TY - JOUR
T1 - Implications of three-dimensional modeling of the proximal femur for cephalomedullary nailing
T2 - An Asian cadaver study
AU - Chon, Chang Soo
AU - Kang, Bokku
AU - Kim, Han Sung
AU - Jung, Gu Hee
N1 - Publisher Copyright:
© 2017 Elsevier Ltd
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2017/10
Y1 - 2017/10
N2 - Purpose To determine the variability in the ideal entry point of cephalomedullary (CM) nail around the greater trochanter (GT) and the consequent conformity with the proximal femur by analyzing three-dimensional (3D) modeling and virtual implantation Materials and methods A total of 105 cadaveric femurs (50 males and 55 females) underwent continuous 1.0 mm slice computed tomography (CT) scans. CT images imported into Mimics® software to reconstruct the 3D model of the proximal femur and medullary canal. PFNA-II® was processed into a 3D model using a 3D-sensor at the actual size and optimally implanted in the proximal femur model using Mimics® software. The ideal entry point, nail conformity with the proximal femur, and the relationship between the entry point and adjacent structures were assessed. Results The ideal entry point was located a mean of 2.38 mm (SD, 3.53 mm) medial to the tip of GT. No lateral cortex impingement of the proximal femur occurred in the coronal plane based on the recommended point. However, a disparity in the sagittal plane between the proximal shaft and nail curvature was found in 47 models (44.8%). Rotation and magnification of the 3D model exposed all nails above the surface of the medial side of the GT. The proximal nail end was contained entirely within bone and circumferential endosteal cortical contact was present at the nail-bone interface.
AB - Purpose To determine the variability in the ideal entry point of cephalomedullary (CM) nail around the greater trochanter (GT) and the consequent conformity with the proximal femur by analyzing three-dimensional (3D) modeling and virtual implantation Materials and methods A total of 105 cadaveric femurs (50 males and 55 females) underwent continuous 1.0 mm slice computed tomography (CT) scans. CT images imported into Mimics® software to reconstruct the 3D model of the proximal femur and medullary canal. PFNA-II® was processed into a 3D model using a 3D-sensor at the actual size and optimally implanted in the proximal femur model using Mimics® software. The ideal entry point, nail conformity with the proximal femur, and the relationship between the entry point and adjacent structures were assessed. Results The ideal entry point was located a mean of 2.38 mm (SD, 3.53 mm) medial to the tip of GT. No lateral cortex impingement of the proximal femur occurred in the coronal plane based on the recommended point. However, a disparity in the sagittal plane between the proximal shaft and nail curvature was found in 47 models (44.8%). Rotation and magnification of the 3D model exposed all nails above the surface of the medial side of the GT. The proximal nail end was contained entirely within bone and circumferential endosteal cortical contact was present at the nail-bone interface.
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U2 - 10.1016/j.injury.2017.07.009
DO - 10.1016/j.injury.2017.07.009
M3 - Article
C2 - 28736124
AN - SCOPUS:85025429986
VL - 48
SP - 2060
EP - 2067
JO - Injury
JF - Injury
SN - 0020-1383
IS - 10
ER -