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International Orthopaedics

Erschienen in:

24.01.2017 | Original Paper

Numerical investigation of fracture impaction in proximal humeral fracture fixation with locking plate and intramedullary nail

verfasst von: Yen-Nien Chen, Chih-Wei Chang, Chia-Wei Lin, Chih-Wei Wang, Yao-Te Peng, Chih-Han Chang, Chun-Ting Li

Erschienen in: International Orthopaedics | Ausgabe 7/2017

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Abstract

Introduction

Fracture impaction is a surgical technique used to support the fractured humerus with locking plate or intramedullary nail when treating proximal humeral fractures. However, few studies have investigated the mechanical difference between fracture impaction with locking plate and with intramedullary nail. The mechanism of fracture impaction to increase stability is still unclear. The aim of this study was to use numerical methods to compare the biomechanical effect of treating proximal humeral fracture.

Methods

Six different humerus models, including intact and fractured humeri with various fixation patterns were used in this study. Fracture impaction was simulated by moving the distal fragment of the humeral shift upwards directly until touching the inferior surface of the proximal fragment. We also considered both poor- and normal-quality bone in the simulation.

Results

Results confirmed that fracture impaction increases fracture stabilityand decreases peak stress in both implant and bone. Also, fracture impaction and plating with medial shift of the humeral shaft provides the highest stability. The metallic implant shared loading with the bone in the impacted models, while implants sustained all the loading alone in the nonimpacted models.

Conclusions

Based on the results, the technique of fracture impaction is suggested for both nail and plate to reduce stresses on bone and implants and to increase structural stability. Furthermore, impaction with medial shift of the humeral shaft with plate is found to achieve the highest stability when treating proximal humeral fractures.

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Titel: Numerical investigation of fracture impaction in proximal humeral fracture fixation with locking plate and intramedullary nail
verfasst von: Yen-Nien Chen
Chih-Wei Chang
Chia-Wei Lin
Chih-Wei Wang
Yao-Te Peng
Chih-Han Chang
Chun-Ting Li
Publikationsdatum: 24.01.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 7/2017
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-017-3401-x

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Abstract

Introduction

Methods

Results

Conclusions

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