Finite element analysis of intramedullary nailing and double locking plate for treating extra-articular proximal tibial fractures

摘要

BackgroundProximal tibia fractures are one of the most familiar fractures. Surgical approaches are usually needed for anatomical reduction. However, no single treatment method has been widely established as the standard care. Our present study aims to compare the stress and stability of intramedullary nails (IMN) fixation and double locking plate (DLP) fixation in the treatment of extra-articular proximal tibial fractures. MethodsA three-dimensional (3D) finite element model of the extra-articular proximal tibial fracture, whose 2-cm bone gap began 7?cm from the tibial plateau articular surface, was created fixed by different fixation implants. The axial compressive load on an adult knee during single-limb stance was imitated by an axial force of 2500?N with a distribution of 60% to the medial compartment, while the distal end was fixed effectively. The equivalent von Mises stress and displacement of the model was used as the output measures for analysis. ResultsThe maximal equivalent von Mises stress value of the system in the IMN model was 293.23?MPa, which was higher comparing against that in the DLP fixation model (147.04?MPa). And the mean stress of the model in the IMN model (9.25?MPa) was higher than that of the DLP fixation system in terms of equivalent von Mises stress (EVMS) ( P ConclusionsThis study demonstrated that the stability provided by the locking plate fixation system was superior to the intramedullary nails fixation system and served as an alternative fixation for the extra-articular proximal tibial fractures of young patients.