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3D Bioprinting of Osteotomy-Aided Module
and resists the bending moment caused by physiological Data curation and Investigation: Daofeng Wang, Lin
loads. The lateral side could effectively reduce the sliding Han, Gaoxiang Xu
and deflection of the femoral neck under physiological Methodology: Lin Han
loading. Under physiological loading, the complete Formal analysis: Daofeng Wang, Huanyu Li
mechanical triangular structure could effectively reduce Writing – original draft: Daofeng Wang
the bending moment of the proximal femur, balance Writing – review & editing: Wupeng Zhang, Hua Li,
the shearing force of the physiological load, realize Cheng Xu
the balanced distribution of stress in the structure, and
maintain the balance and stability of the proximal femoral References
mechanical system. Medial sustainable nail was designed 1. Weeks CA, Begum F, Beaupre LA, et al., 2013, Locking
to form a triangular structure based on triangular stability
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into two groups for statistical analysis of interesting https://doi.org/10.1016/j.jse.2013.02.003
parameters. Second, we included only the composite 2. Rosenblum SF, Zuckerman JD, Kummer FJ, et al., 1992, A
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permit, to use cadaver bone models to verify the accuracy Surg Br, 74:352–7.
and practicability of this method. https://doi.org/10.1302/0301-620x.74b3.1587875
The accuracy of osteotomy directly affects the 3. Elkin DM, Galloway JD, Koury K, et al., 2021, Patella
variability of mechanical loading results. In spite of the Fracture Fixation with a Non-locked Anterior Plating
significance of the precision osteotomy, it is still rather Technique: A Biomechanical Study. Injury, 52:686–91.
challenging to develop and apply osteotomy techniques in
clinical setting. The rapid development of digital orthopedics https://doi.org/10.1016/j.injury.2020.11.040
has facilitated the fine design of medical device, which 4. Johnson J, Deren M, Chambers A, et al., 2019, Biomechanical
would gradually become an emerging trend that will shape Analysis of Fixation Devices for Basicervical Femoral Neck
the orthopedic field going forward [29,30] . The application Fractures. J Am Acad Orthop Surg, 27:e41–8.
of 3D printing and CAD for osteotomy modules in bone https://doi.org/10.5435/jaaos-d-17-00155
biomechanical study would facilitate a shift of osteotomy 5. Polat G, Akgül T, Ekinci M, et al., 2019, A Biomechanical
design from rough operation to precise implementation. We Comparison of Three Fixation Techniques in Osteoporotic
believe that this study could provide a standard method for
osteotomy design in bone biomechanical study. Reverse Oblique Intertrochanteric Femur Fracture with
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Acknowledgment 45:499–505.
We thank the statistician Huanyu Li from China Medical https://doi.org/10.1007/s00068-018-1061-1
University for her statistical assistance. 6. Zdero R, Olsen M, Bougherara H, et al., 2008, Cancellous
Bone Screw Purchase: A Comparison of Synthetic Femurs,
Funding Human Femurs, and Finite Element Analysis. Proc Inst Mech
This work was supported by the Special Projection on the Eng H, 222:1175–83.
Health Care of the Chinese Military Foundation (Grant https://doi.org/10.1243/09544119jeim409
14BJZ09), the Special Research Project of Prevention 7. Duplantier NL, Mitchell RJ, Zambrano S, et al., 2018,
and Treatment of Military Training Injuries (20XLS27), A Biomechanical Comparison of Fifth Metatarsal Jones
and the Beijing Natural Science Foundation (7222180).
Fracture Fixation Methods. Am J Sports Med, 46:1220–7.
Conflict of interest https://doi.org/10.1177/0363546517753376
The authors have no relevant financial or non-financial 8. Windell L, Kulkarni A, Alabort E, et al., 2021, Biomechanical
interests to disclose. Comparison of Periprosthetic Femoral Fracture Risk in Three
Femoral Components in a Sawbone Model. J Arthroplasty,
Author contributions 36:387–94.

Conceptualization: Jiantao Li, Hao Zhang, Jitian Li https://doi.org/10.1016/j.arth.2020.07.061
Funding acquisition: Jiantao Li 9. Windolf M, Braunstein V, Dutoit C, et al., 2009, Is a Helical

114 International Journal of Bioprinting (2022)–Volume 8, Issue 4