Mathematical Modeling of the “Bone-Fixator” System during the Treatment of Intertrochanteric Fractures

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Abstract

Relevance — the need for an objective justification in choosing the type of fixation in the treatment patients with pertrochanteric hip fractures.

Objective — to study the changes in the properties of a consolidating trochanteric fracture fixed by a dynamic cephalomedullary nail when subjected to cyclic dynamic loads.

Materials and methods. A mathematical model was developed for trochanteric fracture of the femur (A1 according to AO classification) when fixed with a dynamic cephalomedullary nail. Then, the properties of the system were studied (pressure between fragments, mechanical stress in the bone and fixation device, displacement amplitude, neck-diaphysis angle) under a virtual load of a 80 kg body at various amount of insertion of the dynamic screw (from 10 mm to 0 mm).

Results. In the process of shortening the femoral neck axis by 1 cm, the stability of the ‘bone-metal fixation device’ system increases, as indicated by a decrease in the maximum amplitude of displacements in the system under load by 16.8%, a decrease in the maximum stress in the fixation elements by 20.2%, a decrease in pressure at the site of contact of fragments by 19.8%. In addition, there was a decrease in the neck-diaphysis angle by 2.8%.

Conclusion. The mathematical modeling of the ‘bone-metal fixation device’ system simulating conditions of dynamic osteosynthesis showed that there is a potential increase in the stability of the cephalomedullary system and that favorable conditions are created for the consolidation of the fracture when subjected to cyclic load of body mass.

About the authors

V. E. Dubrov

Lomonosov Moscow State University

Email: fake@neicon.ru

Vadim E. Dubrov — Dr. Sci. (Med.), professor, chairman, Department of General and Specialized Surgery, School of Medicine

Russian Federation

I. M. Shcherbakov

Lomonosov Moscow State University

Author for correspondence.
Email: imscherbackov@yandex.ru

Ivan M. Shcherbakov — PhD student, Department of General and Specialized Surgery, School of Medicine

Russian Federation

K. A. Saprykina

Lomonosov Moscow State University

Email: fake@neicon.ru

Kseniya A. Saprykina — PhD student, Department of General and Specialized Surgery, School of Medicine

Russian Federation

I. A. Kuzkin

Hexa, LLC

Email: fake@neicon.ru

Ivan A. Kuz’kin — principal engineer.

Moscow Russian Federation

D. A. Zyuzin

Lomonosov Moscow State University

Email: fake@neicon.ru

Dmitrii A. Zyuzin — PhD student, Department of General and Specialized Surgery, School of Medicine

Russian Federation

D. V. Yashin

Lomonosov Moscow State University

Email: fake@neicon.ru

Dmitrii V. Yashin — resident, Department of General and Specialized Surgery, School of Medicine

Russian Federation

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