Biomechanical behavior of retrograde intramedullary nails in distal femoral fractures

Albareda-Albareda, J. (Universidad de Zaragoza) ; Gabarre-Raso, S. ; Rosell-Pradas, J. (Universidad de Zaragoza) ; Puértolas-Broto, S. (Universidad de Zaragoza) ; Ibarz-Montaner, E. (Universidad de Zaragoza) ; Redondo-Trasobares, B. (Universidad de Zaragoza) ; Gómez-Vallejo, J. (Universidad de Zaragoza) ; Blanco-Rubio, N. (Universidad de Zaragoza) ; Sánchez-Gimeno, M. (Universidad de Zaragoza) ; Herrera-Rodríguez, A. (Universidad de Zaragoza) ; Gracia-Villa, L. (Universidad de Zaragoza)

Resumen: Fractures of the distal femur affect to three different groups of individuals: younger people suffering high-energy trauma, elderly people with fragile bones and people with periprosthetic fractures around previous total knee arthroplasty. Main indications of intramedullary nailing are for supracondylar fractures type A or type C of the AO classification. The main objective of the present work is to analyze, by means of FE simulation, the influence of retrograde nail length, considering different blocking configurations and fracture gaps, on the biomechanical behavior of supracondylar fractures of A type. A three dimensional (3D) finite element model of the femur from 55-year-old male donor was developed, and then a stability analysis was performed for the fixation provided by the retrograde nail at a distal fracture with different fracture gaps: 0.5 mm, 3 mm y 20 mm, respectively. Besides, for each gap, three nail lengths were studied with a general extent (320 mm, 280 mm and 240 mm), considering two transversal screws (M/L) at the distal part and different screw combinations above the fracture. The study was focused on the immediately post-operative stage, without any biological healing process. In view of the obtained results, it has been demonstrated new possibilities of blocking configuration in addition to the usual ones, which allows establishing recommendations for nail design and clinical practice, avoiding excessive stress concentrations both in screws, with the problem of rupture and loss of blocking, and in the contact of nail tip with cortical bone, with the problem of a new stress fracture.

Idioma: Inglés

DOI: 10.1016/j.injury.2021.01.052

Año: 2021

Publicado en: Injury 52, Suppl. 4 (2021), S76-S86
ISSN: 0020-1383

Factor impacto JCR: 2.687 (2021)

Categ. JCR: EMERGENCY MEDICINE rank: 14 / 32 = 0.438 (2021) - Q2 - T2
Categ. JCR: ORTHOPEDICS rank: 42 / 86 = 0.488 (2021) - Q2 - T2
Categ. JCR: SURGERY rank: 97 / 213 = 0.455 (2021) - Q2 - T2
Categ. JCR: CRITICAL CARE MEDICINE rank: 25 / 35 = 0.714 (2021) - Q3 - T3

Factor impacto CITESCORE: 3.7 - Medicine (Q2)

Factor impacto SCIMAGO: 0.748 - Surgery (Q1) - Emergency Medicine (Q1)

Financiación: info:eu-repo/grantAgreement/ES/MINECO/DPI2016-77745-R

Tipo y forma: Artículo (PostPrint)

Área (Departamento): Área Traumatología y Ortopedia (Dpto. Cirugía)
Área (Departamento): Área Mec.Med.Cont. y Teor.Est. (Dpto. Ingeniería Mecánica)