A comparative biomechanical study of the Distal Tibia Nail against compression plating for the osteosynthesis of supramalleolar corrective osteotomies.

Autor: Greenfield J; Univ Gustave Eiffel, IFSTTAR, LBMC, UMR_T9406, Univ Lyon, 25 Avenue François Mitterrand, 69500, Bron, France.; Department of Orthopaedics and Traumatology, University Medical Centre of the Johannes Gutenberg University, Langenbeckstrasse 1, 55131, Mainz, Germany., Appelmann P; Department of Orthopaedics and Traumatology, University Medical Centre of the Johannes Gutenberg University, Langenbeckstrasse 1, 55131, Mainz, Germany., Lafon Y; Univ Gustave Eiffel, IFSTTAR, LBMC, UMR_T9406, Univ Lyon, 25 Avenue François Mitterrand, 69500, Bron, France., Bruyère-Garnier K; Univ Gustave Eiffel, IFSTTAR, LBMC, UMR_T9406, Univ Lyon, 25 Avenue François Mitterrand, 69500, Bron, France., Rommens PM; Department of Orthopaedics and Traumatology, University Medical Centre of the Johannes Gutenberg University, Langenbeckstrasse 1, 55131, Mainz, Germany., Kuhn S; Department of Orthopaedics and Traumatology, University Medical Centre of the Johannes Gutenberg University, Langenbeckstrasse 1, 55131, Mainz, Germany. sebastian.kuhn@unimedizin-mainz.de.; Department of Digital Medicine, Medical Faculty OWL, Bielefeld University, Universitätsstr. 25, 33615, Bielefeld, Germany. sebastian.kuhn@unimedizin-mainz.de.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2021 Sep 22; Vol. 11 (1), pp. 18834. Date of Electronic Publication: 2021 Sep 22.
DOI: 10.1038/s41598-021-97968-z
Abstrakt: The Distal Tibia Nail (DTN; Mizuho, Japan) has demonstrated higher biomechanical stiffness to locking plates in previous research for A3 distal tibia fractures. It is here investigated as a fixation option for supramalleolar corrective osteotomies (SMOT). Sixteen Sawbones tibiae were implanted with either a DTN (n = 8) or Medial Distal Tibia Plate (MDTP; n = 8) and a SMOT simulated. Two surgical outcome scenarios were envisaged: "best-case" representing an intact lateral cortex, and "worst-case" representing a fractured lateral cortex. All samples were subjected to compressive (350 N, 700 N) and torsional (± 4 Nm, ± 8 Nm) testing. Samples were evaluated using calculated construct stiffness from force-displacement data, interfragmentary movement and Von Mises' strain distribution. The DTN demonstrated a greater compressive stiffness for the best-case surgical scenario, whereas the MDTP showed higher stiffness (p < 0.05) for the worst-case surgical scenario. In torsional testing, the DTN proved more resistant to torsion in the worst-case surgical setup (p < 0.05) for both ± 4 Nm and ± 8 Nm. The equivalent stiffness of the DTN against the MDTP supports the use of this implant for SMOT fixation and should be considered as a treatment option particularly in patients presenting vascularisation problems where the MDTP is an inappropriate choice.
(© 2021. The Author(s).)
Databáze: MEDLINE
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