Finite element analysis of a novel anatomical plate in posterolateral plateau fractures.

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Abstract

Conflict of interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. 4. Injury. 2024 Jun;55(6):111512. doi: 10.1016/j.injury.2024.111512. Epub 2024 Mar 20. Comparative biomechanical analysis of reconstruction and cephalomedullary nails in the treatment of osteoporotic subtrochanteric fractures. Yoon YC(1), Kim JW(2), Kim TK(2), Oh CW(3), Park KH(4), Lee JH(2). Author information: (1)Orthopedic Trauma Division, Trauma Center, College of Medicine, Gachon University, Incheon, Republic of Korea. (2)Department of Orthopedic Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea. (3)Department of Orthopedic Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea; Joint Institute for Regenerative Medicine, Kyungpook National University, Bio-Medical Research Institute, Kyungpook National University Hospital, Daegu, Republic of Korea. Electronic address: cwoh@knu.ac.kr. (4)Department of Orthopedic Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. INTRODUCTION: This study aimed to compare the biomechanical properties of two types of intramedullary nails - reconstruction nails (RCN) and cephalomedullary nails (CMN) - each with different proximal fixations, in a model of an osteoporotic subtrochanteric femoral fracture. This study focused on assessing stiffness and load to failure of RCN and CMN nails to provide insight into their clinical applications in osteoporotic fracture treatments. MATERIALS AND METHODS: Ten synthetic osteoporotic femoral models were used to generate a comminuted subtrochanteric fracture model. Five femurs were fixed using an RCN, and the remaining five were fixed using a CMN. The constructs were subjected to axial compression to measure their structural stiffness, load to failure, and failure modes. RESULTS: The CMN group demonstrated a slightly higher load to failure (mean, 2250 N) than the RCN group (mean, 2100 N), which was statistically significant (p = 0.008). However, the stiffness in both groups was statistically similar (RCN, 250 N/mm; CMN, 255 N/mm; p = 0.69). Both groups showed a load to failure exceeding 1500 N, a typically exerted load on the femoral head by a 75 kg individual. The failure patterns differed, with CMN failures starting at the nail insertion area and RCN failures starting at the reconstruction screw area. CONCLUSION: The RCN offers stiffness comparable to that of the CMN; although its load to failure is slightly lower than that of the CMN, it still exceeds the physiological tolerance limit. These findings suggest that the RCN is a viable alternative for treating osteoporotic subtrochanteric fractures. Copyright © 2024 Elsevier Ltd. All rights reserved. DOI: 10.1016/j.injury.2024.111512