Initial construct stability of long cephalomedullary nails with superior locking for a complex trochanteric fracture model AO31A2.2– a biomechanical study.

Autor: Schulz, Arndt-Peter, Münch, Matthias, Barth, Tobias, Kowald, Birgitt, Frese, Jasper, Behrends, Lina, Hartel, Maximilian
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Zdroj: Journal of Orthopaedic Surgery & Research; 11/6/2024, Vol. 19 Issue 1, p1-11, 11p
Abstrakt: Background: Complex fractures of the trochanteric region, as well as fractures located in the directly subtrochanteric region, are controversially discussed around the world regarding the nail type to be used. A long nail is recommended by manufacturers but requires longer surgical and fluoroscopy times. A possible solution could be a nail with an appropriate length which can be locked in a minimally invasive manner by the main aiming device. We aimed to determine if such a nail model (DCN SL nail, SWEMAC, Linköping, Sweden) offers similar structural stability on biomechanical testing on artificial bone as a standard long nail when used to treat complex trochanteric fractures and compared it to long nails usually used in this setting. Methods: An osteoporotic bone model was chosen. The Swemac Hansson DCN Nail System was used as osteosynthesis material. Two types of nails were chosen: a superior lock nail which can be implanted with a singular targeting device, and a long nail with distal locking using free-hand technique. AO31A2.2 fractures were simulated in a standardised manner. Axial height of the construct, varus collapse, and rotational deformity directly after nail insertion were simulated. A Universal Testing Machine was used. Measurements were made with a stereo-optic tracking system. Findings: There was a detectable difference in the axial fracture movement resulting in narrowing of the fracture gap. There was no difference in varus collapse or rotational deformity between the nail variants Conclusion: We conclude that there are small differences which are clinically insignificant and that a superior locking nail can safely be used to manage complex trochanteric fractures. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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