{"title":"一种治疗AO/OTA 31-A3.3粗隆间骨折的新型钉钢板结构：有限元分析","authors":"Jixing Fan, Yuan Cao, Zengzhen Cui, Shan Gao, Yang Lv, Fang Zhou","doi":"10.3389/fbioe.2025.1559765","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The AO/OTA 31-A3.3 is the most unstable type with a lesser trochanteric fragment and a broken lateral femoral wall (LFW), which constitute a four-part unstable intertrochanteric fracture. Implant failure remains one of the catastrophic consequences after surgical treatment. A novel nail-plate construct, called proximal femoral universal nail system (PFUN), is proposed by our team to fix comminuted LFW fracture fragment and lesser trochanteric fragment. The aim of this study is to evaluate the biomechanical properties of PFUN compared with proximal femoral nails anti-rotation (PFNA) for the treatment of AO/OTA 31-A3.3 intertrochanteric fractures.</p><p><strong>Methods: </strong>An AO/OTA 31-A3.3 intertrochanteric fracture model was established by computed tomography images. The models of implant (PFUN and PFNA) were created and virtually inserted into the A3.3 fracture model. The von Mises stress on the proximal femur, fracture end, implant and the total displacement of the device components were evaluated and compared for both PFUN and PFNA models.</p><p><strong>Results: </strong>The maximum von Mises stress in the proximal femur of the PFNA model increased by 85.81% when compared with the PFUN model in A 3.3 intertrochanteric fractures. The peak von Mises stress was located at the medial-inferior part of the fracture ends in the PFUN and PFNA models and the maximum von Mises stress in the PFUN model and PFNA model was 27.27 MPa and 49.95MPa, respectively. The PFUN model and PFNA model had similar peak von Mises stress in the implant. Furthermore, the maximum displacement in the PFUN model was much smaller than that in the PFNA model.</p><p><strong>Conclusion: </strong>The PFUN exhibited a lower peak von Mises stress in the proximal femur and fracture end, and a smaller maximum model displacement than PFNA in A3.3 intertrochanteric fractures. Our findings might provide valuable references for clinical decision making in surgical treatment of complex intertrochanteric fractures.</p>","PeriodicalId":12444,"journal":{"name":"Frontiers in Bioengineering and Biotechnology","volume":"13 ","pages":"1559765"},"PeriodicalIF":4.3000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133827/pdf/","citationCount":"0","resultStr":"{\"title\":\"A novel nail-plate construct for the treatment of AO/OTA 31-A3.3 intertrochanteric fractures: a finite element analysis.\",\"authors\":\"Jixing Fan, Yuan Cao, Zengzhen Cui, Shan Gao, Yang Lv, Fang Zhou\",\"doi\":\"10.3389/fbioe.2025.1559765\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The AO/OTA 31-A3.3 is the most unstable type with a lesser trochanteric fragment and a broken lateral femoral wall (LFW), which constitute a four-part unstable intertrochanteric fracture. Implant failure remains one of the catastrophic consequences after surgical treatment. A novel nail-plate construct, called proximal femoral universal nail system (PFUN), is proposed by our team to fix comminuted LFW fracture fragment and lesser trochanteric fragment. The aim of this study is to evaluate the biomechanical properties of PFUN compared with proximal femoral nails anti-rotation (PFNA) for the treatment of AO/OTA 31-A3.3 intertrochanteric fractures.</p><p><strong>Methods: </strong>An AO/OTA 31-A3.3 intertrochanteric fracture model was established by computed tomography images. The models of implant (PFUN and PFNA) were created and virtually inserted into the A3.3 fracture model. The von Mises stress on the proximal femur, fracture end, implant and the total displacement of the device components were evaluated and compared for both PFUN and PFNA models.</p><p><strong>Results: </strong>The maximum von Mises stress in the proximal femur of the PFNA model increased by 85.81% when compared with the PFUN model in A 3.3 intertrochanteric fractures. The peak von Mises stress was located at the medial-inferior part of the fracture ends in the PFUN and PFNA models and the maximum von Mises stress in the PFUN model and PFNA model was 27.27 MPa and 49.95MPa, respectively. The PFUN model and PFNA model had similar peak von Mises stress in the implant. Furthermore, the maximum displacement in the PFUN model was much smaller than that in the PFNA model.</p><p><strong>Conclusion: </strong>The PFUN exhibited a lower peak von Mises stress in the proximal femur and fracture end, and a smaller maximum model displacement than PFNA in A3.3 intertrochanteric fractures. Our findings might provide valuable references for clinical decision making in surgical treatment of complex intertrochanteric fractures.</p>\",\"PeriodicalId\":12444,\"journal\":{\"name\":\"Frontiers in Bioengineering and Biotechnology\",\"volume\":\"13 \",\"pages\":\"1559765\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2025-05-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133827/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Bioengineering and Biotechnology\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.3389/fbioe.2025.1559765\",\"RegionNum\":3,\"RegionCategory\":\"工程技术\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"BIOTECHNOLOGY & APPLIED MICROBIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Bioengineering and Biotechnology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.3389/fbioe.2025.1559765","RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"BIOTECHNOLOGY & APPLIED MICROBIOLOGY","Score":null,"Total":0}
A novel nail-plate construct for the treatment of AO/OTA 31-A3.3 intertrochanteric fractures: a finite element analysis.
Background: The AO/OTA 31-A3.3 is the most unstable type with a lesser trochanteric fragment and a broken lateral femoral wall (LFW), which constitute a four-part unstable intertrochanteric fracture. Implant failure remains one of the catastrophic consequences after surgical treatment. A novel nail-plate construct, called proximal femoral universal nail system (PFUN), is proposed by our team to fix comminuted LFW fracture fragment and lesser trochanteric fragment. The aim of this study is to evaluate the biomechanical properties of PFUN compared with proximal femoral nails anti-rotation (PFNA) for the treatment of AO/OTA 31-A3.3 intertrochanteric fractures.
Methods: An AO/OTA 31-A3.3 intertrochanteric fracture model was established by computed tomography images. The models of implant (PFUN and PFNA) were created and virtually inserted into the A3.3 fracture model. The von Mises stress on the proximal femur, fracture end, implant and the total displacement of the device components were evaluated and compared for both PFUN and PFNA models.
Results: The maximum von Mises stress in the proximal femur of the PFNA model increased by 85.81% when compared with the PFUN model in A 3.3 intertrochanteric fractures. The peak von Mises stress was located at the medial-inferior part of the fracture ends in the PFUN and PFNA models and the maximum von Mises stress in the PFUN model and PFNA model was 27.27 MPa and 49.95MPa, respectively. The PFUN model and PFNA model had similar peak von Mises stress in the implant. Furthermore, the maximum displacement in the PFUN model was much smaller than that in the PFNA model.
Conclusion: The PFUN exhibited a lower peak von Mises stress in the proximal femur and fracture end, and a smaller maximum model displacement than PFNA in A3.3 intertrochanteric fractures. Our findings might provide valuable references for clinical decision making in surgical treatment of complex intertrochanteric fractures.
期刊介绍：
The translation of new discoveries in medicine to clinical routine has never been easy. During the second half of the last century, thanks to the progress in chemistry, biochemistry and pharmacology, we have seen the development and the application of a large number of drugs and devices aimed at the treatment of symptoms, blocking unwanted pathways and, in the case of infectious diseases, fighting the micro-organisms responsible. However, we are facing, today, a dramatic change in the therapeutic approach to pathologies and diseases. Indeed, the challenge of the present and the next decade is to fully restore the physiological status of the diseased organism and to completely regenerate tissue and organs when they are so seriously affected that treatments cannot be limited to the repression of symptoms or to the repair of damage. This is being made possible thanks to the major developments made in basic cell and molecular biology, including stem cell science, growth factor delivery, gene isolation and transfection, the advances in bioengineering and nanotechnology, including development of new biomaterials, biofabrication technologies and use of bioreactors, and the big improvements in diagnostic tools and imaging of cells, tissues and organs.
In today`s world, an enhancement of communication between multidisciplinary experts, together with the promotion of joint projects and close collaborations among scientists, engineers, industry people, regulatory agencies and physicians are absolute requirements for the success of any attempt to develop and clinically apply a new biological therapy or an innovative device involving the collective use of biomaterials, cells and/or bioactive molecules. “Frontiers in Bioengineering and Biotechnology” aspires to be a forum for all people involved in the process by bridging the gap too often existing between a discovery in the basic sciences and its clinical application.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
