Roles of a nonvascularized fibular graft with and without fixation in the treatment of segmental tibial bone loss: A finite element analysis

IF 2 3区医学 Q3 CRITICAL CARE MEDICINE

Injury-International Journal of the Care of the Injured Pub Date : 2025-09-15 DOI:10.1016/j.injury.2025.112764

Surasak Jitprapaikulsarn , Nattapon Chantarapanich , Theerachai Apivatthakakul , Chantawat Ruchawapol , Arthit Gromprasit , Pasit Sengpanich , Chantas Mahaisavariya , Ravisara Sukhan

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引用次数: 0

Abstract

Background

A nonvascularized fibular graft (NVFG) is considered to be an alternative option in managing segmental bone loss of the tibia. Nevertheless, there has been no consensus on optimal graft position and graft fixation technique. The purposes of the present study were to mechanically test the influences of various NVFG fixation techniques on the overall stability of the fixation construct by use of finite element analysis.

Methods

Seven FE models of tibias with segmental bone loss stabilized with various fixation techniques were developed including medial and lateral plate-screw, medial and lateral plate-screw with a NVGF on the opposite cortex, medial and lateral plate-screw with an additional locking screw inserting into a NVGF, and intramedullary nail. Single-legged loading with 388 N applying on the tibial plateau was under consideration.

Results

A NVGF placed on opposite cortex to the plate played an important role in withstanding bending moment which could reduce implant stress. An additional locking screw inserted into the NVGF helped to keep the NVGF in position and was essential for maintaining fracture gap width.

Conclusion

A NVFG with locking screw fixation could be an effective modality in managing segmental bone loss of the tibia. A construct of lateral LCP with a NVFG stabilized by a locking screw was mechanically superior to the others.

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带和不带固定的非血管化腓骨移植物在治疗节段性胫骨骨丢失中的作用：有限元分析

背景：非血管化腓骨移植物（NVFG）被认为是治疗胫骨节段性骨丢失的另一种选择。然而，对于最佳植骨位置和植骨固定技术尚无共识。本研究的目的是通过有限元分析来机械测试各种NVFG固定技术对固定结构整体稳定性的影响。方法采用不同的固定技术，建立了7种稳定的胫骨节段性骨丢失的有限元模型，包括内外侧钢板螺钉、内外侧钢板螺钉与对侧皮质内固定NVGF、内外侧钢板螺钉与附加锁定螺钉插入NVGF和髓内钉。在胫骨平台上施加388 N的单腿负荷正在考虑之中。结果将sa NVGF置于与钢板相对的皮质层上，具有显著的抗弯矩作用，可降低种植体应力。额外的锁定螺钉插入NVGF有助于保持NVGF的位置，对于保持裂缝间隙宽度至关重要。结论NVFG联合锁定螺钉固定是治疗胫骨节段性骨丢失的有效方法。用锁定螺钉稳定NVFG的外侧LCP结构在机械上优于其他结构。

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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来源期刊

Injury-International Journal of the Care of the Injured 医学-急救医学

CiteScore

4.00

自引率

8.00%

发文量

699

审稿时长

96 days

期刊介绍： Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery. Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team.