Biomechanical analysis of supracondylar femoral fractures fixed with modern retrograde intramedullary nails

被引:18
作者
Hora, N
Markel, DC
Haynes, A
Grimm, MJ
机构
[1] Wayne State Univ, Dept Orthopaed Surg, Detroit, MI USA
[2] Wayne State Univ, Ctr Bioengn, Detroit, MI USA
[3] Providence Hosp, Dept Orthopaed Surg, Southfield, MI 48037 USA
关键词
retrograde nails; supracondylar nails; femur fracture; supracondylar fracture; intramedullary nails;
D O I
10.1097/00005131-199911000-00004
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objectives: Several new retrograde supracondylar intramedullary nails have been developed to specifically address fractures of the distal femur. The nails appear clinically effective, but there are few biomechanical data documenting the stability of the fixation or the mechanical stiffness of the different designs. The goal of this study was to assess the torsional and bending stiffness of four designs of intramedullary nails developed for this application. Methods: Four nail designs were tested in torsion and bending to determine system stiffness: Ace supracondylar, Richards "five hole" and "multi-hole" supracondylar, and Biomet retrograde. The nails were inserted into cadaveric femurs in which a one-centimeter distraction osteotomy had been created seven centimeters proximal to the condyles. The constructs were then tested on an Instron biaxial testing system. Results: There were no statistically significant differences in bending stiffness among the groups of nails (range 0.79 to 1.18 newtons/meter; p > 0.1). However, the Ace nails (1.10 newton meters/degree) did exhibit a statistically lower torsional stiffness compared with the other nails (2.20 to 2.21 newton-meters/degree; p < 0.1). No differences were noted as a function of the number of locking holes, Conclusions: The bending stiffness of four currently available designs of retrograde intramedullary nails does not appear to be dependent on design variations. The torsional stiffness did vary among the four designs, but this was not determined by the number of fixation holes provided. It appears that a well-placed retrograde supracondylar nail of modern design should have sufficient stiffness to support the femur and provide stability during fracture healing.
引用
收藏
页码:539 / 544
页数:6
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