With the aging population, intertrochanteric femur fracture in the elderly has become one of the most serious public health issues and a hot topic of research in trauma orthopedics. Due to the limitations of internal fixation techniques and the insufficient mechanical design of nails, the occurrence of complications delays patient recovery after surgical treatment. Design of a proximal femur bionic nail (PFBN) based on Zhang’s N triangle theory provides triangular supporting fixation, which dramatically decreases the occurrence of complications and has been widely used for clinical treatment of unstable intertrochanteric femur fracture worldwide. In this work, we developed an equivalent biomechanical model to analyze improvement in bone remodeling of unstable intertrochanteric femur fracture through PFBN use. The results show that compared with proximal femoral nail antirotation (PFNA) and InterTan, PFBN can dramatically decrease the maximum strain in the proximal femur. Based on Frost’s mechanostat theory, the local mechanical environment in the proximal femur can be regulated into the medium overload region by using a PFBN, which may render the proximal femur in a state of physiological overload, favoring post-operative recovery of intertrochanteric femur fracture in the elderly. This work shows that PFBN may constitute a panacea for unstable intertrochanteric femur fracture and provides insights into improving methods of internal fixation.

中文翻译：

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股骨近端仿生钉（PFBN）：不稳定股骨粗隆间骨折的灵丹妙药

随着人口老龄化，老年人股骨粗隆间骨折已成为最严重的公共卫生问题之一，也是创伤骨科研究的热点。由于内固定技术的限制以及钉子机械设计的不足，并发症的发生延迟了患者手术治疗后的康复。基于张氏N三角理论设计的股骨近端仿生钉（PFBN）提供了三角形支撑固定，大大减少了并发症的发生，已在国内外广泛应用于临床治疗不稳定股骨粗隆间骨折。在这项工作中，我们开发了一个等效的生物力学模型来分析通过使用 PFBN 对不稳定股骨粗隆间骨折骨重塑的改善。结果表明，与近端股骨防旋钉（PFNA）和InterTan相比，PFBN可以显着降低股骨近端的最大应变。基于Frost力学调节器理论，PFBN可将股骨近端局部力学环境调节至中等过载区域，使股骨近端处于生理过载状态，有利于股骨粗隆间骨折术后恢复。老年人。这项工作表明PFBN可能成为治疗不稳定股骨粗隆间骨折的灵丹妙药，并为改进内固定方法提供了见解。