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Journal of Long-Term Effects of Medical Implants

Publication de 4  numéros par an

ISSN Imprimer: 1050-6934

ISSN En ligne: 1940-4379

SJR: 0.184 SNIP: 0.485 CiteScore™:: 1.1 H-Index: 39

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A Comparison of the Compressive Strength of Various Distal Locking Screw Options in the Treatment of Tibia Fractures with Intramedullary Nails

Volume 21, Numéro 3, 2011, pp. 185-192
DOI: 10.1615/JLongTermEffMedImplants.v21.i3.10
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RÉSUMÉ

Treatment of distal metaphyseal tibia fractures is often challenging. Newer tibial intramedullary (IM) nails are designed with a wider variety of distal locking options to offer greater stability in treating these fractures. In this study we attempted to determine the most biomechanically stable number and configuration of distal locking screws when treating distal metaphyseal tibia fractures with IM nails. A transverse osteotomy was created 4 cm from the tibial plafond in identical composite saw bones models (Type 43A fracture) as well as in human cadaveric bones. Each specimen was nailed using a tibial nail (Stryker T2). Distal locking was performed in one of the three configurations: (a) Group I: two screws in the medial lateral (ML) direction; (b) Group II: one ML screw and one screw in the anterior posterior (AP) direction; (c) Group 111: two ML screws and one AP screw. The specimens were then mounted onto a uniaxial material testing machine (Instron) and tested in compression. Our results showed that there was no statistical difference in the load-carrying capacity of Group 1 and Group II. This suggests that the treating surgeon can choose either of these two configurations depending on the wound or other considerations without sacrificing the compressive load-carrying capacity of the IM nail fixation. The load-carrying capacity of the Group III samples with these locking screws was higher than those of Group I & II, although this difference was not statistically significant. This work is being continued to compare the load-carrying capacity of the bone samples with the cortical thickness of bone. We also plan to examine the relationship between the load-carrying capacity of these surgical constructs with the bone mineral density of the metaphysis of these tibial specimens.

CITÉ PAR
  1. Taylor Benjamin C., Hartley Brandi R., Formaini Nathan, Bramwell Thomas J., Necessity for fibular fixation associated with distal tibia fractures, Injury, 46, 12, 2015. Crossref

  2. Augat P., Bühren V., Marknagelosteosynthese an der distalen Tibia, Der Unfallchirurg, 118, 4, 2015. Crossref

  3. Kruppa Christiane G., Hoffmann Martin F., Sietsema Debra L., Mulder Michelle B., Jones Clifford B., Outcomes After Intramedullary Nailing of Distal Tibial Fractures, Journal of Orthopaedic Trauma, 29, 9, 2015. Crossref

  4. Van Maele M., Molenaers B., Geusens E., Nijs S., Hoekstra H., Intramedullary tibial nailing of distal tibiofibular fractures: additional fibular fixation or not?, European Journal of Trauma and Emergency Surgery, 44, 3, 2018. Crossref

  5. Krettek Christian, Baumann Andreas, Interlocking, in Intramedullary Nailing, 2015. Crossref

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