Qingdao Municipal Hospital, Qingdao, Shandong, 266011, China.
Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine, Beijing, 100007, China.
BMC Musculoskelet Disord. 2024 Jan 20;25(1):83. doi: 10.1186/s12891-023-07110-5.
As a novel internal fixation for femoral neck fractures, the femoral neck system has some advantages for young Pauwels type III femoral neck fractures without clear biomechanical effects and mechanisms. Thus, the objection of the study is to realize the biomechanical effects and mechanism of FNS cannulated screws on treating young patients with Pauwels type III femoral neck fractures compared to cannulated screws which are commonly used for femoral neck fractures by finite element analysis.
Firstly, the model of young Pauwels type III femoral neck fractures, femoral neck system (FNS), and three cannulated screws (CS) arranged in an inverted triangle were established, and the internal fixations were set up to fix young Pauwels type III femoral neck fractures. Under 2100 N load, the finite element was performed, and the deformation, peak von Mises stress (VMS), and contact at fracture segments were recorded to analyze the biomechanical effects and mechanism of FNS and three-CS fixing young Pauwels type III femoral neck fractures.
Compared to three-CS, the deformation of the whole model, internal fixation, and fracture segments after FNS fixation were lower, and the peak VMS of the whole model and the internal fixation after FNS were higher with lower peak VMS of the distal femur and the fracture segments. With a sticking contact status, the contact pressure at fracture segments after FNS fixation was lower than that of three-CS.
FNS can provide better mechanical effects for young patients with Pauwels type III femoral neck fractures, which may be the mechanical mechanism of the clinical effects of FNS on femoral neck fracture. Although there is high stress on FNS, it is still an effective and safe internal fixation for young patients with Pauwels type III femoral neck fractures.
作为一种新型股骨颈骨折内固定物,股骨颈系统对于无明确生物力学效应和机制的年轻型Ⅲ型 Pauwels 股骨颈骨折具有一定优势。因此,本研究旨在通过有限元分析,实现 FNS 空心钉治疗年轻型Ⅲ型 Pauwels 股骨颈骨折的生物力学效应和机制,并与临床上常用的股骨颈骨折空心钉进行比较。
首先建立年轻型Ⅲ型 Pauwels 股骨颈骨折模型、股骨颈系统(FNS)和以倒三角形式排列的三根空心钉(CS),对 FNS 内固定治疗年轻型Ⅲ型 Pauwels 股骨颈骨折进行有限元分析,在 2100N 载荷下,记录模型整体、内固定物和骨折段的变形、峰值 von Mises 应力(VMS)和骨折段的接触情况,以分析 FNS 和三根 CS 固定年轻型Ⅲ型 Pauwels 股骨颈骨折的生物力学效应和机制。
与三根 CS 相比,FNS 固定后模型整体、内固定物和骨折段的变形更小,模型整体和内固定物的峰值 VMS 更高,而股骨远端和骨折段的峰值 VMS 更低。FNS 固定后骨折段的接触压力呈粘着接触状态,低于三根 CS。
FNS 可为年轻型Ⅲ型 Pauwels 股骨颈骨折患者提供更好的力学效果,这可能是 FNS 治疗股骨颈骨折临床效果的力学机制。尽管 FNS 上存在高应力,但对于年轻型Ⅲ型 Pauwels 股骨颈骨折患者,它仍然是一种有效且安全的内固定方法。