Abstract
Objective To obtain morphologic parameters of intramedullary nailing appropriate for proximal femur fractures in Chinese population by assessing the geometric match between 3 kinds of intramedullary nailing and Chinese proximal femurs.Methods One hundred and twenty Chinese femurs were scanned by computed tomography.3D models of Chinese femur were reconstructed on a collection of the CT data using Minics 10.01 software.Parameters of intramedullary nailing designed for proximal femur fractures were measured on the 3D models.3D models of internal fixation of the proximal femur with 3 kinds of intramedullary nailing,Proximal Femoral Nail Antirotation(PFNA),PFNA-Ⅱ and InterTan,were reconstructed using proE 4.0 software.The 3D models of 3 intramedullary nailing systems were imported into the Mimics software to match the 3D models of Chinese femur.The geometric match was assessed between the 3nailing systems and 20 Chinese femurs,which were randomly selected from 120 samples.The relative positions between the nail and the lateral wall of femur as well as between the nail and the top of greater troehanter were observed.Results The average protrusion of the nail into the lateral femoral cortex was significantly thicker in PFNA(1.51 ± 0.58 mm)than in PFNA-Ⅱ(0.12 ±0.21 mm)and InterTan(0.33 ± 0.26 mm)(F =57.189,P ＜ 0.001).The average extension distance of the nail beyond the top of the proximal femur was significantly shorter in InterTan(0.25 ± 0.34 mm)than in PFNA(3.47 ± 0.85 mm)and PFNA-Ⅱ(4.11 ±0.92 mm)(F =67.600,P ＜ 0.001).Conclusions PFNA-Ⅱ,as an improvement of PFNA,has evidently reduced intraoperative invasion to the lateral wall of femur,but does not solve the problem of proximal length.InterTan,with evidently reduced invasion to the lateral wall of femur and an appropriate proximal length,has a better anatomic match for the Chinese femur. Key words: Femur; Fracture fixation, intramedullary; Bone nails; Anatomy, comparative
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