Freitas Anderson, Toledo Júnior Joubert Vieira, Ferreira Dos Santos Adeni, Aquino Rubén Jeri, Leão Vitor Negreiro, Péricles de Alcântara Weverton
Hospital Regional do Gama, Brasília, Distrito Federal, Brazil.
Instituto de Pesquisa e Ensino do Hospital Ortopédico e Medicina Especializada (IPE - H O M E), Brasília, Distrito Federal, Brazil.
J Clin Orthop Trauma. 2020 Jun 9;14:145-150. doi: 10.1016/j.jcot.2020.06.006. eCollection 2021 Mar.
To evaluate biomechanical behavior of different internal fixation methods for the treatment of Pauwels Type III femoral neck fractures.
Three internal fixators were developed to treat Pauwels Type III femoral neck fracture using finite elements: dynamic hip screw (DHS); DHS combined with anti-rotation screw; three cannulated screws in an inverted triangular configuration (ASNIS). Under the same conditions, vertical fracture displacement, and maximum and minimum principal, and Von Mises stresses were evaluated.
The vertical displacements evaluated were: 5.43 mm, 5.33 mm and 6.22 mm, rotational displacements values were 1.1 mm, 0.4 mm and 1.3 mm; maximum principle stress values obtained for the upper region of the femoral neck were 3.26 hPa, 2.77 hPa, and 4.5 hPa, minimum principal stress values obtained for the inferior region of the femoral neck were -1.97 hPa, -1.8 hPa and t -3.15 hPa; Von Mises peak stress values were 340.0 MPa, 315.5 MPa and 326.1 Mpa, for DHS, DHS with anti-rotation device, and ASNIS, respectively. : The DHS combined with anti-rotation screw yielded better results in terms of rotational and vertical displacements, traction and compression distributions on fractures, and Von Mises stress, demonstrating mechanical superiority for Pauwels Type III fracture.
评估不同内固定方法治疗 Pauwels III 型股骨颈骨折的生物力学行为。
使用有限元方法开发三种内固定器来治疗 Pauwels III 型股骨颈骨折：动力髋螺钉（DHS）；DHS 联合防旋螺钉；呈倒三角形配置的三枚空心螺钉（ASNIS）。在相同条件下，评估垂直骨折位移、最大和最小主应力以及 Von Mises 应力。
评估得到的垂直位移分别为：5.43 毫米、5.33 毫米和 6.22 毫米，旋转位移值分别为 1.1 毫米、0.4 毫米和 1.3 毫米；股骨颈上部区域获得的最大主应力值分别为 3.26 百帕、2.77 百帕和 4.5 百帕，股骨颈下部区域获得的最小主应力值分别为 -1.97 百帕、-1.8 百帕和 -3.15 百帕；DHS、带防旋装置的 DHS 和 ASNIS 的 Von Mises 峰值应力值分别为 340.0 兆帕、315.5 兆帕和 326.1 兆帕。：DHS 联合防旋螺钉在旋转和垂直位移、骨折处的牵引和压缩分布以及 Von Mises 应力方面产生了更好的结果，显示出对 Pauwels III 型骨折的力学优势。
