Hrubina M, Horak Z, Skotak M, Letocha J, Baca V, Dzupa V
Bratisl Lek Listy. 2015;116(5):302-10. doi: 10.4149/bll_2015_057.
The study was aimed at the assessment of specific complications depending on the sliding hip screw position.
The finite element method in the biomechanical analysis of this implant may be used to predict the mechanical failure due to the screw position.
380 sliding screw osteosyntheses for stable pertrochanteric fractures of 365 patients were included in the study. We divided and analysed the osteosyntheses with five various screw positions and focused on the specific complications development. For the construction of the finite element model of the femur, the program ABAQUS 6.9 was used. Analyses were performed with evaluation of the bone response to the different screw locations (strain and stress) with maximum low-cycle high stress loading.
The specific complication rate was 10 %, with the re-operation rate of 4.2 %. If placing the screw in the middle third of the neck it reduced significantly strain patterns of the plate and screw. A screw position in the superior third of the neck significantly increased the strain of the plate and screw by more than 63 %.
The conformity in the clinical and biomechanical analyses was observed. The finite element model can be considered as valid in predicting sliding screw failures (Tab. 4, Fig. 8, Ref. 30).
本研究旨在评估取决于滑动髋螺钉位置的特定并发症。
该植入物生物力学分析中的有限元方法可用于预测因螺钉位置导致的机械故障。
本研究纳入了365例患者的380例用于稳定型转子间骨折的滑动螺钉内固定术。我们将内固定术分为五种不同的螺钉位置并进行分析，重点关注特定并发症的发生情况。对于股骨有限元模型的构建，使用了ABAQUS 6.9程序。通过评估骨对不同螺钉位置（应变和应力）的反应，采用最大低周高应力加载进行分析。
特定并发症发生率为10%，再次手术率为4.2%。将螺钉置于颈中部三分之一处可显著降低钢板和螺钉的应变模式。螺钉位于颈上部三分之一处会使钢板和螺钉的应变显著增加超过63%。
观察到临床分析和生物力学分析结果具有一致性。有限元模型在预测滑动螺钉失效方面可被认为是有效的（表4，图8，参考文献30）。
