Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, China.
Injury. 2019 Nov;50(11):1895-1900. doi: 10.1016/j.injury.2019.08.024. Epub 2019 Aug 19.
Displaced femoral neck fractures in young adults are most likely to result from high energy trauma that causes a vertically-oriented shearing injury through the femoral neck. The optimal strategy for treatment of displaced femoral neck fractures remains an unsolved challenge in orthopedic surgery.
our group has previously designed a medial anatomical buttress plate (MABP) based on the analysis of the computed tomography (CT) data of anatomical structures derived from a large sample population. In this study, finite element analyses (FEA) were carried out to compare the outcomes of the combination of our MABP with cannulated screws to those of the combination of tubular plate with cannulated screws, and to those of using cannulated screws alone.
MABP resulted in a more stable fixation as compared to the other two approaches, with respect to the femur and the stress distributions, stress peaks, and Z axis displacements.
The FEA encouraged us that addition of a medial buttress plate not only achieved superior medial buttress stability but also achieves superior performance because it perfectly fits with the existing anatomic structure of medial femoral neck. The results from our study may provide references for clinical decision making in dealing with such patients.
年轻成人移位股骨颈骨折最有可能是由高能量创伤引起的，这种创伤会导致股骨颈垂直方向的剪切损伤。因此，对于移位股骨颈骨折的最佳治疗策略仍然是骨科领域未解决的挑战。
我们的团队之前根据从大量样本人群中得出的解剖结构的计算机断层扫描（CT）数据分析，设计了一种内侧解剖支撑钢板（MABP）。在这项研究中，进行了有限元分析（FEA），以比较我们的 MABP 与空心螺钉组合的结果与管状钢板与空心螺钉组合的结果，以及单独使用空心螺钉的结果。
与其他两种方法相比，MABP 在股骨和应力分布、应力峰值和 Z 轴位移方面的固定效果更稳定。
FEA 鼓励我们，内侧支撑钢板的添加不仅实现了更好的内侧支撑稳定性，而且还实现了更好的性能，因为它与内侧股骨颈的现有解剖结构完美匹配。我们的研究结果可为处理此类患者的临床决策提供参考。
