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Erschienen in: European Journal of Trauma and Emergency Surgery 4/2017

03.05.2016 | Original Article

A novel nail providing more biomechanical rotational and axial stability than conventional interlocking nail in femur complex fracture model

verfasst von: A. A. Karaarslan, N. Acar, Y. Örgen, H. Aycan, F. Ertem, E. Sesli

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 4/2017

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Abstract

Purpose

Inter-fragmentary rotational and axial instabilities are major challenges in nailing of complex or comminuted fractures. We aimed to compare the inter-fragmentary rotational and axial stability of novel anti-rotation interlocking nail and the conventional interlocking nail in complex or comminuted femur shaft fractures.

Methods

Twenty composite femurs were divided into two groups, 30 mm was resected from the mid-portion of all composite femurs. The inter-fragmentary rotational and axial stabilities were assessed.

Results

Between 10-N m external and 6-N m internal rotation torques, mean maximum inter-fragmentary rotational arc motion in the novel nails was 1.63 mm and 291 % less than that of the conventional nails (6.38 mm, P = 0.000). Between 150 N distraction and 2300 N compression, mean axial motion in the novel nails was 0.8 mm and 257 % less than that of the conventional nails (2.86 mm, p = 0.000).

Conclusion

An anti-rotational novel nail is superior to the conventional interlocking nail in terms of maximum inter-fragmentary rotational and axial stabilities in complex and comminuted femur shaft fractures.
Literatur
1.
Zurück zum Zitat Claes L, Eckert-Hubner K, Augat P. The effect of mechanical stability on local vascularization and tissue differentiation in callus healing. J Orthop Res. 2002;20(5):1099–105.CrossRefPubMed Claes L, Eckert-Hubner K, Augat P. The effect of mechanical stability on local vascularization and tissue differentiation in callus healing. J Orthop Res. 2002;20(5):1099–105.CrossRefPubMed
2.
Zurück zum Zitat Klein P, Schell H, Streitparth F, Heller M, Kassi JP, Kandziora F, et al. The initial phase of fracture healing is specifically sensitive to mechanical conditions. J Orthop Res. 2003;21(4):662–9.CrossRefPubMed Klein P, Schell H, Streitparth F, Heller M, Kassi JP, Kandziora F, et al. The initial phase of fracture healing is specifically sensitive to mechanical conditions. J Orthop Res. 2003;21(4):662–9.CrossRefPubMed
3.
Zurück zum Zitat Wolf JW Jr, White AA 3rd, Panjabi MM, Southwick WO. Comparison of cyclic loading versus constant compression in the treatment of long-bone fractures in rabbits. J Bone Jt Surg (Am vol). 1981;63(5):805–10.CrossRef Wolf JW Jr, White AA 3rd, Panjabi MM, Southwick WO. Comparison of cyclic loading versus constant compression in the treatment of long-bone fractures in rabbits. J Bone Jt Surg (Am vol). 1981;63(5):805–10.CrossRef
4.
Zurück zum Zitat Gonschorek O, Hofmann GO, Buhren V. Interlocking compression nailing: a report on 402 applications. Arch Orthop Trauma Surg. 1998;117(8):430–7.CrossRefPubMed Gonschorek O, Hofmann GO, Buhren V. Interlocking compression nailing: a report on 402 applications. Arch Orthop Trauma Surg. 1998;117(8):430–7.CrossRefPubMed
5.
Zurück zum Zitat Klein P, Opitz M, Schell H, Taylor WR, Heller MO, Kassi JP, et al. Comparison of unreamed nailing and external fixation of tibial diastases–mechanical conditions during healing and biological outcome. J orthop res. 2004;22(5):1072–8.CrossRefPubMed Klein P, Opitz M, Schell H, Taylor WR, Heller MO, Kassi JP, et al. Comparison of unreamed nailing and external fixation of tibial diastases–mechanical conditions during healing and biological outcome. J orthop res. 2004;22(5):1072–8.CrossRefPubMed
6.
Zurück zum Zitat Citak M, Kendoff D, Gardner MJ, Oszwald M, O’Loughlin PF, Olivier LC, et al. Rotational stability of femoral osteosynthesis in femoral fractures–navigated measurements. Technol health. 2009;17(1):25–32. Citak M, Kendoff D, Gardner MJ, Oszwald M, O’Loughlin PF, Olivier LC, et al. Rotational stability of femoral osteosynthesis in femoral fractures–navigated measurements. Technol health. 2009;17(1):25–32.
7.
Zurück zum Zitat DiBennardo R, Taylor JV. Sex assessment of the femur: a test of a new method. Am J Phys Anthropol. 1979;50(4):635–7.CrossRefPubMed DiBennardo R, Taylor JV. Sex assessment of the femur: a test of a new method. Am J Phys Anthropol. 1979;50(4):635–7.CrossRefPubMed
8.
Zurück zum Zitat Uzel AP, Deloumeaux J, Rouvillain JL, Laflamme GY, Durandeau A, Caix P. Comparative study of femoral diaphyseal morphometry in two male populations, in France and a French West Indies island: an example of clinical relevance of comparative anatomy for orthopedic practice. Surg Radiol Anat (SRA). 2011;33(3):235–40.CrossRef Uzel AP, Deloumeaux J, Rouvillain JL, Laflamme GY, Durandeau A, Caix P. Comparative study of femoral diaphyseal morphometry in two male populations, in France and a French West Indies island: an example of clinical relevance of comparative anatomy for orthopedic practice. Surg Radiol Anat (SRA). 2011;33(3):235–40.CrossRef
9.
Zurück zum Zitat Kose N, Gunal I, Wang X, Athanasiou KA, Agrawal CM, Mabrey JD. Setscrew distal locking for intramedullary nails: a biomechanical study. J Orthop Trauma. 2000;14(6):414–9.CrossRefPubMed Kose N, Gunal I, Wang X, Athanasiou KA, Agrawal CM, Mabrey JD. Setscrew distal locking for intramedullary nails: a biomechanical study. J Orthop Trauma. 2000;14(6):414–9.CrossRefPubMed
10.
Zurück zum Zitat Wang G, Pan T, Peng X, Wang J. A new intramedullary nailing device for the treatment of femoral shaft fractures: a biomechanical study. Clin Biomech. 2008;23(3):305–12.CrossRef Wang G, Pan T, Peng X, Wang J. A new intramedullary nailing device for the treatment of femoral shaft fractures: a biomechanical study. Clin Biomech. 2008;23(3):305–12.CrossRef
11.
Zurück zum Zitat Karaarslan AA, Karakaşli A, Karci T, Aycan H, Yildirim S, Sesli E. A new compression design that increases proximal locking screw bending resistance in femur compression nails. Acta Orthop Belg. 2015;81:245–50.PubMed Karaarslan AA, Karakaşli A, Karci T, Aycan H, Yildirim S, Sesli E. A new compression design that increases proximal locking screw bending resistance in femur compression nails. Acta Orthop Belg. 2015;81:245–50.PubMed
12.
Zurück zum Zitat Yilmaz E, Karakurt L, Bulut M, Belhan O, Serin E. Treatment of femoral shaft fractures and pseudoarthrosis with compressive and interlocking intramedullary nailing. Acta orthop et traumatol turc. 2005;39:7–15. Yilmaz E, Karakurt L, Bulut M, Belhan O, Serin E. Treatment of femoral shaft fractures and pseudoarthrosis with compressive and interlocking intramedullary nailing. Acta orthop et traumatol turc. 2005;39:7–15.
13.
Zurück zum Zitat Taylor SJ, Walker PS, Perry JS, Cannon SR, Woledge R. The forces in the distal femur and the knee during walking and other activities measured by telemetry. J Arthroplast. 1998;13(4):428–37.CrossRef Taylor SJ, Walker PS, Perry JS, Cannon SR, Woledge R. The forces in the distal femur and the knee during walking and other activities measured by telemetry. J Arthroplast. 1998;13(4):428–37.CrossRef
14.
Zurück zum Zitat Taylor SJ, Walker PS. Forces and moments telemetered from two distal femoral replacements during various activities. J Biomech. 2001;34(7):839–48.CrossRefPubMed Taylor SJ, Walker PS. Forces and moments telemetered from two distal femoral replacements during various activities. J Biomech. 2001;34(7):839–48.CrossRefPubMed
15.
Zurück zum Zitat Schneider E, Michel MC, Genge M, Zuber K, Ganz R, Perren SM. Loads acting in an intramedullary nail during fracture healing in the human femur. J Biomech. 2001;34(7):849–57.CrossRefPubMed Schneider E, Michel MC, Genge M, Zuber K, Ganz R, Perren SM. Loads acting in an intramedullary nail during fracture healing in the human femur. J Biomech. 2001;34(7):849–57.CrossRefPubMed
16.
Zurück zum Zitat Wähnert D, Stolarczyk Y, Hoffmeier KL, Raschke MJ, Hofmann GO, Mückley T. The primary stability of angle-stable versus conventional locked intramedullary nails. Int Orthop. 2012;36(5):1059–64.CrossRefPubMed Wähnert D, Stolarczyk Y, Hoffmeier KL, Raschke MJ, Hofmann GO, Mückley T. The primary stability of angle-stable versus conventional locked intramedullary nails. Int Orthop. 2012;36(5):1059–64.CrossRefPubMed
17.
Zurück zum Zitat Wähnert D, Stolarczyk Y, Hoffmeier KL, Raschke MJ, Hofmann GO, Mückley T. Long-term stability of angle-stable versus conventional locked intramedullary nails in distal tibia fractures. BMC musculoskelet disord. 2013;14:66.CrossRefPubMedPubMedCentral Wähnert D, Stolarczyk Y, Hoffmeier KL, Raschke MJ, Hofmann GO, Mückley T. Long-term stability of angle-stable versus conventional locked intramedullary nails in distal tibia fractures. BMC musculoskelet disord. 2013;14:66.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Hoffmann S, Gerber C, von Oldenburg G, Kessler M, Stephan D, Augat P. Effect of angular stability and other locking parameters on the mechanical performance of intramedullary nails. Biomed Tech (Berl). 2015;60(2):157–64.CrossRef Hoffmann S, Gerber C, von Oldenburg G, Kessler M, Stephan D, Augat P. Effect of angular stability and other locking parameters on the mechanical performance of intramedullary nails. Biomed Tech (Berl). 2015;60(2):157–64.CrossRef
19.
Zurück zum Zitat Karaarslan AA, Karakaşlı A, Aycan H, Ertem F, Sesli E. Biomechanical comparison of three-point bending resistance of titanium and stainless steel locking screws in intramedullary nails. Eklem Hastalik Cerrahisi. 2015;26(3):145–50.CrossRefPubMed Karaarslan AA, Karakaşlı A, Aycan H, Ertem F, Sesli E. Biomechanical comparison of three-point bending resistance of titanium and stainless steel locking screws in intramedullary nails. Eklem Hastalik Cerrahisi. 2015;26(3):145–50.CrossRefPubMed
20.
Zurück zum Zitat Hsu CC, Yongyut A, Chao CK, Lin J. Notch sensitivity of titanium causing contradictory effects on locked nails and screws. Med Eng Phys. 2010;32:454–60.CrossRefPubMed Hsu CC, Yongyut A, Chao CK, Lin J. Notch sensitivity of titanium causing contradictory effects on locked nails and screws. Med Eng Phys. 2010;32:454–60.CrossRefPubMed
21.
Zurück zum Zitat Chong AC, Friis EA, Ballard GP, Czuwala PJ, Cooke FW. Fatigue performance of composite analogue femur constructs under high activity loading. Ann Biomed Eng. 2007;35(7):1196–205.CrossRefPubMed Chong AC, Friis EA, Ballard GP, Czuwala PJ, Cooke FW. Fatigue performance of composite analogue femur constructs under high activity loading. Ann Biomed Eng. 2007;35(7):1196–205.CrossRefPubMed
22.
Zurück zum Zitat Brown NA, Bryan NA, Stevens PM. Torsional stability of intramedullary compression nails: tibial osteotomy model. Clin Biomech. 2007;22(4):449–56.CrossRef Brown NA, Bryan NA, Stevens PM. Torsional stability of intramedullary compression nails: tibial osteotomy model. Clin Biomech. 2007;22(4):449–56.CrossRef
Metadaten
Titel
A novel nail providing more biomechanical rotational and axial stability than conventional interlocking nail in femur complex fracture model
verfasst von
A. A. Karaarslan
N. Acar
Y. Örgen
H. Aycan
F. Ertem
E. Sesli
Publikationsdatum
03.05.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 4/2017
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-016-0677-2

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