Biomechanical efficacy of four different dual screws fixations in treatment of talus neck fracture: a three-dimensional finite element analysis

作者：Zhengrui Fan, Jianxiong Ma, Jian Chen, Baocheng Yang, Ying Wang, Haohao Bai, Lei Sun, Yan Wang, Bin Lü, Benchao Dong, Aixian Tian, Xinlong Ma · 发表于：Journal of Orthopaedic Surgery and Research · 年份：2020 · DOI：10.1186/s13018-020-1560-8 · 被引用次数：17 · 研究领域：Foot and Ankle Surgery、Lower Extremity Biomechanics and Pathologies、Orthopedic Surgery and Rehabilitation

BACKGROUND: Current there are different screws fixation methods used for fixation of the talar neck fracture. However, the best method of screws internal fixation is still controversial. Few relevant studies have focused on this issue, especially by finite element analysis. The purpose of this study was to explore the mechanical stability of dual screws internal fixation methods with different approaches and the best biomechanical environment of the fracture section, so as to provide reliable mechanical evidence for the selection of clinical internal fixation. METHODS: The computed tomography (CT) image of the healthy adult male ankle joint was used for three-dimensional reconstruction of the ankle model. Talus neck fracture and screws were constructed by computer-aided design (CAD). Then, 3D model of talar neck fracture which fixed with antero-posterior (AP) parallel dual screws, antero-posterior (AP) cross dual screws, postero-anterior (PA) parallel dual screws, and postero-anterior (PA) cross dual screws were simulated. Finally, under the condition of 2400N vertical load, finite element analysis (FEA) were carried out to compare the outcome of the four different internal fixation methods. The results of Von Mises stress, displacement of four groups which contain talus fracture fragments and screws internal fixations were analyzed. RESULTS: Compared with the other three groups, postero-anterior (PA) parallel dual screws had better results in the stress peak, stress distribu...