• Injury · Dec 2022

    Modified Ni-Nail and C-Nail systems for intra-articular fractures of the calcaneus: A biomechancial study.

    • Zihuan Xu, Wanju Sun, Pengfei Li, Yongqin Wang, Duo Wai-Chi Wong, James Chung-Wai Cheung, Wenxin Niu, Haowei Zhang, and Ming Ni.
    • School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China.
    • Injury. 2022 Dec 1; 53 (12): 390439113904-3911.

    ObjectivesWe have proposed a novel intramedullary nail (Ni-Nail) by incorporating a sustentaculum tali screw to improve the fixation stability of minimally invasive treatment for calcaneal fractures. This study aimed to evaluate the biomechanical characters of the Ni-Nail system and compare it with traditional C-Nail system.MethodsA finite element model of a Sanders type-IIIAB calcaneal fracture was reconstructed and fixed using two intramedullary nail systems, which was validated by a cadaver study. A vertical loading of 700 N was applied to the subtalar joint surfaces, and 525 N Achilles tendon tension was applied to the superior border of the Achilles tuberosity. The von Mises stresses and fracture displacements of both fixation models were evaluated.ResultsThe maximum von Mises stress of the screws of Ni-Nail and C-Nail were 27.92 MPa and 57.42 MPa, respectively, while that of the main nail were 67.44 MPa and 53.01 MPa. In addition, the maximum fracture displacement of the Ni-Nail was larger than that of C-Nail by 15.6% (0.37 mm vs.0.32 mm).ConclusionsOur static simulation analysis showed that both Ni-Nail and C-Nail demonstrated similar biomechanical stability for calcaneal fixation. The Ni-Nail features a simple structure that is easier to operate and less traumatizing. Future studies may consider to further evaluate the clinical effectiveness by clinical trials and follow-ups.Copyright © 2022. Published by Elsevier Ltd.

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