{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:50:51Z","timestamp":1792687851875,"version":"4.5.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T00:00:00Z","timestamp":1683590400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> To evaluate the biomechanical effects of Poller screws (PS) combined with small-diameter intramedullary nails in the treatment of distal tibial fractures at different locations and on different planes.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Nine finite element (FE) models were used to simulate the placement of the intramedullary nail (IMN) and the PS for distal tibial fractures. Structural stiffness and interfragmentary motion (IFM) through the fracture were investigated to assess the biomechanical effects of the PS. The allowable stress method was used to evaluate the safety of the construct.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> With the axial load of 500\u00a0N, the mean axial stiffness of IMN group was 973.38 \u00b1 95.65\u00a0N\/mm, which was smaller than that at positions A and B of the coronal group and sagittal group (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). The shear IFM of the IMN group was 2.10 \u00b1 0.02\u00a0mm, which were smaller than that at positions A and B of the coronal group and sagittal group (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). Under physiological load, the stresses of all internal fixation devices and the nail-bone interface were within a safe range.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> In the treatment of distal tibial fractures, placing the PS in the proximal fracture block can obtain better biomechanical performance. The IMN fixation system can obtain higher structural stiffness and reduce the IFM of the fracture end by adding PS.<\/jats:p>","DOI":"10.3389\/fbioe.2023.1172013","type":"journal-article","created":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T05:26:47Z","timestamp":1683610007000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["In silico biomechanical analysis of poller screw-assisted small-diameter intramedullary nail in the treatment of distal tibial fractures"],"prefix":"10.3389","volume":"11","author":[{"given":"Jinchuan","family":"Tan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuecheng","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanbin","family":"Ouyang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongliang","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuping","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhua","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,9]]},"reference":[{"key":"B26","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1177\/0954411920941664","article-title":"Fixation of distal tibia fracture through plating, nailing, and nailing with Poller screws: A comparative biomechanical-based experimental and numerical investigation","volume":"234","author":"Baseri","year":"2020","journal-title":"Proc. Inst. Mech. Eng. H."},{"key":"B1","doi-asserted-by":"publisher","first-page":"406","DOI":"10.5435\/00124635-200607000-00003","article-title":"Surgical treatment of nonarticular distal tibia fractures","volume":"14","author":"Bedi","year":"2006","journal-title":"J. Am. Acad. Orthop. Sur"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1652","DOI":"10.2106\/JBJS.I.01111","article-title":"Far cortical locking can improve healing of fractures stabilized with locking plates","volume":"92","author":"Bottlang","year":"2010","journal-title":"J. Bone Jt. Surg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"S28","DOI":"10.1097\/BOT.0000000000000467","article-title":"Biomechanical concepts for fracture fixation","volume":"29","author":"Bottlang","year":"2015","journal-title":"J. Orthop. Trauma"},{"key":"B4","doi-asserted-by":"publisher","first-page":"466","DOI":"10.2106\/JBJS.O.00705","article-title":"Dynamic stabilization with active locking plates delivers faster, stronger, and more symmetric fracture-healing","volume":"98","author":"Bottlang","year":"2016","journal-title":"J. Bone Jt. Surg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s13018-017-0707-8","article-title":"Finite element analysis of intramedullary nailing and double locking plate for treating extra-articular proximal tibial fractures","volume":"13","author":"Chen","year":"2018","journal-title":"J. Orthop. Surg. Res."},{"key":"B6","doi-asserted-by":"publisher","first-page":"S132","DOI":"10.1097\/00003086-199810001-00015","article-title":"Effects of mechanical factors on the fracture healing process","volume":"355","author":"Claes","year":"1998","journal-title":"Clin. Orthop. Relat. Res."},{"key":"B7","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1080\/10255842.2020.1844882","article-title":"Biomechanical assessment of screw safety between far cortical locking and locked plating constructs","volume":"24","author":"Deng","year":"2021","journal-title":"Comput. Methods Biomech. Biomed. Engin"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1016\/j.injury.2014.02.029","article-title":"A novel technique for accurate Poller (blocking) screw placement","volume":"45","author":"Hannah","year":"2014","journal-title":"Injury"},{"key":"B9","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1097\/TA.0b013e318251683f","article-title":"Biomechanical comparison of locked plate osteosynthesis, reamed and unreamed nailing in conventional interlocking technique, and unreamed angle stable nailing in distal tibia fractures","volume":"73","author":"Hoegel","year":"2012","journal-title":"J. Trauma Acute Care"},{"key":"B10","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1302\/0301-620X.81B6.0810963","article-title":"The use of Poller screws as blocking screws in stabilising tibial fractures treated with small diameter intramedullary nails","volume":"81","author":"Krettek","year":"","journal-title":"J. bone Jt. Surg. Br."},{"key":"B11","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1097\/00005131-199911000-00006","article-title":"The mechanical effect of blocking screws (\"Poller screws\") in stabilizing tibia fractures with short proximal or distal fragments after insertion of small-diameter intramedullary nails","volume":"8","author":"Krettek","year":"1999","journal-title":"J. Orthop. trauma"},{"key":"B12","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1177\/230949901202000308","article-title":"Intramedullary nailing supplemented with poller screws for proximal tibial fractures","volume":"20","author":"Kulkarni","year":"2012","journal-title":"J. Orthop. Surg. Hong. Kong)"},{"key":"B13","doi-asserted-by":"publisher","first-page":"312","DOI":"10.4055\/cios.2014.6.3.312","article-title":"Biomechanical analysis of operative methods in the treatment of extra-articular fracture of the proximal tibia","volume":"6","author":"Lee","year":"","journal-title":"Clin. Orthop. Surg."},{"key":"B14","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1097\/BOT.0b013e3181b013d2","article-title":"Intramedullary nailing versus percutaneous locked plating of extra-articular proximal tibial fractures: Comparison of 56 cases","volume":"23","author":"Lindvall","year":"2009","journal-title":"J. Orthop. Trauma"},{"key":"B15","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1097\/BOT.0b013e3181be6720","article-title":"Locked plating of distal femur fractures leads to inconsistent and asymmetric callus formation","volume":"24","author":"Lujan","year":"2010","journal-title":"J. Orthop. Trauma"},{"key":"B16","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1302\/2058-5241.5.190040","article-title":"Systematic review on the outcomes of poller screw augmentation in intramedullary nailing of long bone fracture","volume":"5","author":"Maria","year":"2020","journal-title":"EFORT Open Rev."},{"key":"B17","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1007\/s00776-003-0671-5","article-title":"Biomechanical analysis for stress fractures of the anterior middle third of the tibia in athletes: Nonlinear analysis using a three-dimensional finite element method","volume":"8","author":"Norio Sonoda","year":"2003","journal-title":"J. Orthop. Sci."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1302\/0301-620x.84b8.13752","article-title":"Evolution of the internal fixation of long bone fractures: The scientific basis of biological internal fixation: Choosing a new balance between stability and biology","volume":"84","author":"Perren","year":"2002","journal-title":"Bone Jt. J."},{"key":"B19","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1016\/j.injury.2011.12.006","article-title":"Finite element analysis of Puddu and Tomofix plate fixation for open wedge high tibial osteotomy","volume":"43","author":"Raja Izaham","year":"","journal-title":"Injury"},{"key":"B20","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1097\/00005131-200105000-00005","article-title":"Fractures of the proximal third of the tibial shaft treated with intramedullary nails and blocking screws","volume":"15","author":"Ricci","year":"1999","journal-title":"J. Orthop. Trauma"},{"key":"B27","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1177\/0954411919856138","article-title":"Stability of femoral neck fracture fixation: A finite element analysis","volume":"233","author":"Samsami","year":"2019","journal-title":"Proc. Inst. Mech. Eng. H.J."},{"key":"B21","doi-asserted-by":"publisher","first-page":"S12","DOI":"10.1097\/BOT.0000000000000697","article-title":"Intramedullary tibial nail fixation of simple intraarticular distal tibia fractures","volume":"30","author":"Scolaro","year":"2016","journal-title":"J. Orthop. Trauma"},{"key":"B22","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1007\/s00590-011-0853-3","article-title":"Treatment for distal tibial fractures with intramedullary nails and blocking screws","volume":"22","author":"Seyhan","year":"2012","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1002\/jbm.820270205","article-title":"Experimentaldetermination of friction characteristics at the trabecular bone\/porous-coated metal interface in cementlessimplants","volume":"27","author":"Shirazi-Adl","year":"1993","journal-title":"J. Biomed.Mat.Res."},{"key":"B24","doi-asserted-by":"publisher","first-page":"17","DOI":"10.2106\/00004623-200412002-00004","article-title":"The logic and clinical applications of blocking screws","author":"Stedtfeld","year":"2004","journal-title":"J. Bone Jt. Surg. Am."},{"key":"B25","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1016\/j.injury.2013.10.024","article-title":"Intramedullary nailing versus plating for extra-articular distal tibial metaphyseal fracture: A systematic review and meta-analysis","volume":"45","author":"Xue","year":"2014","journal-title":"Injury"}],"container-title":["Frontiers in Bioengineering and Biotechnology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2023.1172013\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T05:26:50Z","timestamp":1683610010000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2023.1172013\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,9]]},"references-count":27,"alternative-id":["10.3389\/fbioe.2023.1172013"],"URL":"https:\/\/doi.org\/10.3389\/fbioe.2023.1172013","relation":{},"ISSN":["2296-4185"],"issn-type":[{"value":"2296-4185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,9]]},"article-number":"1172013"}}