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A patient specific finite element simulation of intramedullary nailing to predict the displacement of the distal locking hole

Mortazavi, J ; Sharif University of Technology | 2018

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  1. Type of Document: Article
  2. DOI: 10.1016/j.medengphy.2018.03.004
  3. Publisher: Elsevier Ltd , 2018
  4. Abstract:
  5. Distal locking is a challenging subtask of intramedullary nailing fracture fixation due to the nail deformation that makes the proximally mounted targeting systems ineffective. A patient specific finite element model was developed, based on the QCT data of a cadaveric femur, to predict the position of the distal hole of the nail postoperatively. The mechanical interactions of femur and nail (of two sizes) during nail insertion was simulated using ABAQUS in two steps of dynamic pushing and static equilibrium, for the intact and distally fractured bone. Experiments were also performed on the same specimen to validate the simulation results. A good agreement was found between the model predictions and the experimental observations. There was a three-point contact pattern between the nail and medullary canal, only on the proximal fragment of the fractured bone. The nail deflection was much larger in the sagittal plane and increased for the larger diameter nail, as well as for more distally fractured or intact femur. The altered position of the distal hole was predicted by the model with an acceptable error (mean: 0.95; max: 1.5 mm, in different tests) to be used as the compensatory information for fine tuning of proximally mounted targeting systems. © 2018 IPEM
  6. Keywords:
  7. Femoral fracture fixation ; Interlocking nail ; Locking screws ; Nail deformation ; Targeting systems ; Bone ; Deformation ; Diagnostic products ; Forecasting ; Fracture ; Fracture fixation ; Locks (fasteners) ; Point contacts ; Interlocking nails ; Mechanical interactions ; Patient specific ; Patient-specific finite element models ; Static equilibrium ; Finite element method ; Adult ; Article ; Bone density ; Cadaver ; Computer assisted tomography ; Controlled study ; Distal femur fracture ; Finite element analysis ; Human ; Intramedullary nailing ; Limit of quantitation ; Male ; Middle aged ; Postoperative period ; Prediction ; Priority journal ; Simulation ; Validation process
  8. Source: Medical Engineering and Physics ; Volume 55 , May , 2018 , Pages 34-42 ; 13504533 (ISSN)
  9. URL: https://www.sciencedirect.com/science/article/pii/S1350453318300468