With the aging population,intertrochanteric femur fracture in the elderly has become one of the most serious public health issues and a hot topic of research in trauma orthopedics.Due to the limitations of internal fi...With the aging population,intertrochanteric femur fracture in the elderly has become one of the most serious public health issues and a hot topic of research in trauma orthopedics.Due to the limitations of internal fixation techniques and the insufficient mechanical design of nails,the occurrence of complications delays patient recovery after surgical treatment.Design of a proximal femur bionic nail(PFBN)based on Zhang’s N triangle theory provides triangular supporting fixation,which dramatically decreases the occurrence of complications and has been widely used for clinical treatment of unstable intertrochanteric femur fracture worldwide.In this work,we developed an equivalent biomechanical model to analyze improvement in bone remodeling of unstable intertrochanteric femur fracture through PFBN use.The results show that compared with proximal femoral nail antirotation(PFNA)and InterTan,PFBN can dramatically decrease the maximum strain in the proximal femur.Based on Frost’s mechanostat theory,the local mechanical environment in the proximal femur can be regulated into the medium overload region by using a PFBN,which may render the proximal femur in a state of physiological overload,favoring post-operative recovery of intertrochanteric femur fracture in the elderly.This work shows that PFBN may constitute a panacea for unstable intertrochanteric femur fracture and provides insights into improving methods of internal fixation.展开更多
In this editorial,I present my comments on the article by Solarino et al.Conversion hip arthroplasty,which is an optional salvage procedure performed following unsuccessful fixation of intertrochanteric femur fracture...In this editorial,I present my comments on the article by Solarino et al.Conversion hip arthroplasty,which is an optional salvage procedure performed following unsuccessful fixation of intertrochanteric femur fractures in elderly pati-ents,entails more complex processes and higher rates of operative complications than primary arthroplasty.Hence,it is important to consider the appropriateness of the primary treatment choice,as well as the adequacy of nailing fixation for intertrochanteric fractures.This article briefly analyzes the possible factors contributing to the nailing failure of intertrochanteric fractures and attempts to find corresponding countermeasures to prevent fixation failures.It also analyzes the choice of treatment between nailing fixation and primary arthroplasty for intertrochanteric fractures.展开更多
Purpose:To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods:The study group is treated...Purpose:To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods:The study group is treated with PFNA internal fixation.The control group is treated by internal fixation with anatomical locking plate of proximal femur.Results:The time of operation,the amount of intraoperative bleeding and the time of fracture healing in the study group are significantly less than those in the control group.The incidence rate of complication in the study group(3.23%)is significantly lower than that in the control group(17.2%).Data comparison shows P<0.05.Conclusion:The curative effect and prognosis for patients with intertrochanteric fracture of femur treated by PFNA internal fixation are more ideal.展开更多
Purpose To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods The study group is treated...Purpose To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods The study group is treated with PFNA internal fixation.The control group is treated by internal fixation with anatomical locking plate of proximal femur.Results The time of operation,the amount of intraoperative bleeding and the time of fracture healing in the study group are significantly less than those in the control group.The incidence rate of complication in the study group(3.23%)is significantly lower than that in the control group(17.2%).Data comparison shows P<0.05.Conclusion The curative effect and prognosis for patients with intertrochanteric fracture of femur treated by PFNA internal fixation are more ideal.展开更多
The number and spatial configuration of the screws will affect the stability and prognosis of the fractures.In our study,we assessed the biomechanical effects of the double-head cannulated compression screw(DhCCS)and ...The number and spatial configuration of the screws will affect the stability and prognosis of the fractures.In our study,we assessed the biomechanical effects of the double-head cannulated compression screw(DhCCS)and ordinary cannulated compression screw(OCCS)for the treatment of femoral neck fractures by using computer finite element analysis.The original digital imaging and communications in medicine(DICOM)data of a proximal femur were imported into Materialise’s interactive medical image control system(MIMICS)software for modeling.Both DhCCS and OCCS 3D-models were obtained by using the 3D scan technique.Using the fracture model and internal fixation assembly model with an inverted triangle,two horizontal and vertical distribution were established in UG software.Next,the displacement and stress distribution were calculated in ANSYS software.The displacement value of the femoral head in the DhCCS group was smaller than that in the OCCS group,and the displacement value in the two horizontal groups was smaller than that in the vertical group.The stress distribution in the DhCCS group was concentrated on the screw rod at the fracture block and thread end,while only at the fracture block in the OCCS group.The stress in the horizontal group was more dispersed on the screws than that in the vertical group.DhCCS has reliable stability for the fixation of femoral neck fractures and applied in the clinical work and 2 horizontal fixation can be used when two screws are selected.展开更多
基金supported by the National Natural Science Foundation of China(32130052,82072447,and 82272578)the Fundamental Research Funds for the Central Universities,Nankai University(730-C02922112 and 730-DK2300010314).
文摘With the aging population,intertrochanteric femur fracture in the elderly has become one of the most serious public health issues and a hot topic of research in trauma orthopedics.Due to the limitations of internal fixation techniques and the insufficient mechanical design of nails,the occurrence of complications delays patient recovery after surgical treatment.Design of a proximal femur bionic nail(PFBN)based on Zhang’s N triangle theory provides triangular supporting fixation,which dramatically decreases the occurrence of complications and has been widely used for clinical treatment of unstable intertrochanteric femur fracture worldwide.In this work,we developed an equivalent biomechanical model to analyze improvement in bone remodeling of unstable intertrochanteric femur fracture through PFBN use.The results show that compared with proximal femoral nail antirotation(PFNA)and InterTan,PFBN can dramatically decrease the maximum strain in the proximal femur.Based on Frost’s mechanostat theory,the local mechanical environment in the proximal femur can be regulated into the medium overload region by using a PFBN,which may render the proximal femur in a state of physiological overload,favoring post-operative recovery of intertrochanteric femur fracture in the elderly.This work shows that PFBN may constitute a panacea for unstable intertrochanteric femur fracture and provides insights into improving methods of internal fixation.
文摘In this editorial,I present my comments on the article by Solarino et al.Conversion hip arthroplasty,which is an optional salvage procedure performed following unsuccessful fixation of intertrochanteric femur fractures in elderly pati-ents,entails more complex processes and higher rates of operative complications than primary arthroplasty.Hence,it is important to consider the appropriateness of the primary treatment choice,as well as the adequacy of nailing fixation for intertrochanteric fractures.This article briefly analyzes the possible factors contributing to the nailing failure of intertrochanteric fractures and attempts to find corresponding countermeasures to prevent fixation failures.It also analyzes the choice of treatment between nailing fixation and primary arthroplasty for intertrochanteric fractures.
文摘Purpose:To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods:The study group is treated with PFNA internal fixation.The control group is treated by internal fixation with anatomical locking plate of proximal femur.Results:The time of operation,the amount of intraoperative bleeding and the time of fracture healing in the study group are significantly less than those in the control group.The incidence rate of complication in the study group(3.23%)is significantly lower than that in the control group(17.2%).Data comparison shows P<0.05.Conclusion:The curative effect and prognosis for patients with intertrochanteric fracture of femur treated by PFNA internal fixation are more ideal.
文摘Purpose To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods The study group is treated with PFNA internal fixation.The control group is treated by internal fixation with anatomical locking plate of proximal femur.Results The time of operation,the amount of intraoperative bleeding and the time of fracture healing in the study group are significantly less than those in the control group.The incidence rate of complication in the study group(3.23%)is significantly lower than that in the control group(17.2%).Data comparison shows P<0.05.Conclusion The curative effect and prognosis for patients with intertrochanteric fracture of femur treated by PFNA internal fixation are more ideal.
基金This research was supported by the health and family planning commission of chongqing under grant 2016MSXM162.
文摘The number and spatial configuration of the screws will affect the stability and prognosis of the fractures.In our study,we assessed the biomechanical effects of the double-head cannulated compression screw(DhCCS)and ordinary cannulated compression screw(OCCS)for the treatment of femoral neck fractures by using computer finite element analysis.The original digital imaging and communications in medicine(DICOM)data of a proximal femur were imported into Materialise’s interactive medical image control system(MIMICS)software for modeling.Both DhCCS and OCCS 3D-models were obtained by using the 3D scan technique.Using the fracture model and internal fixation assembly model with an inverted triangle,two horizontal and vertical distribution were established in UG software.Next,the displacement and stress distribution were calculated in ANSYS software.The displacement value of the femoral head in the DhCCS group was smaller than that in the OCCS group,and the displacement value in the two horizontal groups was smaller than that in the vertical group.The stress distribution in the DhCCS group was concentrated on the screw rod at the fracture block and thread end,while only at the fracture block in the OCCS group.The stress in the horizontal group was more dispersed on the screws than that in the vertical group.DhCCS has reliable stability for the fixation of femoral neck fractures and applied in the clinical work and 2 horizontal fixation can be used when two screws are selected.
