Biomechanical design using in-vitro finite element modeling of distal femur fracture plates made from semi-rigid materials versus traditional metals for post-operative toe-touch weight-bearing

被引：14

作者：

Gee, Aaron ^{[1
]}

Bougherara, Habiba ^{[2
]}

Schemitsch, Emil H. ^{[1
,3
]}

Zdero, Radovan ^{[1
,2
,3
,4
]}

机构：

[1] Victoria Hosp, Orthopaed Biomech Lab, Room A6-144,800 Commissioners Rd, London N6A 5W9, England

[2] Ryerson Univ, Dept Mech & Ind Engn, Toronto, ON, Canada

[3] Western Univ, Div Orthopaed Surg, Dept Surg, London, ON, Canada

[4] Western Univ, Dept Mech & Mat Engn, London, ON, Canada

来源：

MEDICAL ENGINEERING & PHYSICS | 2021年 / 87卷

关键词：

Biomechanics; Distal femur fracture; Semi-rigid material; Plate; Toe-touch; LOCKED PLATING CONSTRUCTS; FAR CORTICAL LOCKING; TOTAL HIP IMPLANT; WORKING LENGTH; INTERFRAGMENTARY MOVEMENT; BOUNDARY-CONDITIONS; PLASTIC PLATES; INITIAL PHASE; POROUS METALS; FIXATION;

D O I：

10.1016/j.medengphy.2020.11.015

中图分类号：

R318 [生物医学工程];

学科分类号：

0831 ;

摘要：

This proof-of-concept study designs distal femur fracture plates from semi-rigid materials vs. traditional metals for toe-touch weight-bearing recommended to patients immediately after surgery. The two-fold goal was to (a) reduce stress shielding (SS) by increasing cortical bone stress thereby reducing the risk of bone absorption and plate loosening, and (b) reduce delayed healing (DH) via early callus formation by optimizing axial interfragmentary motion (AIM). Finite element analysis was used to design semi-rigid plates whose elastic moduli E ensured plates permitted AIM of 0.2 - 1 mm for early callus formation. A low hip joint force of 700 N (i.e. 100% x body weight) was applied, which corresponds to a typical 140 N toe-touch foot-to-ground force (i.e. 20% x body weight) recommended to patients after surgery. Analysis was done using 2 screw materials (steel or titanium) and types (locked or non-locked). Steel and titanium plates were also analyzed. Semi-rigid plates (vs. metal plates) had lower overall femur/plate construct stiffnesses of 508 - 1482 N/mm, higher cortical bone stresses under the plate by 2.02x - 3.27x thereby reducing SS, and lower E values of 414 - 2302 MPa to permit AIM of 0.2 - 1 mm thereby reducing DH. (C) 2020 IPEM. Published by Elsevier Ltd. All rights reserved.

引用

页码：95 / 103

页数：9