Experimental and probabilistic analysis of distal femoral XXXX : a comparison of locking plate and intramedullary nail fixation. Part B: probabilistic investigation.

@entity79 @entity3564 @entity174
The following is Part B of a two-part study. Part A evaluated, biomechanically, intramedullary (IM) nails versus locking plates for fixation of an extra-articular, metaphyseal wedge @entity174 in @entity79 . Part B of this study introduces deterministic finite element (FE) models of each construct type in @entity79 and investigates the probability of @entity3564 of the locking plate compared with the retrograde IM nail using Monte Carlo simulation. Deterministic FE models of the @entity174 implanted with IM nail and locking plate, respectively, were developed and validated using experimental data presented in Part A of this study. The models were validated by comparing the load-displacement curve of the experimental data with the load-displacement curve of the FE simulation with a root-mean square error of less than 3  mm. The validated FE models were then modified by defining the cortical and cancellous bone modulus of elasticity as uncertain variables that could be assumed to vary randomly. Monte Carlo simulation was used to evaluate the @entity174 ( @entity174 ) of each fixation. The @entity174 represents the cumulative probability that the predicted shear stresses in the cortical bone will exceed the expected shear strength of the cortical bone. This investigation provides information regarding the significance of post-operative damage accumulation on the @entity174 of the implanted bones when the two fixations are used. The probabilistic analysis found the locking plate fixation to have a higher @entity174 than the IM nail fixation under the applied loading conditions (locking plate 21.8% versus IM nail 0.019%).
