オカザキ　ケン   OKAZAKI Ken   岡崎　賢    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Impact of support instruments in medial closed-wedge distal femoral osteotomy: a finite element analysis.
掲載誌名	正式名：Archives of orthopaedic and trauma surgery 略　 称：Arch Orthop Trauma Surg ISSNコード：14343916/09368051
掲載区分	国外
巻・号・頁	144(3),pp.1039-1045
著者・共著者	Kuwashima Umito, Itoh Masafumi, Itou Junya, Okazaki Ken
担当区分	最終著者
発行年月	2024/03
概要	INTRODUCTION:Medial closed-wedge distal femoral osteotomy (MCWDFO) is a valuable treatment approach for lateral knee osteoarthritis with femoral valgus deformity. Improved results have been reported with the upgrade of surgical techniques and locking plates. However, the risk of nonunion and loss of correction increases in cases of lateral hinge fractures. This study aimed to evaluate the mechanical impact of hinge fractures and support instruments in MCWDFO using finite element analysis (FEA).MATERIALS AND METHODS:Five femur models were developed using Mechanical Finder 11.0 FEA software. We simulated the following models: only a medial locking plate (MLP) (group A); an MLP with a lateral support screw (group B); and an MLP with a lateral support plate (group C). The equivalent stress around the hinge was evaluated and the percentage of the plastic deformation zone was calculated for the hinge area in the no-hinge fracture model. The equivalent stress of the MLP and the degree of displacement were calculated using the hinge fracture model.RESULTS:The percentages of the plastic deformation zone in groups A, B, and C were 18.0 ± 11.7%, 3.3 ± 2.4%, and 2.3 ± 2.8%, respectively. The percentages tended to be lower in groups B and C than in group A. In the hinge fracture model, the mean equivalent stress of the MLP in group C was significantly less than that in group A. In terms of the mean degree of displacement, group A showed more than 1 mm of displacement, which was significantly larger than that of the other groups.CONCLUSION:The support instruments provided stability to the hinge site and reduced the equivalent stress of the main plate in the MCWDFO with hinge fractures. No significant difference was observed between the two instruments in terms of stability.
DOI	10.1007/s00402-023-05152-x
PMID	38110736