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Finite element analysis of medial closing and lateral opening wedge osteotomies of the distal femur in relation to hinge fractures.
Meisterhans, Michel; Flury, Andreas; Zindel, Christoph; Zimmermann, Stefan M; Vlachopoulos, Lazaros; Snedeker, Jess G; Fucentese, Sandro F.
Afiliación
  • Meisterhans M; Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland. michel.meisterhans@balgrist.ch.
  • Flury A; Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
  • Zindel C; Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
  • Zimmermann SM; Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
  • Vlachopoulos L; Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
  • Snedeker JG; Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
  • Fucentese SF; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland.
J Exp Orthop ; 10(1): 33, 2023 Mar 27.
Article en En | MEDLINE | ID: mdl-36973592
PURPOSE: Intraoperative hinge fractures in distal femur osteotomies represent a risk factor for loss of alignment and non-union. Using finite element analysis, the goal of this study was to investigate the influence of different hinge widths and osteotomy corrections on hinge fractures in medial closed-wedge and lateral open-wedge distal femur osteotomies. METHODS: The hinge was located at the proximal margin of adductor tubercle for biplanar lateral open-wedge and at the upper border of the lateral femoral condyle for biplanar medial closed-wedge distal femur osteotomies, corresponding to optimal hinge positions described in literature. Different hinge widths (5, 7.5, 10 mm) were created and the osteotomy correction was opened/closed by 5, 7.5 and 10 mm. Tensile and compressive strain of the hinge was determined in a finite element analysis and compared to the ultimate strain of cortical bone to assess the hinge fracture risk. RESULTS: Doubling the correction from 5 to 10 mm increased mean tensile and compressive strain by 50% for lateral open-wedge and 48% for medial closed-wedge osteotomies. A hinge width of 10 mm versus 5 mm showed increased strain in the hinge region of 61% for lateral open-wedge and 32% for medial closed-wedge osteotomies. Medial closed-wedge recorded a higher fracture risk compared to lateral open-wedge osteotomies due to a larger hinge cross-section area (60-67%) for all tested configurations. In case of a 5 mm hinge, medial closed-wedge recorded 71% higher strain in the hinge region compared to lateral open-wedge osteotomies. CONCLUSION: Due to morphological features of the medial femoral condyle, finite element analysis suggests that lateral-open wedge osteotomies are the preferable option if larger corrections are intended, as a thicker hinge can remain without an increased hinge fracture risk.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: J Exp Orthop Año: 2023 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: J Exp Orthop Año: 2023 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Alemania