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Finite element analysis of the effect of medullary contact on fracture healing and remodeling in the intramedullary interlocking nail‐fixed tibia fracture
Author(s) -
Wang Haosen,
Hao Zhixiu,
Wen Shizhu
Publication year - 2017
Publication title -
international journal for numerical methods in biomedical engineering
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.741
H-Index - 63
eISSN - 2040-7947
pISSN - 2040-7939
DOI - 10.1002/cnm.2816
Subject(s) - medullary cavity , intramedullary rod , bone healing , interlocking , tibia , nonunion , materials science , nail (fastener) , fracture (geology) , bone remodeling , tibia fracture , biomechanics , reduction (mathematics) , orthodontics , medicine , anatomy , composite material , structural engineering , engineering , mathematics , metallurgy , geometry
Summary Intramedullary interlocking nail is an effective treatment for tibial diaphyseal fracture. The contact between medullary rod and diaphyseal cortex is able to enhance fracture stability. However, how and to what degree the contact affects fracture healing and subsequent bone remodeling is still unclear. To investigate this, fracture healing and remodeling algorithms were combined, improved, and used to simulate the healing and remodeling processes in a transverse tibial diaphyseal fracture fixed with an intramedullary interlocking nail device. Two different diaphyseal fracture statuses, three different initial loading levels, and two nail materials were considered. The results showed that the medullary contact could significantly enhance the fixation stability; the strain reduction was up to 80% in the initial granulation callus. However, low initial loading level was found to be a more potential risk factor for the insufficient loading‐induced nonunion other than medullary contact and stiffer nail material. Furthermore, the stabilizing effect of medullary contact diminished when stiff bone tissue formed in the callus; thus, the remodeling in the long‐term was not affected by medullary contact. Copyright © 2016 John Wiley & Sons, Ltd.