{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T11:57:16Z","timestamp":1784807836776,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,9,19]],"date-time":"2022-09-19T00:00:00Z","timestamp":1663545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>How to restrict sliding of cephalomedullary nail and rigid reconstruct medial support for unstable intertrochanteric fractures remains a challenge. This study aims to explore the feasibility of a novel cephalomedullary nail for restriction sliding and reconstruction of medial femoral support to prevent failure in unstable trochanteric fractures through finite element analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The DICOM files of a unilateral femur spiral computed tomography (CT) scans from a elderly female were converted into STL files, and the most common clinical trochanteric fracture model with the absence of medial support, AO\/OTA 31\u2010A2.3 was simulated by removing the posterior medial femur. The model of a novel medial sustain nail (MSN\u2010II) and a widely used nail (proximal femoral nail anti\u2010rotation PFNA\u2010II) were modeled according to the manufacturer\u2010provided engineering drawing. Different loads were applied to the femoral head to simulate the postoperative weight bearing gait. The sliding distance of helical blade in femoral neck, maximum stress of femur and nail, displacement of proximal fragment were analyzed to revealing the mechanical stability of unstable trochanteric fracture stabilized by different implant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The sliding distance of helical blade in the femoral neck, the maximum stress on the femur and nail, the displacement of proximal fragment in MSN\u2010II under 2100N axial load were 0.65\u2009mm, 689\u2009MPa, 1271\u2009MPa, 16.84\u2009mm respectively, while that were 1.43\u2009mm, 720.8\u2009MPa, 1444\u2009MPa, 18.18\u2009mm, respectively in PFNA\u2010II. The difference between the two groups was statistically significant (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) and the stress was mainly distributed in medial distal side of nail but helical blade and the proximal aperture for the nail in MSN\u2010II. Compared to PFNA\u2010II, MSN\u2010II demonstrates biomechanical merit against femur medialization, cut\u2010out and coax varus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The sliding distance of helical blade in femoral neck, the maximum stress on the femur and nail, and the displacement of proximal fragment of MSN\u2010II were less than those of PFNA\u2010II in the treatment of unstable intertrochanteric fractures. Therefore MSN\u2010II has better stability than PFNA\u2010II and it may have the potential to avoid femur medialization and cut out. It might be an option in unstable trochanteric fracture because of its superiority in restricted sliding and medial support reconstruction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13497","type":"journal-article","created":{"date-parts":[[2022,9,19]],"date-time":"2022-09-19T08:29:16Z","timestamp":1663576156000},"page":"3009-3018","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["<scp>Finite\u2010Element<\/scp> Analysis of a Novel Cephalomedullary Nail for Restricted Sliding to Reduce Risk of Implant Failure in Unstable Intertrochanteric Fractures"],"prefix":"10.1111","volume":"14","author":[{"given":"Shaobo","family":"Nie","sequence":"first","affiliation":[{"name":"Department of Orthopedics PLA General Hospital  Beijing China"},{"name":"National Clinical Research Center for Orthopedics Sports Medicine &amp; Rehabilitation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiantao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics PLA General Hospital  Beijing China"},{"name":"National Clinical Research Center for Orthopedics Sports Medicine &amp; Rehabilitation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics PLA General Hospital  Beijing China"},{"name":"National Clinical Research Center for Orthopedics Sports Medicine &amp; Rehabilitation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Orthopedics PLA General Hospital  Beijing China"},{"name":"National Clinical Research Center for Orthopedics Sports Medicine &amp; Rehabilitation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics PLA General Hospital  Beijing China"},{"name":"National Clinical Research Center for Orthopedics Sports Medicine &amp; Rehabilitation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of orthopedics Yan'an Hospital Affiliated to Kunming Medical University  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuewen","family":"Gan","sequence":"additional","affiliation":[{"name":"Department of orthopedics Yan'an Hospital Affiliated to Kunming Medical University  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6782-1749","authenticated-orcid":false,"given":"Licheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics PLA General Hospital  Beijing China"},{"name":"National Clinical Research Center for Orthopedics Sports Medicine &amp; Rehabilitation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4279-1704","authenticated-orcid":false,"given":"Peifu","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics PLA General Hospital  Beijing China"},{"name":"National Clinical Research Center for Orthopedics Sports Medicine &amp; Rehabilitation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.4842"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-022-01082-0"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1611090"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12853"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-017-0648-2"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-018-4098-1"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00776-015-0750-4"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.104B2.BJJ-2021-1078.R1"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-022-02921-z"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2019.11.006"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-020-03668-6"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04873-7"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2016.12.013"},{"issue":"2","key":"e_1_2_7_15_1","first-page":"CD013405","article-title":"Surgical interventions for treating extracapsular hip fractures in older adults: a network meta\u2010analysis","volume":"2","author":"Lewis SR","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.810.BJR-2019-0032.R1"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.87.BJR-2018-0271.R1"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2021.01.011"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001193"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.4055\/cios.2015.7.3.291"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2022.02.049"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2020.06.008"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(17)30489-8"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-020-04795-4"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.13144"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2021.103003"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2022.816250"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-021-01746-5"},{"key":"e_1_2_7_29_1","first-page":"314","volume-title":"PLAGH's Orthopaedic trauma surgery","author":"Tang PF","year":"2013"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2019.02.008"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.912.BJR-2020-0284.R1"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000001031"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2019.03.032"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2012.10.023"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.22469"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000008"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2018.01.005"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.25.2000150"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/7618079"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-019-01251-w"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2019.05.012"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000022"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2016.11.016"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.18.00997"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-014-2306-1"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000000945"},{"issue":"21","key":"e_1_2_7_47_1","first-page":"144","article-title":"Peri\u2010implant atypical femoral fracture after nail or plate osteosynthesis [published online ahead of print, 2021 May 27]","volume":"0949","author":"Kim JW","year":"2021","journal-title":"J Orthop Sci"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2011.03.014"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13497","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.13497","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13497","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T17:17:39Z","timestamp":1692638259000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.13497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,19]]},"references-count":47,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1111\/os.13497"],"URL":"https:\/\/doi.org\/10.1111\/os.13497","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,19]]},"assertion":[{"value":"2022-05-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}