Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6343
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
Failure to fix unstable intertrochanteric fractures impairs return to daily activities.
To evaluate whether postoperative rehabilitation can be completed with or without medial and lateral support after intramedullary fixation of intertrochanteric fracture.
To analyze the stress and displacement distribution of unstable intertrochanteric fracture under different stress modes in postoperative rehabilitation.
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.
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.
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.
To develop an effective treatment plan for medial and lateral defects.