Comparison of oblique triangular configuration and inverted equilateral triangular configuration of three cannulated screws in treating unstable femoral neck fracture: A finite element analysis

Zhang，Ru Yi1; Li，Jian Tao2,3; Zhao，Jing Xin2,3; Zhao，Zhe4; Zhang，Li Cheng2,3; Yun，Cai1; Su，Xiu Yun5; Tang，Pei Fu2,3

2021

10.1016/j.injury.2021.10.029

INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED   影响因子和分区

0020-1383

1879-0267

Background: The cross-sectional area of three parallel screws might affect the stability of the internal fixation of femoral neck fractures. The screws fixed in the oblique-triangle configuration (OTC) were assumed to have a larger cross-sectional area, but the biomechanical stability has not yet been validated. In this study, finite element analyses were performed to compare the biomechanical properties of the internal fixation fixed by the OTC and the traditional Inverted Equilateral Triangle Configuration (IETC). Method: Pauwels type III fracture was established on the three-dimensional femoral model and three cannulated screws with the OTC and traditional IETC methods were applied. The oblique-triangle configuration with the largest area inscribed the femoral neck isthmus by the three screws was determined, the area and circumference of the cross-section formed by the OTC and IETC model were compared. Stress, strain, and displacement peaks of the two configuration models under different loads were compared. Twelve pairs of nodes on the fracture ends were selected and the displacement of the fracture ends was evaluated through the displacement between these nodes. Results: The area and circumference of the cross-section formed by the OTC were larger than those in the IETC model. The degree of stress dispersion around the screw holes in the OTC model was better than that of the IETC, but the stress distribution order of the three screws in the two models was consistent. The maximum stress, strain, displacement, and displacement of the fracture end in the OTC model were smaller than those in the IETC model. The stress, strain, displacement, and fracture end displacement peaks of the two fixed models gradually increase with the increase of loads. Conclusion: The oblique-triangle configuration showed superior mechanical properties than the IETC in finite element analyses. This study suggests that when three screws are fixed in parallel method, the larger the cross-sectional area of the screw configuration, the better stability of the internal fixation might be obtained. Furthermore, the biomechanical properties of various spatial configurations and screw holes of the three parallel screws need to be considered before clinical practice.

Femoral neck fracture Finite element analysis Oblique triangle Screw Spatial configuration

SCI

英语

其他

General & Internal Medicine ; Emergency Medicine ; Orthopedics ; Surgery

Critical Care Medicine ; Emergency Medicine ; Orthopedics ; Surgery

WOS:000749798400020

ELSEVIER SCI LTD

CLINICAL MEDICINE

2-s2.0-85119999133

Scopus

1.Department of Orthopaedics,Shijingshan Teaching Hospital of Capital Medical University,Beijing Shijingshan Hospital,Beijing,No. 24, Shijingshan Road,100043,China
2.The Faculty of Orthopaedics,The Fourth Medical Center,Chinese PLA General Hospital,Beijing,China
3.National Clinical Research Center for Orthopaedics,Sports Medicine & Rehabilitation,Beijing,100853,China
4.Department of Orthopaedics,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing,102218,China
5.Department of Orthopaedics,Southern University of Science and Technology Hospital,Shenzhen,518055,China

Zhang，Ru Yi,Li，Jian Tao,Zhao，Jing Xin,et al. Comparison of oblique triangular configuration and inverted equilateral triangular configuration of three cannulated screws in treating unstable femoral neck fracture: A finite element analysis[J]. INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED,2021,53(2).

Zhang，Ru Yi.,Li，Jian Tao.,Zhao，Jing Xin.,Zhao，Zhe.,Zhang，Li Cheng.,...&Tang，Pei Fu.(2021).Comparison of oblique triangular configuration and inverted equilateral triangular configuration of three cannulated screws in treating unstable femoral neck fracture: A finite element analysis.INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED,53(2).

Zhang，Ru Yi,et al."Comparison of oblique triangular configuration and inverted equilateral triangular configuration of three cannulated screws in treating unstable femoral neck fracture: A finite element analysis".INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED 53.2(2021).