Highlights
- •A novel intramedullary nail was developed, which has better biomechanical stability than traditional C-Nail.
- •The intramedullary nail and screws could be precisely placed under the guidance of navigation handle.
- •The intramedullary nail system and navigation handle could be assembled and carried.
- •Sustentaculum tali screws effectively enhance the stability of intramedullary nails.
Abstract
Objectives
We have proposed a novel intramedullary nail (Ni-Nail) by incorporating a sustentaculum
tali screw to improve the fixation stability of minimally invasive treatment for calcaneal
fractures. This study aimed to evaluate the biomechanical characters of the Ni-Nail
system and compare it with traditional C-Nail system.
Methods
A finite element model of a Sanders type-IIIAB calcaneal fracture was reconstructed
and fixed using two intramedullary nail systems, which was validated by a cadaver
study. A vertical loading of 700 N was applied to the subtalar joint surfaces, and
525 N Achilles tendon tension was applied to the superior border of the Achilles tuberosity.
The von Mises stresses and fracture displacements of both fixation models were evaluated.
Results
The maximum von Mises stress of the screws of Ni-Nail and C-Nail were 27.92 MPa and
57.42 MPa, respectively, while that of the main nail were 67.44 MPa and 53.01 MPa.
In addition, the maximum fracture displacement of the Ni-Nail was larger than that
of C-Nail by 15.6% (0.37 mm vs.0.32 mm).
Conclusions
Our static simulation analysis showed that both Ni-Nail and C-Nail demonstrated similar
biomechanical stability for calcaneal fixation. The Ni-Nail features a simple structure
that is easier to operate and less traumatizing. Future studies may consider to further
evaluate the clinical effectiveness by clinical trials and follow-ups.
Keywords
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Article info
Publication history
Published online: September 25, 2022
Accepted:
September 22,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.