Mechanical evaluation for the finite element analysis of intramedullary nailing and plate screw system used in humerus transverse fractures

Simulation analysis of surgical neck fractures of the humerus related to bone degeneration

The most common type of proximal humerus fracture is surgical neck fracture. The purpose of this paper is to study the mechanical mechanism and the effect of bone degeneration on humeral surgical neck fractures. The right humerus finite element models were established based on CT computed tomography. The stress values and crack propagation process under an axial force were obtained. Three indexes (mechanical property, cortical bone thickness of diaphysis and cancellous bone volume fraction) in this article were used to describe bone degeneration. The results showed that the three models group with different index had the same conclusions. The calculation results showed that the higher the bone degeneration level, the shorter the fracture time and the lower the fracture stress. The crack initiated from the medial side of the humerus, then gradually grew toward lateral side along the both sides, and finally broke. The medial crack was flat and single like "a thin line", while the lateral fracture of the humerus was irregular and crushed into fragments. The medial humerus cracks were generated by tensile stress, while the lateral cracks were generated by compressive stress. The thickness of humerus diaphysis might be used as the index of fracture risk due to direct readability from clinical images and quantitative relation of fracture risk. This article would provide reference data for the treatment and prevention of humeral surgical neck fracture.

Biomechanical study of the effect of traction on elbow joint capsule contracture

Dynamic orthoses have a significant effect on the treatment of elbow capsular contracture. Because of the lack of quantitative research on traction forces, determining the appropriate traction force to help stretch soft tissues and maintain the joint's range of motion is a challenge in the rehabilitation process. We developed a human elbow finite element (FE) model incorporating the activity behavior of the muscles and considering different capsular contracture locations, including total, anterior and posterior capsular contractures, to analyze the internal biomechanical responses of different capsular contracture models during flexion (30 to 80 degrees). Traction loads of 10, 20, 30 and 40 N were applied to the ulna and radius at the maximum flexion angle (80 degrees) to explore the appropriate traction loads at week 4 after a joint capsule injury. We observed a significant increase in posterior capsule stress with anterior capsular contracture (ACC), and the maximum peak stress was 1.3 times higher than that in the healthy model. During the fourth week after elbow capsule injury, the appropriate traction forces for total capsule contracture (TCC), ACC and posterior capsule contracture (PCC) were 20, 10 and 20 N, respectively; these forces maintained a stable biomechanical environment for the elbow joint and achieved a soft tissue pulling effect, thus increasing elbow mobility. The results can be used as a quantitative guide for the rehabilitation physicians to determine the traction load for a specific patient.