Proximal Femur N Triangle Theory and the Design Concept of Proximal Femur Bionic Nail (PFNB)

doi:10.3877/cma.j.issn.2096-0263.2021.05.001

Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition) ›› 2021, Vol. 07 ›› Issue (05): 257-259. doi: 10.3877/cma.j.issn.2096-0263.2021.05.001

Special Issue: Orthopedics；

• Research Letters • Next Articles

Proximal Femur N Triangle Theory and the Design Concept of Proximal Femur Bionic Nail (PFNB)

Yanbin Zhu¹, Wei Chen¹, Dandan Ye², Qi Zhang², Hongzhi Lyu², Zhanle Zheng¹, Yingze Zhang³^,^†()

^1. Orthopedic Research Institution of Hebei Province; Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University; Key Laboratory of Biomechanics of Hebei Province; NHC Key Laboratory of Intelligent Orthopaedic Equipment (The Third Hospital of Hebei Medical University), Shijiazhuang 050051, China
^2. Orthopedic Research Institution of Hebei Province; Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University; NHC Key Laboratory of Intelligent Orthopaedic Equipment (The Third Hospital of Hebei Medical University), Shijiazhuang 050051, China
^3. Orthopedic Research Institution of Hebei Province; Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University; Key Laboratory of Biomechanics of Hebei Province; NHC Key Laboratory of Intelligent Orthopaedic Equipment (The Third Hospital of Hebei Medical University), Shijiazhuang 050051, China; Chinese Academy of Engineering, Beijing 10088, China

Received:2021-09-25 Online:2021-10-05 Published:2021-12-06
Contact: Yingze Zhang

Abstract

Abstract:

Ward's triangle was proposed by Ward in 1838 and was an important finding to understand the anatomical structure and mechanical conduction characteristics of the femur at that time. In fact, there is far more than one Ward triangle, but it is composed of several "macroscopic triangles" and a large number of "microscopic triangles", which is the "Zhang's N triangle theory". Based on Zhang's N triangle theory, and after analyzing the causes of complications of internal fixation after femoral fracture surgery, the research team designed and developed a proximal femoral bionic nail (PFBN) that is more in accordance with the mechanical characteristics of the human body. The aim of this paper is to provide research ideas for the scientificity and rationality of its clinical application by elaborating the structural and mechanical characteristics of PFBN developed under the guidance of "Zhang's N triangle theory".

Key words: Intertrochanteric fracture, Proximal femur, Ward triangle, Bionic intramedullary nail, Zhang's N triangle theory

Yanbin Zhu, Wei Chen, Dandan Ye, Qi Zhang, Hongzhi Lyu, Zhanle Zheng, Yingze Zhang. Proximal Femur N Triangle Theory and the Design Concept of Proximal Femur Bionic Nail (PFNB)[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2021, 07(05): 257-259.

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References 11

1	White TD, Black MT, Folkens PA. - Human osteology[Z]. 3rd ed, New York: Academic Press, 2011: 593-632.
2	Wolf JH. [Julis Wolff and his "law of bone remodeling"]. Orthopade. 1995, 24(5): 378-86.
3	Mavrogenis AF, Panagopoulos GN, Megaloikonomos PD, et al. Complications after hip nailing for fractures[J]. Orthopedics, 2016, 39(1): e108-e116.
4	Von Rüden C, Hungerer S, Augat P, et al. Breakage of cephalomedullary nailing in operative treatment of trochanteric and subtrochanteric femoral fractures[J]. Arch Orthop Trauma Surg, 2015, 135(2): 179-185.
5	Lim SJ, So SY, Yc Y, et al. A forward-striking technique for reducing fracture gaps during intramedullary nailing: A technical note with clinical results[J]. Injury, 2015, 46(12): 2507-2511.
6	Horner NS, Samuelsson K, Solyom J, et al. Implant-Related complications and mortality after use of short or long gamma nail for intertrochanteric and subtrochanteric fractures:a prospective study with minimum 13-Year follow-up[J]. JB JS Open Access, 2017, 2(3): 26-32.
7	Zhang YZ. Clinical epidemiology of orthopaedic trauma[M]. 2nd ed, Stuttgart: Thieme, 2016: 157-213.
8	Bovbjerg PE, Larsen MS, Madsen CF, et al. Failure of short versus long cephalomedullary nail after intertrochanteric fractures[J]. J Orthop, 2020, 18: 209-212.
9	Kokoroghiannis C, Aktselis I, Deligeorgis A, et al. Evolving concepts of stability and intramedullary fixation of intertrochanteric fractures--a review[J]. Injury, 2012, 43(6): 686-693.
10	Norris R, Bhattacharjee D, Parker MJ. Occurrence of secondary fracture around intramedullary nails used for trochanteric hip fractures: a systematic review of 13,568 patients[J]. Injury, 2012, 43(6): 706-711.
11	张英泽，王海程，陈伟，等. 三角支撑固定：股骨转子间骨折手术的革新——来自生物力学研究的证据[J]. 中华创伤骨科杂志，23：461-466.

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