Reina-Romo Esther, Giráldez-Sánchez Ma, Mora-Macías J, Cano-Luis P, Domínguez Jaime
Department of Mechanical Engineering, University of Seville, Seville, Spain
Departamento de traumatología, Hospital Universitario Virgen del Rocío, Seville, Spain.
Proc Inst Mech Eng H. 2014 Oct;228(10):1043-52. doi: 10.1177/0954411914554634. Epub 2014 Oct 20.
Less Invasive Stabilization System femoral plates are currently accepted as a suitable fixation technique for supra-intercondylar femoral fractures. However, general agreement does not exist regarding the optimum design of this fixator type. Therefore, the aim of this article is to reduce the intrinsic Less Invasive Stabilization System complications by clarifying, from a biomechanical point of view, how the number of screws, the screw connection type (unicortical or bicortical), or the structured position of the screws can influence the outcome of the fracture site. These studies include a specific finite element analysis that determines how several biomechanical variables, such as the movement at the fracture site, are influenced by the preconditions of bone healing. The results of this study show that the screw type affects the mechanical stabilization of the femur to a greater extent than the material type of the Less Invasive Stabilization System femoral plates. The most significant differences among all the analyzed configurations are observed in the shear interfragmentary strain between screw types. Values are approximately 50% higher with unicortical screws than with bicortical ones.
微创稳定系统股骨钢板目前被认为是治疗股骨髁间骨折的一种合适固定技术。然而，对于这种固定器类型的最佳设计尚未达成普遍共识。因此，本文的目的是从生物力学角度阐明螺钉数量、螺钉连接类型（单皮质或双皮质）或螺钉的结构位置如何影响骨折部位的愈合结果，从而减少微创稳定系统的固有并发症。这些研究包括一项特定的有限元分析，该分析确定了诸如骨折部位的移动等几个生物力学变量如何受到骨愈合前提条件的影响。这项研究的结果表明，螺钉类型比微创稳定系统股骨钢板的材料类型对股骨的机械稳定性影响更大。在所有分析的构型中，观察到螺钉类型之间的剪切骨折块间应变存在最显著差异。单皮质螺钉的值比双皮质螺钉高约50%。
