Abstract
The Marchetti-Vicenzi's nail is an intramedullary device where six curved nails are kept straight by a closing ring in order to allow their insertion into the medullary canal of a long bone; in a following step, these nails stabilize the fracture due to the ring withdrawal and to the consequent elastic expansion of the nails. Pre-clinical testing of this sort of device is strongly advocated in order to be able to foresee their stability inside the medullary canal and to quantify their stiffening action on a broken bone. In this numerical work, an MB (Multi Body) model of the device has been developed, with the dual purpose of evaluating forces between the bone and the system components during its progressive opening and verifying the behavior of the stabilized bone when it undergoes external loading. Different solutions, for flexible body modeling (discretization with lumped parameters, “flexible body,” “FE Part”), have been analyzed and compared in terms of accuracy of results and required computational resources. Contact parameters have been identified and criteria to simplify geometries and therefore to reduce simulation times have been given. Results have allowed to demonstrate how a moderate lateral force is able to dislocate the fracture and how the final position of the retention nut can be optimized. On the whole, a tool for the pre-clinical testing of elastic intramedullary nails has been given.
Highlights
Intramedullary nails are orthopedic devices for fractures fixation, successful in the treatment of long bones fractures (Eveleigh, 1994; Bong et al, 2007; Dutta and Datta, 2008)
Internal fixation devices have evolved over time (Court-Brown, 1991; Hessmann, 2015): at the beginning, they were rigid systems composed by one single nail implanted into the medullary cavity
The complexity of this work derives from solid bodies contacting flexible bodies undergoing large displacements
Summary
Intramedullary nails are orthopedic devices for fractures fixation, successful in the treatment of long bones fractures (Eveleigh, 1994; Bong et al, 2007; Dutta and Datta, 2008). The Marchetti-Vicenzi’s nail falls within the category of flexible intramedullary systems (Figure 1) This device has been developed for the first time in the middle ‘90s and its design has evolved over the years; its latest version is characterized by the presence of six nails which are pre-curved away from the longitudinal nail axis. These nails are kept closed by a ring nut, working as a retention system, in order to allow their introduction into the medullary canal. With reference to femoral fractures, the system does not seem to be able to provide the required stability according to some studies (Anastopoulos et al, 2001; Madan et al, 2003), leading to implant failure or long healing periods
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