screw in the middle hole of the ulnar head, the values of model displacement and the peak stress in fixation system are lower, but it may evidently concentrate the stress on the middle screw. Conclusions: In conclusion, our study indicated that plating locking plate on ulnar side had lower stress distribution on the plate and better stability than on dorsal side in ulnar head fracture fixation. Adding the additional screw on the ulnar head could reduce the displacement of the fixation system and increase the stability of the fixation system. This study requires clinical confirmation as to its practicality in the treatment of ulnar head fracture.

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Finite element analysis of different internal fixation methods for the treatment of Pauwels type III femoral neck fracture

Cited by 64 publications

References 23 publications

Effects of proximal fibular osteotomy on stress changes in mild knee osteoarthritis with varus deformity: a finite element analysis

Effects of proximal fibular osteotomy on stress changes in mild knee osteoarthritis with varus deformity: a finite element analysis

Finite element analysis of a new internal fixation implant for Pauwels type III femoral neck fractures

Finite element analysis of different locking-plate fixation methods for the treatment of ulna head fracture

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