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改良型股骨近端髓内钉治疗反斜型股骨转子间骨折的生物力学评估

Biomechanical evaluation of the modified proximal femoral nail for the treatment of reverse obliquity intertrochanteric fractures.

作者信息

Wang Qian, Sun Liang, Liu Lu, Ma Teng, Li Zhong, Zhang Kun, Huang Qiang

机构信息

Department of Orthopedics, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China.

出版信息

Sci Rep. 2025 Jan 25;15(1):3261. doi: 10.1038/s41598-025-87951-3.

Abstract

The best treatment method for reverse obliquity intertrochanteric fractures (ROIFs) is still under debate. Our team designed the modified proximal femoral nail (MPFN) specially for treating such fractures. The objective of this research was to introduce the MPFN device and compare the biomechanical properties with Proximal Femoral Nail Antirotation (PFNA) and InterTAN nail via finite element modelling. An AO/OTA 31-A3.1 ROIF model was established via Mimics software. Three implants were depicted and assembled on the ROIF models. The axial, bending, and torsion loads were simulated to test stress and displacement of three fixation models. Compared to the PFNA and InterTAN models, the MPFN model had more dispersed stress distribution under axial loads of 2,100 N. The MPFN showed lower von Mises stress on bones compared with that of PFNA and InterTAN in axial loads. In term of maximum displacement, the MPFN had a 12.6% reduction compared to the PFNA model in axial load case. In bending and torsion loads, the MPFN model also demonstrated better biomechanical properties than the PFNA and InterTAN models. The modified proximal femoral nail presented the best biomechanical performance, followed by the InterTAN nail, and the PFNA for fixing reverse obliquity intertrochanteric fractures. The MPFN has the potential to be a promising device for patients with ROIFs.

摘要

反向斜行转子间骨折(ROIFs)的最佳治疗方法仍存在争议。我们的团队专门设计了改良型股骨近端髓内钉(MPFN)来治疗此类骨折。本研究的目的是介绍MPFN装置,并通过有限元建模将其生物力学性能与股骨近端抗旋髓内钉(PFNA)和InterTAN髓内钉进行比较。通过Mimics软件建立了AO/OTA 31-A3.1 ROIF模型。在ROIF模型上描绘并组装了三种植入物。模拟轴向、弯曲和扭转载荷,以测试三种固定模型的应力和位移。与PFNA和InterTAN模型相比,在2100 N轴向载荷下,MPFN模型的应力分布更分散。在轴向载荷下,MPFN在骨头上的von Mises应力低于PFNA和InterTAN。在最大位移方面,在轴向载荷情况下,MPFN与PFNA模型相比减少了12.6%。在弯曲和扭转载荷下,MPFN模型的生物力学性能也优于PFNA和InterTAN模型。改良型股骨近端髓内钉在固定反向斜行转子间骨折方面表现出最佳的生物力学性能,其次是InterTAN髓内钉,PFNA最差。MPFN有可能成为治疗ROIFs患者的一种有前景的装置。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd67/11763255/d0fa6a0162b4/41598_2025_87951_Fig1_HTML.jpg

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