Finite Element Evaluation Of Healing Performance Of Nailing And Plating For Femur Shaft Fractures Of Different Orientations

Fixation's flexibility allows for micromotion between fragments, resulting in faster bone healing. In the present study, a computational study has been performed to investigate and compare the healing performance of nailing and plating in different stability modes. The diaphyseal fractures in three different orientations have been considered. A nonlinear contact analysis has been conducted on 15 different fixations incorporating the nail and plate. The finite element analysis’s results revealed that the flexibility rather than rigidity in nail implantation increases axial micromotion (P < 0.05) and shear micromotion (P < 0.05) close to fracture region by 47.4 % and 12.4 % respectively for Proximal Lateral to Distal Medial fracture (PLDM), 36.5 % and 37.2 % for transverse fracture, and 21.5 % and 9.4 % for Proximal Medial to Distal Lateral fracture (PMDL). For limited contact dynamic compression plate (LCDCP) implantation, the flexible fixation enhances the axial and shear micromotion close to the fracture region by 75.7 % and 25.3 % for PLDM fracture, 37.8 % and 141.9 % for transverse fracture, and 54.1 % and 115.1 % for PMDL fracture. This study suggests that the flexibly fixed interlock nail for all fracture types, flexibly fixed LCDCP with 6 screws for PLDM fracture and the rigidly fixed interlock nail for transverse fracture provide a favorable mechanical environment for the healing of diaphyseal fracture.