Influence of intramedullary nail diameter and locking mode on the stability of tibial shaft fracture fixation

Abstract

On biomechanical grounds, the largest possible nail diameter should be used, with minimal reaming, so as to minimize fracture site movement. Compression after meticulous reduction should be considered in axially stable fractures.

Sex and Gender Considerations in Male Patients With Osteoporosis

“…The intramedullary canals in men are larger and can permit larger intramedullary implants. The larger-sized implants provide greater biomechanical stability than smaller-diameter implants [42], which aids in fracture healing. Despite these advantages in implant selection and screw fixation being more common in men, data from hip fracture studies suggest men continue to experience worse overall morbidity and mortality than women [28].…”

A newly designed intramedullary nail with distal interlocking system for tibia fractures in adults - the clinical results

“…[9] Attempts have been made for reducing movements and increasing stability at the fracture site following IM nailing. [21] Nevertheless, none of the currently available unreamed nailing systems provides enough stability to allow FWB the day after surgery. In our IM nail system, all patients are allowed FWB the day after surgery and none of them experienced a complication that could be related to instability of the fracture site.…”

Role of the fibula in the stability of diaphyseal tibial fractures fixed by intramedullary nailing

“…Following protocols developed by other investigators (Augat et al, 2008, Epari et al, 2007, Kaspar et al, 2005, Penzkofer et al, 2009 and applied by ourselves previously for characterisation of tibial IM nailing stability , Dailey et al, 2013, we carried out testing in axial tension/compression, anteroposterior ( …”

“…For the bending test, the crosshead load was ramped at 0.25 mm/s to produce a maximum bending moment of 20 N-m with tension on the anterior side of the tibia. Some previous investigators have clamped specimens at all four support points, which allows for bidirectional bending (Augat et al, 2008, Penzkofer et al, 2009). We followed the procedure used for testing composite bones, in which only one clamp and three rollers are used to minimise the geometric constraints and more-closely mimic physiological conditions.…”

“…Fibular fractures accompanying distal-third tibial fractures may also be more likely to be addressed by surgical intervention when surgeons exercise discretionary choice (Egol et al, 2006, Whorton andHenley, 1998). However, we selected the midshaft osteotomy model for this study because this model has been used by previous investigators in cadaveric tests (Augat et al, 2008, Penzkofer et al, 2009) and biomechanical stability of these fractures has not been as well-documented. We did not find compelling evidence to support the clinical choice to fix fibular fractures in order to support speedy diaphyseal tibial fracture healing.…”