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A quantitative biomechanical study of positive buttress techniques for femoral neck fractures: a finite element analysis

BACKGROUND: Refractory femoral neck fractures cannot be anatomically reduced by closed traction reduction which may affect fracture healing. We evaluated the biomechanical effects of positive, negative, and anatomic reduction of various degrees of displacement in Pauwels I femoral neck fractures by...

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Autores principales: Wang, Gang, Wang, Bin, Tang, Yong, Yang, Hui-Lin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6846255/
https://www.ncbi.nlm.nih.gov/pubmed/31658158
http://dx.doi.org/10.1097/CM9.0000000000000490
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author Wang, Gang
Wang, Bin
Tang, Yong
Yang, Hui-Lin
author_facet Wang, Gang
Wang, Bin
Tang, Yong
Yang, Hui-Lin
author_sort Wang, Gang
collection PubMed
description BACKGROUND: Refractory femoral neck fractures cannot be anatomically reduced by closed traction reduction which may affect fracture healing. We evaluated the biomechanical effects of positive, negative, and anatomic reduction of various degrees of displacement in Pauwels I femoral neck fractures by a finite element analysis. METHODS: Five reduction models of Pauwels type I femoral neck fracture were established using the Mimics 17.0 (Materialize, Leuven, Belgia) and Hypermesh 12.0 (Altair Engineering, Troy, MI, USA). According to the degree of fracture displacement, there were three models of positive support, an anatomic reduction model, and a negative 2 mm reduction model. Finite element analysis was conducted using the ABAQUS 6.9 software (Simulia, Suresnes, France). The von Mises stress distribution and the stress peak of internal fixation in different models, the displacement between fracture blocks, and the principal strain of the femoral neck cancellous bone model were recorded under the axial stress of 2100 N. RESULTS: The peak von Mises stress on screw of each model was located at the thread of the screw tip. The peak von Mises stress was the lowest at the tip of the anatomic reduction model screw (261.2 MPa). In the positive 4 mm model, the von Mises stress peak was the highest (916.1 MPa). The anatomic reduction model showed the minimum displacement (0.388 mm) between fracture blocks. The maximum displacement was noted in the positive 4 mm model (0.838 mm). The displacement in the positive 3 mm model (0.721 mm) was smaller than that in the negative 2 mm model (0.786 mm). Among the five models, the strain area of the femoral neck cancellous bone was mainly concentrated around the screw hole, and the area around the screw hole could be easily cut. CONCLUSIONS: Compared with negative buttress for femoral neck fracture, positive buttress can provide better biomechanical stability. In Pauwel type I fracture of femoral neck, the range of positive buttress should be controlled below 3 mm as far as possible.
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spelling pubmed-68462552019-11-26 A quantitative biomechanical study of positive buttress techniques for femoral neck fractures: a finite element analysis Wang, Gang Wang, Bin Tang, Yong Yang, Hui-Lin Chin Med J (Engl) Original Articles BACKGROUND: Refractory femoral neck fractures cannot be anatomically reduced by closed traction reduction which may affect fracture healing. We evaluated the biomechanical effects of positive, negative, and anatomic reduction of various degrees of displacement in Pauwels I femoral neck fractures by a finite element analysis. METHODS: Five reduction models of Pauwels type I femoral neck fracture were established using the Mimics 17.0 (Materialize, Leuven, Belgia) and Hypermesh 12.0 (Altair Engineering, Troy, MI, USA). According to the degree of fracture displacement, there were three models of positive support, an anatomic reduction model, and a negative 2 mm reduction model. Finite element analysis was conducted using the ABAQUS 6.9 software (Simulia, Suresnes, France). The von Mises stress distribution and the stress peak of internal fixation in different models, the displacement between fracture blocks, and the principal strain of the femoral neck cancellous bone model were recorded under the axial stress of 2100 N. RESULTS: The peak von Mises stress on screw of each model was located at the thread of the screw tip. The peak von Mises stress was the lowest at the tip of the anatomic reduction model screw (261.2 MPa). In the positive 4 mm model, the von Mises stress peak was the highest (916.1 MPa). The anatomic reduction model showed the minimum displacement (0.388 mm) between fracture blocks. The maximum displacement was noted in the positive 4 mm model (0.838 mm). The displacement in the positive 3 mm model (0.721 mm) was smaller than that in the negative 2 mm model (0.786 mm). Among the five models, the strain area of the femoral neck cancellous bone was mainly concentrated around the screw hole, and the area around the screw hole could be easily cut. CONCLUSIONS: Compared with negative buttress for femoral neck fracture, positive buttress can provide better biomechanical stability. In Pauwel type I fracture of femoral neck, the range of positive buttress should be controlled below 3 mm as far as possible. Wolters Kluwer Health 2019-11-05 2019-11-05 /pmc/articles/PMC6846255/ /pubmed/31658158 http://dx.doi.org/10.1097/CM9.0000000000000490 Text en Copyright © 2019 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Original Articles
Wang, Gang
Wang, Bin
Tang, Yong
Yang, Hui-Lin
A quantitative biomechanical study of positive buttress techniques for femoral neck fractures: a finite element analysis
title A quantitative biomechanical study of positive buttress techniques for femoral neck fractures: a finite element analysis
title_full A quantitative biomechanical study of positive buttress techniques for femoral neck fractures: a finite element analysis
title_fullStr A quantitative biomechanical study of positive buttress techniques for femoral neck fractures: a finite element analysis
title_full_unstemmed A quantitative biomechanical study of positive buttress techniques for femoral neck fractures: a finite element analysis
title_short A quantitative biomechanical study of positive buttress techniques for femoral neck fractures: a finite element analysis
title_sort quantitative biomechanical study of positive buttress techniques for femoral neck fractures: a finite element analysis
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6846255/
https://www.ncbi.nlm.nih.gov/pubmed/31658158
http://dx.doi.org/10.1097/CM9.0000000000000490
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