Improved Intramedullary Nail Interlocking in Osteoporotic Bone

Ito, Keita; Hungerbühler, Ruth; Wahl, D.; Grass, R.

doi:10.1097/00005131-200103000-00008

Cited by 81 publications

(42 citation statements)

References 6 publications

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“…Therefore, a new field of possible materials including high-strength metals with low ductility or fibre-reinforced mainly nondegradable plastics may now be considered. [128][129][130] Fillers or bone substitutes may provide strength but their absorption and influence on the blood supply need clarification. Open porous, expandable resorbable foams with elastic properties may prove to be useful.…”

Section: Further Developmentmentioning

confidence: 99%

Evolution of the Internal Fixation of Long Bone Fractures

Perren

2002

The Journal of Bone and Joint Surgery. British volume

641

183

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Section: Further Developmentmentioning

confidence: 99%

Evolution of the Internal Fixation of Long Bone Fractures

Perren

2002

The Journal of Bone and Joint Surgery. British volume

641

183

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“…The reason for this could be the helical blade, which fixes better in the head and distributes stress over a greater area when compared to the sliding screw. 8,9 However, the greater trochanter was avulsed in one of the Synthes nailbone units at 800 N load. This was due to cracking of the cortex during the impacted insertion of the helical blade, which occurred in all the three samples and caused weakening of the proximal metaphysis.…”

Section: Discussionmentioning

confidence: 99%

Three different interlocking intramedullary nails for unstable reverse oblique inter-trochanteric fractures: a bio-mechanical comparative study

et al. 2016

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Background: Biomechanical testing, intramedullary devices have proven advantageous over the extramedullary devices in the management of unstable intertrochanteric fractures. Reverse oblique type of intertrochanteric fractures are highly unstable and intramedullary nails are currently the method of internal fixation. The currently available nails seems to provide rotational, axial and angular stability, but biomechanical analysis of the strain pattern in the bone and implant in this fractures are lacking. The aim of this experimental study was to analyse the strain in three different long femoral nail-bone units under physiological loading when implanted in Saw bone model after creating a reverse oblique intertrochanteric fracture.Methods: A total of 12 sawbones were divided in to 4 equal groups. Group 1 was intact saw bones and were used as controls. Group 2, Group 3 and Group 4 were implanted with Depuy, Stryker and Synthes nails respectively after creating a reverse oblique intertrochanteric fracture. All the four groups were axially loaded with 100 N increments until physiological loads. The strain patterns were measured at the posteromedial cortex and the peak strains were extracted at partial weight bearing i.e. 500 N and full weight bearing physiological loads i.e. 1000 N.Results: There was no significant difference in peak strains among the groups at partial loads. However at 1000 N loads the peak strain in the DePuy nail-bone unit was significantly high compared to the other two nail-bone units and the controls. Conclusions: These results question the safety of immediate full weight bearing following surgery when treating the reverse oblique unstable fractures with DePuy intramedullary nails. A period of partial weight bearing following fixation of reverse oblique fractures would be wise when using DePuy nails.

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“…Unter Berü cksichtigung der biomechanischen Erkenntnisse [4,5] und der bisheriAbb.13 Distale Schraubenverriegelung. Abb.14 Distale Spiralklingenverriegelung.…”

Section: Nachbehandlungunclassified

“…Eigene vorab an Leichenfemura durchgefü hrte vergleichende biomechanische Testungen zeigten fü r die axiale Hauptbeanspruchung eine ü berlegene Steifigkeit und Festigkeit des DFN gegenü ber der Kondylenplatte und fü r osteoporotische Frakturen signifikante Stabilitä tsvorteile der Spiralklingenverriegelung gegenü ber der Schraubenverriegelung [4,5]. …”

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OP-Technik und Erfahrungsbericht über den distalen AO-Femurnagel (DFN)

Grass¹,

Biewener²,

Herzmann³

et al. 2000

OP-Journal

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subjektiv in 87 % als sehr gut und gut und in 13 % als befriedigend eingestuft. In der abschließenden Gesamtbeurteilung der verantwortlichen Operateure wurde der Verlauf in 84 % als sehr gut und gut und in 17 % als befriedigend eingeschä tzt. Schlussfolgerung: Geschlossene Reposition und Retention von suprakondylä ren und supra-diakondylä-ren Femurfrakturen sind in der beschriebenen Technik minimal invasiv und technisch einfach zu bewerkstelligen. Der DFN ist fü r die Versorgung extraartikulärer und kombiniert intraund extraartikulärer distaler Femurfrakturen ein geeignetes, sicheres und empfehlenswertes Implantat. Die Kombination grö ßere Oberflä che der Spiralklinge mit daraus resultierender gü nstigerer Verteilung der auf den weichen metaphysä ren Knochen axial eingeleiteten Last und winkelstabile Verankerung lassen vor allem beim osteoporotischen Knochen und/oder hochgradig instabilen Frakturen bei der Spiralklingenverriegelung einen gü nstigen Einfluss auf das bei der Anwendung anderer distaler Nageltechniken beobachtete Problem der Bolzenlockerung, Bolzen-und Nagelprotrusion erwarten. Einleitung

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Improved Intramedullary Nail Interlocking in Osteoporotic Bone

Abstract: This study showed the biomechanical benefits of increasing the bone-implant interface surface for improving the acute stiffness and strength of fracture fixation in osteoporotic cancellous bone. The fixator-bone construct withstood higher forces before failure in these fragile bones.

Cited by 81 publications

References 6 publications

Evolution of the Internal Fixation of Long Bone Fractures

Evolution of the Internal Fixation of Long Bone Fractures

Three different interlocking intramedullary nails for unstable reverse oblique inter-trochanteric fractures: a bio-mechanical comparative study

OP-Technik und Erfahrungsbericht über den distalen AO-Femurnagel (DFN)

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