Finite element analysis on the position of the spiral blade in the
femoral head of internal fixation for intertrochanteric fractures
Abstract
Background: Intramedullary fixation is the preferred treatment for AO
type 31A2.2-3.3 intertrochanteric fractures. However, the planting
position of the spiral blade into the femoral head is controversial, and
relative biomechanical studies are sparse. This article aims to
investigate the influence of different position of spiral blade on
fixation of intertrochanteric fracture. Methods: A three-dimensional
(3D) finite element model of a femoral intertrochanteric fracture with
proximal femoral nail antirotation (PFNA) fixation was developed in
which the collum femoris was divided into three parts based on the
length of the spiral blades. Subsequently, we measured the displacement
and stress both the intertrochanteric fracture model and the spiral
blade in nine fixation modalities. Results: When the spiral blade was
placed in the middle position of the femoral neck, the displacement was
the lowest (2.68 mm) and the stress was the least (180.77 Mpa), followed
by the lower position of femoral neck, while the displacement and the
stress of the upper position of the femoral neck were the largest. The
stress decreased stepwise from the tip of the spiral blade to the distal
end of the intramedullary nail. Conclusion: The upper spiral blade
position produced the largest displacement of the finite element model.
A medium-length spiral blade located in the middle of the femoral neck
can achieve a stable fixation, and reduce the cutting effect on the
femoral head, which is recommended for the treatment of
intertrochanteric fractures.