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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2024 | Femoral Fracture | Research article

Finite element analysis of the effect of residual lateral wall volume on postoperative stability in intertrochanteric fractures

Authors: Yachun Zhang, Enzhe Zhao, Jian Zhu, Dou Wu, Yujie Fu, Xingyu Zhang, Xiaolun Zhang, Xubin Song

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2024

Abstract

Background

Lateral wall fractures represent crucial risk factors for postoperative internal fixation failure in intertrochanteric femoral fractures. However, no consensus exists on the type of lateral wall fracture requiring interventional management. This study aimed to investigate the effect of residual lateral wall volume on the postoperative stability of intertrochanteric femur fractures with associated lateral wall fractures, providing valuable reference for the clinical management of the lateral wall.

Methods

Eleven bone defect models of intertrochanteric femur fractures with varying residual lateral wall volumes were constructed using finite element analysis. These models were fixed with proximal femoral nail antirotation (PFNA). Simulations of von Mises stress and displacement distribution of the PFNA and femur during normal walking were conducted. Statistical analysis was performed to assess the correlation between volume and the maximum von Mises stresses and displacements of the PFNA and femur.

Results

In all 11 models, the maximum von Mises stress and displacement of the helical blade, intramedullary nail, and femur occurred at the same locations. As residual lateral wall volume increased, the maximum von Mises stress and displacement of the helical blade, intramedullary nail, and maximum femoral displacement gradually decreased. However, the overall trend of the maximum femoral von Mises stress gradually decreased. At 70% retention of the residual lateral wall volume, there was a more pronounced change in the value of the maximum stress change of the helical blade and the intramedullary nail. Statistical analysis, including the Shapiro–Wilk test and Pearson correlation analysis, demonstrated a significant negative correlation between volume and the maximum von Mises stress and displacement of the helical blade, intramedullary nail, and femur. Linear regression analysis further confirmed this significant negative correlation.

Conclusion

Finite element analysis of the residual lateral wall revealed a significant correlation between volume and the postoperative stability of intertrochanteric femur fractures. A volume of 70% may serve as the threshold for stabilizing the residual lateral wall. Volume emerges as a novel index for evaluating the strength of the residual lateral walls.

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Title: Finite element analysis of the effect of residual lateral wall volume on postoperative stability in intertrochanteric fractures
Authors: Yachun Zhang
Enzhe Zhao
Jian Zhu
Dou Wu
Yujie Fu
Xingyu Zhang
Xiaolun Zhang
Xubin Song
Publication date: 01-12-2024
Publisher: BioMed Central
Keyword: Femoral Fracture
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2024
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-023-04501-1

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Finite element analysis of the effect of residual lateral wall volume on postoperative stability in intertrochanteric fractures

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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