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. 2023 Mar 27;13(4):587.
doi: 10.3390/jpm13040587.

Biomechanical Comparison of Conventional Plate and the C-Nail® System for the Treatment of Displaced Intra-Articular Calcaneal Fractures: A Finite Element Analysis

Roxana Maria Pînzaru  1 , Silviu Dumitru Pavăl  2 , Mihaela Perțea  3 , Ovidiu Alexa  1 , Paul Dan Sîrbu  1 , Alexandru Filip  1 , Adrian Claudiu Carp  1 , Liliana Savin  1 , Norin Forna  1 , Bogdan Veliceasa  1
Affiliations

Biomechanical Comparison of Conventional Plate and the C-Nail® System for the Treatment of Displaced Intra-Articular Calcaneal Fractures: A Finite Element Analysis

Roxana Maria Pînzaru et al. J Pers Med. .

Abstract

The C-Nail® system is a novel intramedullary fixation method for displaced intra-articular calcaneal fractures. The aim of this study was to evaluate the biomechanical performance of the C-Nail® system and compare it with conventional plate fixation for the treatment of displaced intra-articular calcaneal fractures using finite element analysis. The geometry of a Sanders type-IIB fracture was constructed using the computer-aided design software Ansys SpaceClaim. The C-Nail® system (Medin, Nové Mesto n. Morave, Czech Republic) and the calcaneal locking plate (Auxein Inc., 35 Doral, Florida) and screws were designed according to the manufacturer specifications. Vertical loading of 350 N and 700 N were applied to the subtalar joint surfaces to simulate partial weight bearing and full weight bearing. Construct stiffness, total deformation, and von Mises stress were assessed. The maximum stress on the C-Nail® system was lower compared with the plate (110 MPa vs. 360 MPa). At the bone level the stress was found to have higher values in the case of the plate compared to the C-Nail® system. The study suggests that the C-Nail® system can provide sufficient stability, making it a viable option for the treatment of displaced intra-articular calcaneal fractures.

Keywords: C-Nail; biomechanics; calcaneal fracture; finite element analysis; interlocking nail; locking plate.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Sanders fracture type-IIB.
Figure 2
Figure 2
C-Nail® implant.
Figure 3
Figure 3
Calcaneal locking plate.
Figure 4
Figure 4
Force distribution and orientation.
Figure 5
Figure 5
Fixed boundaries (coloured in dark blue).
Figure 6
Figure 6
Colour-coded scale for deformation simulations.
Figure 7
Figure 7
Colour-coded scale for stress simulations.
Figure 8
Figure 8
The von Mises stress on the C-Nail® implant structure.
Figure 9
Figure 9
The von Mises stress on the plate implant structure.
Figure 10
Figure 10
The von Mises stress for calcaneal bone with the C-Nail® implant (left lateral view).
Figure 11
Figure 11
The von Mises stress for calcaneal bone with the plate implant (left lateral view).
Figure 12
Figure 12
The von Mises stress for calcaneal bone with the C-Nail® implant (left medial view).
Figure 13
Figure 13
The von Mises stress for calcaneal bone with the plate implant (left medial view).
Figure 14
Figure 14
Calcaneal bone displacement in the case of the C-Nail® simulation.
Figure 15
Figure 15
Calcaneal bone displacement in the case of the plate implant simulation.
See this image and copyright information in PMC

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