Terzini Mara, Aldieri Alessandra, Nurisso Stefania, De Nisco Giuseppe, Bignardi Cristina
Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.
PolitoBIOMed Lab, Politecnico di Torino, Turin, Italy.
Front Bioeng Biotechnol. 2020 Jun 23;8:619. doi: 10.3389/fbioe.2020.00619. eCollection 2020.
The incidence of periprosthetic fractures has rapidly increased in the last two decades and has been the cause of a large number of revision surgeries and permanent physical disability for many patients, as well as a significant socioeconomic burden for many nations. This research deals with a periprosthetic femur fracture real event, occurred following a total hip arthroplasty and treated with one of the most widespread internal fixation methods: the implant of a periprosthetic femur plate system. A Finite Element analysis was performed to investigate the implanted femur plate break after a short follow-up and to understand the plate break causes. Such events are currently object of forensic debate as more and more often hospitals, surgeons, and medical device manufacturers are denounced by patients to whom similar events occur. In this work, different load situations acting on the femur during daily and incidental activities were simulated, in order to validate the correct behavior of the plate, according to the intended use recommended by the manufacturer. The analysis demonstrates that the plate failure can occur in situations of unconventional loading such as that caused by stumbling and in presence of incomplete bone healing.
在过去二十年中，假体周围骨折的发生率迅速上升，已导致大量患者接受翻修手术并造成永久性身体残疾，同时也给许多国家带来了巨大的社会经济负担。本研究涉及一起全髋关节置换术后发生的假体周围股骨骨折真实事件，采用了最广泛使用的内固定方法之一进行治疗：植入假体周围股骨钢板系统。进行了有限元分析，以研究在短期随访后植入的股骨钢板断裂情况，并了解钢板断裂的原因。随着越来越多发生类似事件的患者谴责医院、外科医生和医疗设备制造商，此类事件目前已成为法医辩论的对象。在这项工作中，模拟了日常和偶然活动期间作用于股骨的不同载荷情况，以便根据制造商推荐的预期用途验证钢板的正确性能。分析表明，在非常规载荷情况下，如绊倒导致的载荷以及存在不完全骨愈合的情况下，钢板可能会发生失效。
