A Biomechanical Comparison of Two Intramedullary Implants for Subtrochanteric Fracture in Two Healing Stages: A Finite Element Analysis

Background. The biomechanical effect of two implants, namely, proximal femoral nail antirotation for Asia (PFNA-II) and Expert Asian Femoral Nail (A2FN), for treating subtrochanteric fracture during healing stages, is still unclear. Methods. A 3D finite element model of an intact femur was construct...

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Main Authors: Xinlei Wu, Ming Yang, Lijun Wu, Wenxin Niu
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Applied Bionics and Biomechanics
Online Access:http://dx.doi.org/10.1155/2015/475261
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author Xinlei Wu
Ming Yang
Lijun Wu
Wenxin Niu
author_facet Xinlei Wu
Ming Yang
Lijun Wu
Wenxin Niu
author_sort Xinlei Wu
collection DOAJ
description Background. The biomechanical effect of two implants, namely, proximal femoral nail antirotation for Asia (PFNA-II) and Expert Asian Femoral Nail (A2FN), for treating subtrochanteric fracture during healing stages, is still unclear. Methods. A 3D finite element model of an intact femur was constructed and validated. The fractured and postoperative models were accordingly produced. The postoperative models were loaded with the peak joint forces during gait for the soft and hard callus stages. The effects of stress distribution on the implants, femoral head and callus, and the deformation of the proximal femur were examined. Results. Both implants showed similar biomechanical effect in two healing stages. As the healing duration increased, the von Mises stress of two implants and the tensile stress of the femoral head decreased, whereas the compressive stress of the femoral head increased. However, the PFNA-II operation resulted in higher stress on the implant, lower stress on the proximal femur, and lower compressive stress and higher tensile stress on the callus than A2FN operation. Conclusions. The A2FN implant may provide a biomechanically superior construct for subtrochanteric fracture healing. However, the upper screw of the A2FN implant may be more likely to be loose in the healing process.
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spelling doaj-art-e6e6aa02915f43bca7bb9e23f65410832025-08-20T03:26:11ZengWileyApplied Bionics and Biomechanics1176-23221754-21032015-01-01201510.1155/2015/475261475261A Biomechanical Comparison of Two Intramedullary Implants for Subtrochanteric Fracture in Two Healing Stages: A Finite Element AnalysisXinlei Wu0Ming Yang1Lijun Wu2Wenxin Niu3Institute of Digitized Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325035, ChinaDepartment of Orthopaedics & Traumatology, Peking University People’s Hospital, Beijing 100044, ChinaInstitute of Digitized Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325035, ChinaLaboratory of Sports Biomechanics, Yang Zhi Rehabilitation Hospital, Tongji University School of Medicine, Shanghai 2001619, ChinaBackground. The biomechanical effect of two implants, namely, proximal femoral nail antirotation for Asia (PFNA-II) and Expert Asian Femoral Nail (A2FN), for treating subtrochanteric fracture during healing stages, is still unclear. Methods. A 3D finite element model of an intact femur was constructed and validated. The fractured and postoperative models were accordingly produced. The postoperative models were loaded with the peak joint forces during gait for the soft and hard callus stages. The effects of stress distribution on the implants, femoral head and callus, and the deformation of the proximal femur were examined. Results. Both implants showed similar biomechanical effect in two healing stages. As the healing duration increased, the von Mises stress of two implants and the tensile stress of the femoral head decreased, whereas the compressive stress of the femoral head increased. However, the PFNA-II operation resulted in higher stress on the implant, lower stress on the proximal femur, and lower compressive stress and higher tensile stress on the callus than A2FN operation. Conclusions. The A2FN implant may provide a biomechanically superior construct for subtrochanteric fracture healing. However, the upper screw of the A2FN implant may be more likely to be loose in the healing process.http://dx.doi.org/10.1155/2015/475261
spellingShingle Xinlei Wu
Ming Yang
Lijun Wu
Wenxin Niu
A Biomechanical Comparison of Two Intramedullary Implants for Subtrochanteric Fracture in Two Healing Stages: A Finite Element Analysis
Applied Bionics and Biomechanics
title A Biomechanical Comparison of Two Intramedullary Implants for Subtrochanteric Fracture in Two Healing Stages: A Finite Element Analysis
title_full A Biomechanical Comparison of Two Intramedullary Implants for Subtrochanteric Fracture in Two Healing Stages: A Finite Element Analysis
title_fullStr A Biomechanical Comparison of Two Intramedullary Implants for Subtrochanteric Fracture in Two Healing Stages: A Finite Element Analysis
title_full_unstemmed A Biomechanical Comparison of Two Intramedullary Implants for Subtrochanteric Fracture in Two Healing Stages: A Finite Element Analysis
title_short A Biomechanical Comparison of Two Intramedullary Implants for Subtrochanteric Fracture in Two Healing Stages: A Finite Element Analysis
title_sort biomechanical comparison of two intramedullary implants for subtrochanteric fracture in two healing stages a finite element analysis
url http://dx.doi.org/10.1155/2015/475261
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