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. 2020 Feb 11;15(1):45.
doi: 10.1186/s13018-020-1560-8.

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

Zhengrui Fan #  1   2 , Jianxiong Ma #  1   2 , Jian Chen  1   2 , Baocheng Yang  1   2 , Ying Wang  1   2 , Haohao Bai  1   2 , Lei Sun  1   2 , Yan Wang  1   2 , Bin Lu  1   2 , Ben-Chao Dong  1   2 , Aixian Tian  1   2 , Xinlong Ma  3   4   5
Affiliations

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

Zhengrui Fan et al. J Orthop Surg Res. .

Erratum in

Abstract

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 distribution, and displacement of talus and internal fixation.

Conclusions: To sum up, the Von Mises stress of fracture section was the smallest, the stress distribution of screws were the most scattered, and the peak value was the smallest in posterior to anterior parallel double screws fixation, which was obviously better than that in the other three groups. When using screws internal fixation, the method of posterior to anterior screws fixation is better than that of anterior to posterior screws fixation, and the peak value and stress distribution of parallel double screws fixation is better than that of cross double screws fixation. Thus, for the talar neck fracture, the use of posterior to anterior parallel double screws fixation is recommended in clinical surgery.

Keywords: Finite element analysis; Internal fixation; Talus neck fracture; Three-dimensional reconstruction.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Three-dimensional model reconstruction of ankle joint. b Surface fitting of a three-dimensional model of ankle joint. c Meshing of the ankle joint model
Fig. 2
Fig. 2
Model of talus neck fracture showing four different fixation strategies. a Antero-posterior parallel dual screws internal fixation methods. b Antero-posterior cross dual screws internal fixation methods. c Postero-anterior parallel dual screws internal fixation methods. d Postero-anterior cross dual screws internal fixation methods
Fig. 3
Fig. 3
a Interaction settings of 3D model. b Constraint and load settings of 3D model
Fig. 4
Fig. 4
a–d The stress distribution of talus. e–h The stress distribution of internal fixation
Fig. 5
Fig. 5
a–d The displacement of the talus. e–h The displacement of internal fixation
See this image and copyright information in PMC

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