Comparisons Of Different Treatments Of Vancouver Type B3 Fracture Based On Finite Element Analysis

Objective: 1.The Vancouver B3 fracture model was constructed by using 3D finite element technique.The models of M/L Taper prosthesi s,Wagner SL prosthesis of different lengths,allogeneic cortical bone pl ate and locking compression plates were constructed by using 3D finite element technique.2.To compare the effect of revision prosthesis comb ined with different internal fixation methods on the treatment of Vancou ver B3 periprosthetic fracture by finite element analysis.Methods:1.Left femur CT data of 30 healthy aged volunteers were collecte d and stored as DICOM format?The saved CT data in DICOM format was imported into MIMICS software for processing,and the correspondi ng 3D model of femur was made through the computing mechanism.2.Collecting shape data of allogeneic cortical bone plate,M/L Ta per prosthesis,Wagner SL prosthesis of different lengths and locking co mpression plates by using Geomagic Studio software.3.The collected data were imported into the finite element analysis software ABAQUS to establish the model of Vancouver B3 type peripr osthetic fracture,and four kinds of surgical methods were simulated to t reat Vancouver B3 type fracture.Four kinds of surgical methods were r espectively used different length of revision prosthesis combined with di fferent internal fixation methods: Group 1,it was fixed with 225 mm W agner SL prosthesis and allograft cortical bone plate using titanium cabl e;Group 2,it was fixed with 265 mm Wagner SL prosthesis and allogr aft cortical bone plate using titanium cable;Group 3,it was fixed with 225 mm Wagner SL prosthesis,allograft cortical bone plate and locking compression plate using screws and titanium cable;Group 4,it was fixed with 265 mm Wagner SL prosthesis,allograft cortical bone plate and l ocking compression plate using screws and titanium cable.4.The partial load and full load loads were simulated,and the frac ture end displacement of four surgical methods under different loads wa s collected and analyzed statistically.Results: Under the condition of simulating partial load and full loa d,namely 500 N and 2300 N are pressed vertically downward with a tors ional force of 5Nm,there was statistical difference in displacement of fr acture end in each group(P <0.05).With pair-wised comparisons,there was a significant statistical difference in fracture end displacement bet ween group 1 and group 2,group 1 and group 4(P <0.05),and there was no statistical difference in fracture end displacement between group 1 and group 3(P >0.05);There was a statistical difference in fracture end displacement between group 2 and group 3(P <0.05),and no stat istical difference could be found group 2 and group 4(P >0.05);There was a statistically significant difference in fracture end displacement be tween group 3 and group 4(P <0.05).Conclusions:Wagner SL revision prosthesis combined with allograft cortical bone plate fixation can be used to treat Vancouver B3 periprosthetic fractures.The Wagner SL revision prosthesis is used to replace the original M / L Taper prosthesis,and the revision prosthesis should extend through at least two femoral diameters of the fracture site to provide stability for the fracture site internally;the allograft cortical bone plate is a bone graft that provides additional structural support while improving bone mass.On the basis of Wagner SL revision prosthesis combined with allogeneic cortical bone plate binding fixation,the addition of locking plate fixation does not achieve better internal fixation.From the perspective of cost / effect ratio,for the treatment of Vancouver B3 periprosthetic fractures,the only use of Wagner SL revision prosthesis combined with allograft cortical bone plate fixation can achieve good internal fixation.