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Primary Stability of Absorbable Screw Fixation for Intra-articular Calcaneal Fractures: A Finite Element Analysis

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Abstract

Absorbable implants have been widely used in bone osteosynthesis, but biomechanics of its application to calcaneal fracture fixation remains unclear. This study investigates the primary stability of absorbable screws used to fix calcaneal fractures with the finite element method. A Sanders type III calcaneal fracture was modeled according to X-ray and computed tomography images of a representative patient. Fixation with four crossing absorbable screws was simulated using a finite element software package according to clinical operation. The stance phase of gait was simulated to calculate stress and displacement distributions of the calcaneus and screws. The stress concentration of screws was located at the connections between screws and fracture surfaces. For the two transverse screws, the peak von Mises stress of the inferior screw was almost twice that of the superior one. For the two longitudinal screws, the medial screw had a 64 % larger von Mises stress than that of the lateral one. The peak displacement of the calcaneus was located on the medial fragment. No notable relative displacement was seen between different fragments. The displacements of the two transverse screws were similar, and larger than those of the longitudinal screws. The displacement of the medial longitudinal screw was slightly greater than that of the lateral one. Based on the computational stress distribution, a screw with a large diameter should be recommended to fix the anterior part of the posterior facet and the medial tuberosity of the calcaneus. Fixation with crossing absorbable screws is safe and should be recommended for Sanders type III intra-articular calcaneal fractures with good bone quality. Early ambulation and rehabilitational activities should be encouraged after operation.

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Acknowledgments

This study was supported by the Youth Science & Technology project of Shanghai Health Burean (20134Y207), and the National Science Foundation of China (NSFC 11302154).

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Authors and Affiliations

  1. Tongji Hospital, Tongji University School of Medicine, Shanghai, 201200, China

    Ming Ni & Jiong Mei

  2. Department of Orthopedics, Pudong New Area People’s Hospital, Shanghai, 200065, China

    Ming Ni

  3. Yang Zhi Rehabilitation Hospital, Tongji University School of Medicine, Shanghai, 201619, China

    Wen-Xin Niu

  4. Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China

    Xiao-Hong Weng

  5. Chinese Society of Biomedical Engineering, Beijing, 100005, China

    Xiao-Hong Weng

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  1. Ming Ni
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Correspondence to Wen-Xin Niu.

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Ni, M., Weng, XH., Mei, J. et al. Primary Stability of Absorbable Screw Fixation for Intra-articular Calcaneal Fractures: A Finite Element Analysis. J. Med. Biol. Eng. 35, 236–241 (2015). https://doi.org/10.1007/s40846-015-0019-6

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  • DOI: https://doi.org/10.1007/s40846-015-0019-6

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