Biomechanical Stability of Femoral Neck System for Pauwels Type III Femoral Neck Fractures Based on Different Reduction Quality.

Daoqiang Huang, Xiaoping Wang, Bingze Chen, Zhiqiang Hu, Weili Feng
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Abstract

To further investigate the biomechanics of a femoral neck system (FNS) for Pauwels type III femoral fractures based on three different reductions.We constructed three different reduction (anatomical reduction, negative buttress reduction, and positive buttress reduction) models of Pauwels type III femoral neck fractures. Then, three cannulated screws (3CS), dynamic hip screws (DHS), dynamic hip screws combined with an anti-rotation screw (DHS + ARS), one-hole femoral neck system (1HFNS), and two-hole femoral neck system (2HFNS) were assembled with the reduction models, respectively, to simulate the internal fixation surgical procedure. All models had a load of 2100 N in line with the femoral mechanical axis applied. The implant stress, the head and implant displacements, and the rotational angles of all models were recorded and analyzed.Compared to 3CS and 2HFNS, 1HFNS had higher implant stress (higher than 92.5 MPa and 46.3 MPa, respectively) and displacement (higher than 0.9 mm and 0.8 mm, respectively) in the anatomical reduction. 2HFNS exhibited the highest stress values (225.5 MPa) in the anatomical reduction but the lowest values (159.8 MPa) in the positive buttress reduction when compared to the other implants. 2HFNS showed the best rotational stability in the negative and positive buttress reduction (rotational angels of 0.8° and 0.6°, respectively).Based on the outcome of this computational study, it might be concluded that 2HFNS was an alternative fixation for the treatment of Pauwels type III femoral neck fracture, especially when anatomical reduction cannot be perfectly attained. More relevant clinical and biomechanical studies are needed in the future.

基于不同截骨质量的 Pauwels III 型股骨颈骨折股骨颈系统的生物力学稳定性
我们对Pauwels III型股骨颈骨折构建了三种不同的复位模型(解剖复位、负托复位和正托复位)。然后,分别将三枚套管螺钉(3CS)、动态髋螺钉(DHS)、动态髋螺钉与抗旋转螺钉(DHS + ARS)、单孔股骨颈系统(1HFNS)和双孔股骨颈系统(2HFNS)与复位模型组装在一起,模拟内固定手术过程。所有模型都施加了与股骨机械轴线一致的 2100 N 负荷。与 3CS 和 2HFNS 相比,1HFNS 在解剖复位时的植入应力(分别高于 92.5 MPa 和 46.3 MPa)和位移(分别高于 0.9 mm 和 0.8 mm)更大。与其他种植体相比,2HFNS 在解剖缩小中的应力值最高(225.5 兆帕),但在正托缩小中的应力值最低(159.8 兆帕)。根据这项计算研究的结果,我们可以得出结论,2HFNS 是治疗 Pauwels III 型股骨颈骨折的替代固定物,尤其是在无法完美实现解剖复位的情况下。未来还需要进行更多相关的临床和生物力学研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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