Biomechanical assessment and clinical analysis of different intramedullary nailing systems for oblique fractures

Abstract

The aim of this study is to evaluate the fracture union or non-union for a specific patient that presented oblique fractures in tibia and fibula, using a mechanistic-based bone healing model. Normally, this kind of fractures can be treated through an intramedullary nail using two possible configurations that depends on the mechanical stabilisation: static and dynamic. Both cases are simulated under different fracture geometries in order to understand the effect of the mechanical stabilisation on the fracture healing outcome. The results of both simulations are in good agreement with previous clinical experience. From the results, it is demonstrated that the dynamization of the fracture improves healing in comparison with a static or rigid fixation of the fracture. This work shows the versatility and potential of a mechanistic-based bone healing model to predict the final outcome (union, non-union, delayed union) of realistic 3D fractures where even more than one bone is involved.

Keywords:

• Bone healing
• finite element predictions
• design of fixators
• oblique fractures
• multiple bone fragments

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. As a first approximation in this work, we have assumed a linear relationship between traction and separation in the fractured gap, although a non-linear law could be easily implemented.