{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:25:35Z","timestamp":1771921535115,"version":"3.50.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"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:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to compare the fixation performance differences between the traditional proximal femoral nail antirotation (PFNA), \u201cII\u201d proximal femoral bionic nail (PFBN), and proximal femoral total bionic nail (PFTBN) in the treatment of intertrochanteric femoral fractures complicated by lateral wall injury using finite element analysis. Additionally, it intended to explore the biomechanical effects of reamed versus unreamed techniques on these novel intramedullary nail devices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Validated FEA models of intertrochanteric fractures (lateral wall injury) were constructed with 9\u00a0mm (unreamed) and 11\u00a0mm (reamed) medullary canals, followed by implantation of PFNA, \u201cII\u201d PFBN, or PFTBN. Under a vertical load of 2100\u00a0N, Von Mises Stress (VMS) and displacement of the femur and implants were quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Under a vertical load of 2100\u00a0N, in the unreamed condition, the PFTBN exhibited the lowest peak stress and displacement among the three devices, followed by the \u201cII\u201d PFBN, while the traditional PFNA showed the poorest performance. After reaming, all three implants demonstrated increased peak stress and slightly elevated peak displacement; however, PFTBN remained the most stable. Notably, reaming significantly reduced the overall peak stress of the femur. Collectively, PFTBN more effectively reduced the stress and displacement of both the femur and the implant under both reamed and unreamed conditions, with \u201cII\u201d PFBN showing intermediate efficacy. Both novel devices provided superior internal fixation stability compared to PFNA, which may contribute to a reduced risk of postoperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PFTBN outperforms \u201cII\u201d PFBN and PFNA in load\/shear resistance for intertrochanteric fractures with lateral wall injury, regardless of reaming. \u201cII\u201d PFBN also shows superior stability to PFNA. Reaming increases nail-bone contact, mitigating femoral stress concentration and refracture risk. Both PFTBN and \u201cII\u201d PFBN are reliable fixation options with promising clinical utility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fbioe.2026.1758146","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T06:45:43Z","timestamp":1771915543000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Finite element biomechanics of novel intramedullary nails with varying diameters for intertrochanteric femoral fractures with lateral wall injury"],"prefix":"10.3389","volume":"14","author":[{"given":"En","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Emergency Trauma Center, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhongjian","family":"Tang","sequence":"additional","affiliation":[{"name":"Graduate School of Hebei Medical University","place":["Shijiazhuang, China"]},{"name":"Department of Traumatology and Orthopedics, Peking University People\u2019s Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liucheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Second Affiliated Hospital of XuZhou Medical University","place":["Xuzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haitao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Emergency Trauma Center, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiwei","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Second Affiliated Hospital of XuZhou Medical University","place":["Xuzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yonghui","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Emergency Trauma Center, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1016\/j.medengphy.2007.12.009","article-title":"Comparison of an inhomogeneous orthotropic and isotropic material models used for FE analyses","volume":"30","author":"Baca","year":"2008","journal-title":"Med. 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