A comparative study of the finite element analysis of bone cement intramedullary support and intramedullary nail in the treatment of osteoporotic proximal humerus fractures
Objective To compare the biomechanical properties of lateral locking plate combined with polymethyl methacrylate(PM-MA)bone cement and calcium sulfate(CSC)bone cement and Multiloc intramedullary nail in the treatment of osteoporotic proximal humerus fractures by finite element analysis.Methods A three-dimensional finite element model of proximal humerus fracture with bone defect was established on the basis of humerus CT data of an elderly osteoporotic female(69 years old,bonemineraldensity T-val-ue-2.6)volunteer.Three different internal fixation systems,namely lateral locking plate combined with PMMA bone cement intramed-ullary support(LLP-PMMA group),lateral locking plate combined with CSC bone cement intramedullary support(LLP-CSC group)and Multiloc intramedullary nail(Multiloc group),were assembled and combined with fracture models,respectively.To simulate the stress situation of the proximal humerus,the model was subjected to abduction,adduction,flexion and rotation loads.The mechanical stability of different internal fixation systems was evaluated by comparing the structural stiffness,maximum stress and stress distribu-tion,fracture displacements and torsion angles of plants in each model.Results Compared with Multiloc group,LLP-PMMA group and LLP-CSC group had stronger structural stiffness under adduction,abduction,flexion,counterclockwise rotation and clockwise rotation loads.Under vector load,LLP-PMMA group and LLP-CSC group had lower endophytic maximum stress,while under rotational load,Multiloc group had more uniform endophytic stress distribution and lower maximum stress.Compared with Multiloc group,LLP-PMMA group and LLP-CSC group had smaller displacements and torsion angles of broken ends under adduction,abduction,flex-ion,counterclockwise rotation and clockwise rotation loads.Conclusion From the perspective of finite element analysis,the lateral locking plate combined with anatomic bone cement intramedullary support holder has better biomechanical properties than Multiloc in-tramedullary nail in the treatment of osteoporotic proximal humerus fractures,and can provide stronger and more direct intramedullary medial column support.
Proximal humerus fractureOsteoporosisIntramedullary supportMultiloc intramedullary nailBone cementFinite element analysisBiomechanics
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