El fenómeno de cut-out en fractura intertrocantérica de fémur: análisis mediante modelo de elementos finitos

[EN] Objetive: This work aimed to analyze the cut-out phenomenon, which involves oblique displacements and/or rotations of the femoral head around the cephalic component of the intramedullary nail. The analysis was carried out using finite element numerical models. This technique seeks to understand...

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Bibliographic Details
Authors: Arias-Blanco, A., Marco, M., Miguélez, M.H., Caeiro-Rey, J.R., Larraínzar-Garijo, R., Giner Maravilla, Eugenio|||0000-0003-1903-6495
Format: article
Publication Date:2021
Country:España
Institution:Universitat Politècnica de València (UPV)
Repository:RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
Language:Spanish
OAI Identifier:oai:riunet.upv.es:10251/196972
Online Access:https://riunet.upv.es/handle/10251/196972
Access Level:Open access
Keyword:Femur
Hip fracture
Extracapsular fracture
Intramedullary nail
Cut-out
Finite element model
Fémur
Fractura de cadera
Fractura extracapsular
Clavo intramedular
Modelo de elementos finitos
INGENIERIA MECANICA
Description
Summary:[EN] Objetive: This work aimed to analyze the cut-out phenomenon, which involves oblique displacements and/or rotations of the femoral head around the cephalic component of the intramedullary nail. The analysis was carried out using finite element numerical models. This technique seeks to understand the failure of this type of fixation and establish what positioning of the system favors or prevents failure due to cut-out. Material and methods: The study was carried out on a numerical model of the proximal limb of an artificial femur and an intramedullary nail type PFNA (proximal femoral nail anti-rotation). In the numerical model, the position of the intramedullary nail was varied in the anterior/posterior and superior/inferior directions to analyze the influence of the position on the cut-out phenomenon. Stresses in critical areas and torque on the nail under normal position loading were analyzed. Results: The most critical position was the one in which the intramedullary nail is placed in the superior position, due to the high compressions that appear in the trabecular bone of the femoral head. The centered position of the nail decreased the risk of bone damage and the torque that the intramedullary nail has to support. Conclusions: This type of model allows us to simulate the influence of the nail position and obtain variables that are otherwise difficult to analyze. Although it is a simple model with static load, it confirms that a centered position of the intramedullary nail reduces the risk of cut-out.