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Low cost polymer intramedullary nails for fracture fixation: a biomechanical study in a porcine femur model

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Whilst intramedullary nailing is a commonly accepted technique for lower limb fracture fixation, the cost of nails can be prohibitive in hospitals in developing nations. In these institutions bone cement has found many off label applications, that whilst are effective do not meet manufacturers guidelines. The aim of this study was to examine the biomechanics of one such application, fracture fixation using a bone cement intramedullary nail.

Materials and methods

Five porcine femurs underwent a mid-shaft osteotomy and were fixed using a nail made from antibiotic simplex bone cement. The torsional and flexural stiffness and shear modulus of these constructs were compared to five intact porcine femurs.

Results

The bone cement intramedullary nail was able to achieve relative stability in both torsion, with a mean shear modulus of 0.17 GPa and in flexion with a mean flexural stiffness of 358 N/mm. This corresponds to 47 and 22% of the respective measurements in the intact femurs. The mean ultimate flexural strength of fracture/nail constructs was 936 ± 350 N, which is 20% of the ultimate flexural strength of an intact porcine femur (4,820 ± 698 N).

Conclusion

Intramedullary nails made from bone cement were able to provide sufficient promise in this situation to warrant further investigation for their applicability as a low cost alternative for use in developing countries.

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Acknowledgments

We would like to thank Dr. David Dewar for providing the clinical photographs. B.G. would like to acknowledge the support of the Queensland Government Smart State Fellowship scheme.

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Authors and Affiliations

  1. AOSpine Reference Centre, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave Kelvin Grove, Brisbane, 4059, Australia

    D. Lewis, C. Lutton, L. J. Wilson, R. W. Crawford & B. Goss

Authors
  1. D. Lewis
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  2. C. Lutton
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  3. L. J. Wilson
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  4. R. W. Crawford
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  5. B. Goss
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Corresponding author

Correspondence to B. Goss.

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Lewis, D., Lutton, C., Wilson, L.J. et al. Low cost polymer intramedullary nails for fracture fixation: a biomechanical study in a porcine femur model. Arch Orthop Trauma Surg 129, 817–822 (2009). https://doi.org/10.1007/s00402-009-0819-7

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  • DOI: https://doi.org/10.1007/s00402-009-0819-7

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