Martínez-Aznar Carmen, Mateo Jesús, Ibarz Elena, Gracia Luis, Rosell Jorge, Puértolas Sergio
Department of Orthopaedic Surgery and Traumatology, Reina Sofía Hospital, 31500 Tudela, Spain.
Department of Orthopaedic Surgery and Traumatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain.
Bioengineering (Basel). 2023 Oct 11;10(10):1179. doi: 10.3390/bioengineering10101179.
Hip fractures are one of the most frequent fractures presenting to the emergency department and orthopedic trauma teams. The aim of this study was to determine the best indication and therapeutic technique for subtrochanteric fractures and unifying criteria when choosing the most suitable type of nail.
To analyze the influence of the material and the type of distal locking of intramedullary nails (static or dynamic), a femur model with a fracture in the subtrochanteric region stabilized with a long Gamma intramedullary nail was applied using finite element method (FEM) simulation.
The mechanical study shows that titanium nails allow for greater micromobility at the fracture site, which could act as a stimulus for the formation of callus and consolidation of the fracture. In the mechanical study, the type of distal locking mainly affects mobility at the fracture site and stress in the cortical bone around the distal screws, without in any case exceeding values that may compromise the viability of the assembly or that may result in detrimental effects (in terms of mobility at the fracture site) for the consolidation process.
Subtrochanteric fractures treated with titanium nail and static distal locking is safe and does not hinder consolidation.
髋部骨折是急诊科和骨科创伤团队接诊的最常见骨折之一。本研究的目的是确定转子下骨折的最佳适应证和治疗技术，并在选择最合适的髓内钉类型时统一标准。
为分析髓内钉（静态或动态）的材料和远端锁定类型的影响，使用有限元方法（FEM）模拟，应用长伽马髓内钉对转子下区域骨折的股骨模型进行稳定处理。
力学研究表明，钛钉可使骨折部位具有更大的微动性，这可作为刺激骨痂形成和骨折愈合的因素。在力学研究中，远端锁定类型主要影响骨折部位的微动性和远端螺钉周围皮质骨的应力，在任何情况下都不会超过可能损害组件生存能力或可能对愈合过程产生不利影响（就骨折部位的微动性而言）的值。
采用钛钉和静态远端锁定治疗转子下骨折是安全的，且不阻碍骨折愈合。
