Mechanical characterization of femoral interlocking intramedullary nailing systems.
ABSTRACT The most important mechanical characteristics of a nailing system are related to its stiffness (rigidity) and strength. This study evaluates the properties of three commercially available interlocking intramedullary nail systems using standardized test methods. An understanding of the mechanical properties along with the clinical data will assist the surgeon in choosing the optimum implant. Testing indicates that the bending strength and stiffness of the Grosse & Kempf, the AO/ASIF Universal, and the Russell-Taylor interlocking intramedullary nail designs are comparable. It is therefore not surprising that all of these nail systems have excellent clinical results. However, the nonslotted design is approximately 30 times more resistant to torsional loading than either the partially slotted design of the Grosse & Kempf nail or the fully slotted design of the AO/ASIF nail. The clinical relevance of the torsional values may not be known until a long-term comparison of the complication rates for these different systems is available. Analysis of screw design reveals a tradeoff in bending strength when compared to amount of bone purchase. The bending strength of fully threaded screws (allowing bicortical fixation) is less than that of partially threaded screws (allowing only unicortical fixation), which shows that for the implants tested, increased bone purchase requires a compromise in strength for similar sized screws.
SourceAvailable from: Yauheni Zhalniarovich[Show abstract] [Hide abstract]
ABSTRACT: Interlocking nails (ILN) are effective tools for the fixation of long bone fractures, including humeral, femoral and tibial fractures. An interlocking nails are a steel rods which are placed in medullary canal of fractured bone. They have transverse openings which are use to put inside a transcortical screws. Those screws block the nail relative to the main bone fragments. Interlocking nails counteract all forces at the fractured site, thus they are an alternative to bone plates. Simultaneously, the intramedullary nail is placed in a natural position relative to the bone's biomechanical axis and neutralizing bending forces across bone fragments. Unlike bone plates that are eccentrically positioned, the nail has an intramedullary position which makes it much more resistant to compressive, torsional and bending force. This technique requires a relatively low surgical approach to compare with plate osteosynthesis. Most importantly, interlocking nails support biological osteosynthesis and fracture management with minimal surgical intervention. The first application in veterinary medicine of the interlocking nail was at the late 1980s. Since this moment, the technique still evolves providing the next generations of interlocking nails. At these days we have several generations of it. This paper discusses the use of interlocking nails in fracture stabilization in veterinary practice and overviews the development of nail implants and their applications. The advantages of the analyzed technique and the associated complications are discussed. (C) 2011 PVJ. All rights reservedPakistan Veterinary Journal 01/2012; 32(1):10-14. · 1.39 Impact Factor
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ABSTRACT: OBJETIVO: Estudo experimental idealizado com o objetivo de se avaliar a estabilização primária das fraturas da diáfise umeral com três diferentes métodos de osteossíntese, representados por uma placa tipo DCP aplicada com técnica em ponte, uma síntese incomum, denominada SPS®, ainda sem similar na literatura, aplicada pela técnica em ponte, e um terceiro método constituído de uma haste intramedular com um método de bloqueio também incomum proporcionado por um parafuso cortical distalmente e por um fio do tipo Ender proximalmente. MATERIAL E MÉTODO: Vinte e um pares de úmeros humanos foram divididos em três grupos, utilizando-se um tipo de material para cada grupo, os quais foram submetidos a osteotomias, aos procedimentos de fixação e a ensaios não destrutivos de flexo-compressão e de torção, com limites de carga de 200N e de 100N, respectivamente e, num mecanismo de "crossing", foram submetidos secundariamente a novos ensaios de torção e de flexo-compressão, amparados por análise estatística. RESULTADOS: O grupo da placa DCP em ponte mostrou boa resistência às cargas aplicadas, o que também ocorreu no grupo do SPS®, que apesar de mostrar maiores índices de deflexão, apresentou grande capacidade elástica. O grupo da haste intramedular mostrou bons resultados nos ensaios de flexo-compressão, devido ao seu mecanismo de tutor, mas não demonstrou resistência às cargas de torção.Acta Ortopédica Brasileira 12/2007; 16(1):8-12. DOI:10.1590/S1413-78522008000100001 · 0.16 Impact Factor
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ABSTRACT: This study biomechanically evaluates solid and tubular interlocking nails in bovine neonatal femurs. Paired femurs from 40 neonatal dairy calves were obtained for mechanical testing. Intact femurs and four combinations of experimentally manipulated femurs (intact or ostectomized femurs with either a solid or tubular interlocking nail) were tested in craniocaudal and lateromedial bending, eccentric axial compression, and external torsion to evaluate composite rigidity, local/gap stiffness, and load to failure (compression and torsion only). In torsional composite rigidity, femurs with tubular interlocking nails were more compliant than intact femurs or intact femurs with solid interlocking nails (P <.001). Ostectomized femurs with solid interlocking nails were similar to intact femurs with tubular interlocking nails. Within femurs with tubular interlocking nails, ostectomized femurs were more compliant than intact femurs (P <.0001). In craniocaudal and lateromedial bending rigidity, ostectomized femurs were more compliant than intact femurs, regardless of interlocking nail type (P <.001). Within ostectomized femurs, tubular interlocking nails were more compliant than solid interlocking nails in craniocaudal bending (P <.05) and there was a similar trend in lateromedial bending (P=.06). In eccentric axial compression, local/ gap stiffness was significantly greater in intact femurs compared with intact femurs with solid (48% of intact bone) or tubular (45% of intact bone) interlocking nails and ostectomized femurs with solid (18% of intact bone) or tubular (11 % of intact bone) interlocking nails (P <.0001). In torsional testing, local/gap stiffness was not significantly different between intact femurs and intact femurs with interlocking nails, but was significantly lower in ostectomized femurs with solid (2% of intact bone) and tubular (0.2% of intact bone) interlocking nails (P <.0001). In torsional and compressive failure testing, plastic deformation of the tubular interlocking nail occurred at the unoccupied screw hole at the ostectomy site before bone failure. Interlocking nails should be considered as an optional repair method for neonatal bovine femoral fractures. Until the actual physiological loading characteristics of neonatal calf femurs are measured, it is uncertain whether solid or tubular interlocking nails tested in this study will provide sufficient strength and stiffness to stabilize neonatal bovine femoral fractures and facilitate healing.Veterinary Surgery 06/2008; 24(3):235 - 243. DOI:10.1111/j.1532-950X.1995.tb01324.x · 0.99 Impact Factor