Mu JX, Xiang SY, Ma QY, Gu HL. Selection of internal fixation method for femoral intertrochanteric fractures using a finite element method. World J Clin Cases 2021; 9(22): 6343-6356 [PMID: 34435000 DOI: 10.12998/wjcc.v9.i22.6343]
Corresponding Author of This Article
Hai-Lun Gu, PhD, Doctor, Department of Orthopedics, Shengjing Hospital, China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 117004, Liaoning Province, China. guhailun_@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jia-Xuan Mu, Shi-Yang Xiang, Qing-Yu Ma, Hai-Lun Gu, Department of Orthopedics, Shengjing Hospital, China Medical University, Shenyang 117004, Liaoning Province, China
Author contributions: Mu JX conceived and coordinated the study, designed, performed, and analyzed the experiments, and wrote the paper; Xiang SY, Ma QY, and Gu HL carried out data collection and analysis and revised the paper; all authors reviewed the results and approved the final version of the manuscript.
Institutional review board statement: The study was reviewed and approved by the ethic committee of Shengjing Hospital, China Medical University.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Lun Gu, PhD, Doctor, Department of Orthopedics, Shengjing Hospital, China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 117004, Liaoning Province, China. guhailun_@163.com
Received: April 7, 2021 Peer-review started: April 7, 2021 First decision: April 23, 2021 Revised: May 23, 2021 Accepted: June 3, 2021 Article in press: June 3, 2021 Published online: August 6, 2021 Processing time: 111 Days and 23 Hours
ARTICLE HIGHLIGHTS
Research background
Failure to fix unstable intertrochanteric fractures impairs return to daily activities.
Research motivation
To evaluate whether postoperative rehabilitation can be completed with or without medial and lateral support after intramedullary fixation of intertrochanteric fracture.
Research objectives
To analyze the stress and displacement distribution of unstable intertrochanteric fracture under different stress modes in postoperative rehabilitation.
Research methods
This study modeled five different internal fixation methods for unstable proximal femoral fractures. The finite element method was used to simulate the stress loading situation under the postoperative activity to a certain extent.
Research results
The maximum displacement and stress of proximal femoral anti-rotation intramedullary nail and integrated dual-screw fixation (ITN) were 3.51 mm/473 MPa and 2.80 mm/588 MPa for medial defects; 2.55 mm/288 MPa and 2.10 mm/307 MPa for lateral defects; and 3.84 mm/653 MPa and 3.44 mm/641 MPa for medial-lateral defects, respectively. For medial-lateral defects, reconstructing the medial side alone changed maximum displacement and stress to 2.79 mm/515 MPa; reconstructing the lateral side changed them to 3.72 mm/608 MPa; and when both sides were reconstructed, they changed to 2.42 mm/309 MPa.
Research conclusions
When the inner and outer sides are damaged at the same time, one place should be selected for reconstruction (outer or inner side), and low-intensity rehabilitation exercises can be carried out. When the inner and outer sides are damaged at the same time, if the reconstruction cannot be completed, the stability of the ITN system is better.
Research perspectives
To develop an effective treatment plan for medial and lateral defects.
