Traditional and bionic dynamic hip screw fixation for the treatment of intertrochanteric fracture: a finite element analysis
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The dynamic hip screw (DHS) is widely used for fixing intertrochanteric femur fractures. A porous bionic DHS was developed recently to avoid the stress concentration and risk of post-operative complications associated with titanium alloy DHSs. The purpose of this study was to compare the effects of traditional titanium alloy, bionic titanium alloy, and bionic magnesium alloy DHS fixation for treatment of intertrochanteric fractures using finite element analysis.
A three-dimensional model of the proximal femur was established by human computed tomography images. An intertrochanteric fracture was created on the model, which was fixed using traditional and porous bionic DHS, respectively. The von Mises stress, maximum principal stress, and minimum principal stress were calculated to evaluate the effect of bone ingrowth on stress distribution of the proximal femur after fixation.
Stress concentration of the bionic DHS model was lower compared with traditional DHS fixation models. The von Mises stress, maximum principal stress, and minimum principal stress distributions of bionic magnesium alloy DHS models improved, along with simulation of the bone healing process and magnesium alloy degeneration, assumed to biodegrade completely 12 months post-operatively. The distribution of maximum principal stress in the secondary tension zone of the bionic DHS model was close to the intact bone. In the minimum principal stress, the region of minimum stress value less than − 10 MPa was significantly improved compared with traditional DHS models.
The bionic magnesium alloy DHS implant can improve the stress distribution of fractured bone close to that of intact bone while reducing the risk of post-operative complications associated with traditional internal fixations.
KeywordsIntertrochanteric fracture Dynamic hip screw Bionic internal fixation Trabecular bone Stress distribution Finite element analysis
We would like to thank Prof. Cheng-Kung Cheng and Dr. Yu-shu Lai for their assistance in the conduction of finite element analysis.
W. C. and Y. C. designed the study. W. C. and Y. C. searched relevant studies. Y. C., M. L., Y. Z., X. C., and J.D. analyzed and interpreted the data. Y. C., C. D., and S. T. wrote the manuscript and contributed equally to this work. W. C. and Y.C. contributed most in the revision of this manuscript. All authors approved the final version of the manuscript.
This study was supported by the Support Program for the Top Young Talents of Colleges and Universities of Hebei Province (Grant No.BJ2016035), the Hebei National Science Foundation-Outstanding Youth Foundation (Grant no. H2017206104) and the Support Program for the Top Young Talents for Hebei Province (Grant No. 2013-2018) . The funding source has no role in study design, conduction, data collection or statistical analysis.
Compliance with ethical standards
This study conforms to the provisions of the Declaration of Helsinki and has been reviewed and approved by the Institutional Review Board (IRB) of the Third Hospital of Hebei Medical University.
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent was obtained from the individual participant included in the study.
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