Rathor Sandeep, Uddanwadiker Rashmi, Saryam Nandram, Apte Ashutosh
Department of Mechanical Engineering, Visvesvaraya National Institute of Technology, South Ambazari Road, Nagpur, Maharashtra 440010 India.
Maharaja Yeshwantrao Hospital, MY Hospital Road, CRP Line, Indore, Madhya Pradesh 452010 India.
Indian J Orthop. 2022 Dec 12;57(1):146-158. doi: 10.1007/s43465-022-00795-1. eCollection 2023 Jan.
The rigidity in osteosynthesis causes primary healing, and it takes longer to heal. The flexibility provided to the fixation allows micromotion between fragments which accelerates secondary healing.
In this study, the healing outcomes of nailing and plating in different fixation stabilities were investigated and compared by using a finite element tool. The clinical observational study was also performed to verify the results of the finite element analysis. The nonlinear contact analysis was performed on 5 different fixation configurations capturing nail and plate in immediate post-surgery.
The finite element analysis results showed that flexibility instead of rigidity in interlock nail implantation increases the axial and shear micromotion near the fracture site by 47.4% ( < ) and 12.4% ( < ), respectively. For LCDCP implantation, the flexible fixation increases the axial and shear micromotion near fracture site by 75.7% ( < ) and 25.3% ( < ), respectively.
Our findings suggest that flexible fixations of interlock nail and LCDCP provide a preferred mechanical environment for healing, and hence, the LCDCP in flexible mode can be an effective alternative to interlock nail for the femur diaphyseal fracture.
The online version contains supplementary material available at 10.1007/s43465-022-00795-1.
骨固定中的刚性会导致一期愈合，愈合所需时间更长。给予固定装置一定的灵活性可使骨折块之间产生微动，从而加速二期愈合。
在本研究中，使用有限元工具研究并比较了不同固定稳定性下髓内钉和钢板固定的愈合结果。还进行了临床观察研究以验证有限元分析的结果。对术后即刻的5种不同固定构型（包括髓内钉和钢板）进行了非线性接触分析。
有限元分析结果表明，交锁髓内钉植入时采用灵活性而非刚性固定，可使骨折部位附近的轴向微动和剪切微动分别增加47.4%（P< ）和12.4%（P< ）。对于有限接触动力加压钢板（LCDCP）植入，灵活性固定可使骨折部位附近的轴向微动和剪切微动分别增加75.7%（P< ）和25.3%（P< ）。
我们的研究结果表明，交锁髓内钉和LCDCP的灵活性固定为愈合提供了更有利的力学环境，因此，灵活模式下的LCDCP可作为股骨干骨折交锁髓内钉的有效替代方案。
在线版本包含可在10.1007/s43465-022-00795-1获取的补充材料。
