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dc.contributor.authorChen, Shih-Haoen_US
dc.contributor.authorChiang, Ming-Chiehen_US
dc.contributor.authorHung, Ching-Huaen_US
dc.contributor.authorLin, Shang-Chihen_US
dc.contributor.authorChang, Hsiao-Weien_US
dc.date.accessioned2014-12-08T15:35:08Z-
dc.date.available2014-12-08T15:35:08Z-
dc.date.issued2014-01-01en_US
dc.identifier.issn0968-0160en_US
dc.identifier.urihttp://dx.doi.org/10.1016/j.knee.2013.03.006en_US
dc.identifier.urihttp://hdl.handle.net/11536/23852-
dc.description.abstractPurpose: Periprosthetic distal femur fracture after total knee arthroplasty due to the stress-shielding phenomenon is a challenging problem. Retrograde intramedullary nail (RIMN) or locking plate (LP) fixation with/without a strut allograft has been clinically used via less invasive stabilization surgery (LISS) for the treatment of these periprosthetic fractures. However, their biomechanical differences in construct stability and implant stress have not been extensively studied, especially for the osteoporotic femur. Methods: This study used a finite-element method to evaluate the differences between RIMN, LP, and LP/allograft fixation in treating periprosthetic distal femur fractures. There were sixteen variations of two fracture angles (transverse and oblique), two loading conditions (compression and rotation), and four bony conditions (one normal and three osteoporotic). Construct stiffness, fracture micromotion, and implant stress were chosen as the comparison indices. Results: The LP/allograft construct provides both lateral and middle supports to the displaced femur. Comparatively, the LP and RIMN constructs, respectively, transmit the loads through the lateral and middle paths, thus providing more unstable support to the construct and high stressing on the implants. The fracture pattern plays a minor role in the construct stabilization of the three implants. In general, the biomechanical performances of the RIMN and LP constructs were comparable and significantly inferior to those of the LP/allograft construct. The bone quality should be evaluated prior to the selection of internal fixators. Conclusions: The LP/allograft construct significantly stabilizes the fracture gap, reduces the implant stress, and serves as the recommended fixation for periprosthetic distal femur fracture. (C) 2013 Elsevier B.V. All rights reserved.en_US
dc.language.isoen_USen_US
dc.subjectDistal femur fractureen_US
dc.subjectKnee arthroplastyen_US
dc.subjectIntramedullaryen_US
dc.subjectRetrograde nailen_US
dc.subjectIntramedullary allograften_US
dc.subjectOsteoporotic femuren_US
dc.titleFinite element comparison of retrograde intramedullary nailing and locking plate fixation with/without an intramedullary allograft for distal femur fracture following total knee arthroplastyen_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.knee.2013.03.006en_US
dc.identifier.journalKNEEen_US
dc.citation.volume21en_US
dc.citation.issue1en_US
dc.citation.spage224en_US
dc.citation.epage231en_US
dc.contributor.department交大名義發表zh_TW
dc.contributor.department機械工程學系zh_TW
dc.contributor.departmentNational Chiao Tung Universityen_US
dc.contributor.departmentDepartment of Mechanical Engineeringen_US
dc.identifier.wosnumberWOS:000331160300042-
dc.citation.woscount4-
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