Angular Stability Potentially Permits Fewer Locking Screws Compared With Conventional Locking in Intramedullary Nailed Distal Tibia Fractures: A Biomechanical Study
| Autor: | Karl Stoffel, Matthew Lawson-Smith, Ben Ockert, Karsten Schwieger, Boyko Gueorguiev, Markus Windolf, Dirk Wähnert |
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| Rok vydání: | 2011 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Bone Nails Prosthesis Design law.invention Intramedullary rod Fracture Fixation Internal law Cadaver Elastic Modulus Tensile Strength Fracture fixation Humans Medicine Orthopedics and Sports Medicine Tibia Aged Orthodontics integumentary system business.industry Biomechanics General Medicine Middle Aged musculoskeletal system Distal tibia Surgery Equipment Failure Analysis Tibial Fractures Treatment Outcome surgical procedures operative Orthopedic surgery Female business Cadaveric spasm |
| Zdroj: | Journal of Orthopaedic Trauma. 25:340-346 |
| ISSN: | 0890-5339 |
| DOI: | 10.1097/bot.0b013e3182163345 |
| Popis: | To compare mechanical stability of angle-stable locking construct with four screws with conventional five screw locking in intramedullary nailed distal tibia fractures under cyclic loading.Ten pairs of fresh-frozen human cadaveric tibiae were intramedullary nailed and assigned to either an angle-stable locking construct consisting of four screws or conventional five-screw locking. After simulating an unstable distal two-fragmental 42-A3.1 fracture, the specimens were mechanically tested under quasistatic and cyclic sinusoidal axial and torsional loading.Bending stiffness of the angle-stable and the conventional fixation was 644.3 N/° and 416.5 N/°, respectively (P = 0.075, power 0.434). Torsional stiffness of the angle-stable locking (1.91 Nm/°) was significantly higher compared with the conventional one (1.13 Nm/°; P = 0.001, power 0.981). Torsional play of the angle-stable fixation (0.08°) was significantly smaller compared with the conventional one (0.46°; P = 0.002, power 0.965). The angle-stable locking revealed significantly less torsional deformation in the fracture gap after one cycle (0.74°) than the conventional one (1.75°; P = 0.005, power 0.915) and also after 1000 cycles (angle-stable: 1.56°; conventional: 2.51°; P = 0.042, power 0.562). Modes of failure were fracture of the distal fragment, loosening of distal locking screws, nail breakage, and their combination, equally distributed between the groups (P = 0.325).Both the angle-stable locking technique using four screws and conventional locking consisting of five screws showed high biomechanical properties. Hence, angle-stable locking reflects a potential to maintain fixation stability while reducing the number of locking screws compared with conventional locking in intramedullary nailed unstable distal tibia fractures. |
| Databáze: | OpenAIRE |
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