Finite element comparison of retrograde intramedullary nailing and locking plate fixation with/without an intramedullary allograft for distal femur fracture following total knee arthroplasty

Chen, Shih Hao; Chiang, Ming Chieh; Hung, Ching-Hua; Lin, Shu; Chang, Hsiao Wei

doi:10.1016/j.knee.2013.03.006

Cited by 57 publications

(34 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This criterion was widely adopted for biomechanical analysis (Chen et al, 2014;Liang et al, 2011;Ni et al, 2015;Niu et al, 2014;Tupis et al, 2012). Our simulation showed that the maximum stress exerted on the metallic and absorbable screws was less than the bending strength and shear strength of titanium and PLLA (Chen et al, 2014;Fu et al, 2013;van Dijk et al, 2002). All fixations that we studied were sufficiently stable for treating calcaneal fracture and patients who have these fixations should be encouraged to begin early rehabilitation after surgery.…”

Section: Discussionmentioning

confidence: 74%

“…Tetrahedral C3D4 elements were used to mesh the model. The calcaneus and the implants were assumed isotropic and linear elastic materials and their material properties, determined in previous reports (Ni et al, 2015;Chen et al, 2014;Moon et al, 2005), are listed in Table 2.…”

Section: Finite-element Modelingmentioning

confidence: 99%

“…For LPF, we modeled a lateral anatomical locking plate with screws modeled as 3.5-mm-diameter cylinders. The position and placement of the plate were based on the Arbeitsgemeinschaft für Osteosynthesefragen (AO) technique and clinical experience, with a long screw inserted into the sustentaculum tali Table 2 Material properties of cortical and cancellous bone and implants (Ni et al, 2015;Chen et al, 2014;Moon et al, 2005) from the lateral side ( Figure 4A). For MSF and PLLA screw fixation, two 7.3-mm-diameter longitudinal screws were inserted from the posteroinferior calcaneal tuberosity into the calcaneal cuboid joint, and two 3.5-mm-diameter transverse screws were inserted from the lateral side beneath the posterior facet into the sustentaculum tali ( Figure 4B).…”

Section: Surgery Simulationmentioning

confidence: 99%

See 2 more Smart Citations

Biomechanical comparison of locking plate and crossing metallic and absorbable screws fixations for intra-articular calcaneal fractures

Wong

Mei

et al. 2016

Sci. China Life Sci.

View full text Add to dashboard Cite

The locking plate and percutaneous crossing metallic screws and crossing absorbable screws have been used clinically to treat intra-articular calcaneal fractures, but little is known about the biomechanical differences between them. This study compared the biomechanical stability of calcaneal fractures fixed using a locking plate and crossing screws. Three-dimensional finite-element models of intact and fractured calcanei were developed based on the CT images of a cadaveric sample. Surgeries were simulated on models of Sanders type III calcaneal fractures to produce accurate postoperative models fixed by the three implants. A vertical force was applied to the superior surface of the subtalar joint to simulate the stance phase of a walking gait. This model was validated by an in vitro experiment using the same calcaneal sample. The intact calcaneus showed greater stiffness than the fixation models. Of the three fixations, the locking plate produced the greatest stiffness and the highest von Mises stress peak. The micromotion of the fracture fixated with the locking plate was similar to that of the fracture fixated with the metallic screws but smaller than that fixated with the absorbable screws. Fixation with both plate and crossing screws can be used to treat intra-articular calcaneal fractures. In general, fixation with crossing metallic screws is preferable because it provides sufficient stability with less stress shielding.

show abstract

Section: Discussionmentioning

confidence: 74%

Section: Finite-element Modelingmentioning

confidence: 99%

Section: Surgery Simulationmentioning

confidence: 99%

See 1 more Smart Citation

Biomechanical comparison of locking plate and crossing metallic and absorbable screws fixations for intra-articular calcaneal fractures

Wong

Mei

et al. 2016

Sci. China Life Sci.

View full text Add to dashboard Cite

show abstract

“…Fifth, although the shape and thickness of osteoporotic bone are very different to those of normal bone, we created the osteoporotic model only by changing the elastic modulus of the tissue, not by adjusting the shape or thickness. This is similar to the method used in previous research [23–25], and this method can still provide much information related to osteoporotic bone. Sixth, this study only evaluated early postoperative stability, without determining long-term biomechanical stabilization.…”

Section: Discussionmentioning

confidence: 52%

Biomechanical evaluation of a novel dualplate fixation method for proximal humeral fractures without medial support

Zhang

Wang

et al. 2017

J Orthop Surg Res

View full text Add to dashboard Cite

BackgroundComminuted fractures of the proximal humerus are generally treated with the locking plate system, and clinical results are satisfactory. However, unstable support of the medial column results in varus malunion and screw perforation. We designed a novel medial anatomical locking plate (MLP) to directly support the medial column. Theoretically, the combined application of locking plate and MLP (LPMP) would directly provide strong dual-column stability. We hypothesized that the LPMP could provide greater construct stability than the locking plate alone (LP), locking plate combined with a fibular graft (LPSG), and locking plate combined with a distal radius plate (LPDP).MethodsLP, LPMP, LPSG, and LPDP implants were instrumented into the finite element model of a proximal humeral fracture. Axial, shear, and rotational loads were applied to the models under normal and osteoporotic bone conditions. The whole simulation was repeated five times for each fixator. To assess the biomechanical characteristics, the construct stiffness, fracture micromotion, stress distribution, and neck-shaft angle (NSA) were compared.ResultsThe LPMP group showed significantly greater integral and regional construct stiffness, and endured less von Mises stresses, than the other three fixation methods. The stresses on the lateral locking plate were dispersed by the MLP. The LPMP group showed the least change in NSA.ConclusionsFrom the finite element viewpoint, the LPMP method provided both lateral and medial direct support. The LPMP system was effective in treating proximal humeral fracture with an unstable medial column.

show abstract

“…However the main challenges with this technique is the knee pain and union which take longer time as compared to mid shaft fractures. 8 Knee pain with this technique is common because of the reaming, surgical dissection and fracture in distal half. Younger age appeared to be a risk factor for knee pain.…”

Section: Introductionmentioning

confidence: 99%

Retrograde Femur Nail

Shafiq

Akram

Ahmed

et al. 2018

TPMJ

View full text Add to dashboard Cite

ABSTRACT… Background:Retrograde nailing for fracture of distal shaft of femur is common procedure but data about post-operative functional outcome in terms of knee range of motion, union and pain at 6 weeks, 6 months and 1 year follow-up is lacking. Objectives: The main aim of this study was to determine post-operative functional outcome after performing nailing in a retrograde fashion for distal disphyseal femoral fracture in terms of knee range of motion, pain and union at 6 weeks, 6 months and at least 1 year follow-up. Study Design: Descriptive case series. Setting: Orthopedics and Spine Centre, Ghurki Trust Hospital Lahore, Pakistan. Period: 1 st July 2015 to Dec. 2016. Materials and Methodology: 140 patients of either sex and age with fractures of distal disphyseal femoral fracture and were operated using retrograde nailing were included in the study. All the data were analyzed using SPSS 17.0 version. Results: 140 patients were included with mean age of 31.81± 7.117 ranged from 16 to 75 years of age.97 patients (69.3%) were male and remaining 43 patients (30.7%) were female. Pain was significantly decrease in all patients on Visual analogue scale. Mean union were 32.3 ± 5.3 weeks, Knee range of motion after last follow up were more than 120 0 in 126 patients. Conclusion: Retrograde Nailing for distal diaphyseal fractures is an excellent option with good functional outcome. It should always be considered while managing such fractures. Key words:Fractures, Distal Diaphyseal Femur, Retrograde Nail, Functional Outcome, Range of Motion.

show abstract

Finite element comparison of retrograde intramedullary nailing and locking plate fixation with/without an intramedullary allograft for distal femur fracture following total knee arthroplasty

Cited by 57 publications

References 37 publications

Biomechanical comparison of locking plate and crossing metallic and absorbable screws fixations for intra-articular calcaneal fractures

Biomechanical comparison of locking plate and crossing metallic and absorbable screws fixations for intra-articular calcaneal fractures

Biomechanical evaluation of a novel dualplate fixation method for proximal humeral fractures without medial support

Retrograde Femur Nail

Contact Info

Product

Resources

About