Hong J-B, Dan Y, Ouyang L, Liu Y, Xiong L-M, Li S, Feng X-B, Shao Z-W, Yan C, Yang S H, Liu P
Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
J Musculoskelet Neuronal Interact. 2017 Dec 1;17(4):299-302.
The aim of our study was to compare the biomechanical stability of the Proximal Femoral Nail Antirotation (PFNA) (with 200 mm, 240 mm and 280 mm-long main nails) for the management of unstable intertrochanteric femoral fractures.
Tronzo-Evans Type IV and V fractures were built by applying a three-dimensional finite element model. Further, PFNA-II with 200 mm, 240 mm and 280 mm-long main nails were applied for fixation. The above model is the creation of 3 researchers designed in order to obtain average values of numerical stress. Von Mises stress distribution and medial and lateral stress peak of the femur and PFNA were compared.
240 mm and 280 mm PFNA medial stress peak was reduced significantly in comparison to 200 mm PFNA (p⟨0.05). However, there was no difference between 240 mm and 280 mm PFN. Also, no statistical difference was observed with any of 3 lengths in both medial and lateral stress peak for Evans Type IV and V PFNA.
240 mm and 280 mm PFNA could reduce femur fixation medial stress peak. Further, they were more efficient in comparison to the 200 mm PFNA, and their biomechanical stability was similar to that of the 280 mm nail.
本研究旨在比较用于治疗不稳定型股骨转子间骨折的股骨近端防旋髓内钉（PFNA）（主钉长度分别为200mm、240mm和280mm）的生物力学稳定性。
应用三维有限元模型构建Tronzo-Evans IV型和V型骨折。此外，应用主钉长度为200mm、240mm和280mm的PFNA-II进行固定。上述模型由3名研究人员创建，以获取数值应力的平均值。比较股骨和PFNA的Von Mises应力分布以及股骨内外侧应力峰值。
与200mm的PFNA相比，240mm和280mm的PFNA内侧应力峰值显著降低（p＜0.05）。然而，240mm和280mm的PFNA之间没有差异。此外，Evans IV型和V型PFNA在3种长度的内外侧应力峰值方面均未观察到统计学差异。
240mm和280mm的PFNA可降低股骨固定内侧应力峰值。此外，与200mm的PFNA相比，它们效率更高，且其生物力学稳定性与280mm的钉子相似。
