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Comparison of mechanical rigidity between plate augmentation leaving the nail in situ and interlocking nail using cadaveric fracture model of the femur

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Abstract

Thirteen matched pairs of cadaveric femurs were placed into two groups. In each group, a transverse fracture was created at a point 70% distal between the lesser trochanter and the adductor tubercle. One femur out of each matched pair was then stabilised with an interlocking intramedullary nail (nail only group) and the other femur was stabilised with plate augmentation after interlocking intramedullary nailing (plate augmentation group). The bending load to promote 5-mm displacement showed statistically significant differences between the plate augmentation group (mean 843.36 ± 409.13 N) and the nail only group (mean 315.02 ± 219.80 N) (p = 0.001). Torsional torque at the angle of 15 degrees showed statistically significant differences between the two groups; a mean of 2.09 ± 0.53 N·m for the plate augmentation group and a mean of 0.63 ± 0.46 N·m for the nail only group (p = 0.0001). We found a 2.6-fold increase in bending stiffness and a 3.3-fold increase in torsional stiffness in plate augmentation leaving a nail in situ compared to interlocking nailing only in the distal third fracture of femur.

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References

  1. Bankston AB, Keating DA, Simon FD (1992) The biomechanical evaluation of intramedullary nails in distal femoral shaft fractures. Clin Orthop 276:277–282

    PubMed  Google Scholar 

  2. Choi YS, Kim KS (2005) Plate augmentation leaving the nail in situ and bone grafting for nonunion of femoral shaft fractures. Int Orthop 29(5):287–290

    Article  PubMed  CAS  Google Scholar 

  3. Cole JD (1996) The vascular response of bone to internal fixation. In: Browner BD (ed) The science and practice of intramedullary nailing, 2nd edn. Willians and Wilkins, pp 43–69

  4. Finkemeier CG, Chapman MW (2002) Treatment of femoral diaphyseal nonunions. Clin Orthop 398:223–234

    Article  PubMed  Google Scholar 

  5. Hak DJ, Lee SS, Goulet JA (2000) Success of exchange reamed intramedullary nailing for femoral shaft nonunion or delayed union. J Orthop Trauma 14:178–182

    Article  PubMed  CAS  Google Scholar 

  6. Johnson KD, Tencer AF, Blementhal S (1986) Biomechanical performance of locked intramedullary nailing system in comminuted femoral shaft fractures. Clin Orthop 206:151–161

    PubMed  Google Scholar 

  7. Kan WS, Zheng Q, Wang JW, Huang H, Chen PYH, XIe M, Li P (2006) Treatment of the ununited lower limb fracture with reamed intramedullary interlocking nail. Zhonghua Wai Ke Za Zhi 44(20):1417–1419

    PubMed  Google Scholar 

  8. Kempf I, Grosse A, Beak GF (1985) Closed locked Intramedullary nailing. Its application to comminuted fractures of the femur. J Bone Joint Surg Am 67:709–720

    CAS  Google Scholar 

  9. Kuntscher G (1965) Intramedullary surgical technique and its place in orthopaedic surgery. J Bone Joint Surg Am 47:809–818

    Google Scholar 

  10. Kyle RF, Shcaffhausen JM, Bechtold JE (1991) Biomechanical characteristics of interlocking femoral nails in the treatment of complex femoral fractures. Clin Orthop 267:169–173

    PubMed  Google Scholar 

  11. Nadkarni B, Srivastav S, Mittal V, Agarwal S (2008) Use of locking compression plates for long bone nonunions without removing existing intramedullary nail: review of literature and our experience. J Trauma 65(2):482–486

    Article  PubMed  Google Scholar 

  12. Pihlajamaki HK, Salminen ST, Bostman OM (2002) The treatment of nonunions following intramedullary nailing of femoral shaft fractures. J Orthop Trauma 16(6):394–402

    Article  PubMed  Google Scholar 

  13. Steinberg EL, Keynan O, Sternheim A, Drexler M, Luger E (2009) Treatment of diaphyseal nonunion of the femur and tibia using an expandable nailing system. Injury 40(3):309–314

    Article  PubMed  Google Scholar 

  14. Tarr RR, Wiss DA (1986) The mechanics and biology of intramedullary fracture fixation. Clin Orthop 212:10–17

    PubMed  Google Scholar 

  15. Ueng SWN, Chao EK, Lee SS, Shih CH (1995) Augmentative plate fixation for the management of femoral nonunion after intramedullary nailing. J Trauma 43:640–644

    Article  Google Scholar 

  16. Weresh MJ, Hakanson R, Stover M, Sims SH, Kellam JK, Bosse MJ (2000) Failure of exchange reamed intramedullary nails for ununited femoral shaft fractures. J Orthop Trauma 14:335–338

    Article  PubMed  CAS  Google Scholar 

  17. Wu CC (1997) The effect of dynamization on slowing the healing of femur shaft fractures after interlocking nailing. J Trauma 43(2):263–267

    Article  PubMed  CAS  Google Scholar 

  18. Zhang X, Zhong B, Sui S, Yu X, Jiang Y (2001) Treatment of distal femoral nonunion and delayed union by using a retrograde intramedullary interlocking nail. Chin J Traumatol 4(3):180–184

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics, Kwangju Christian Hospital, Gwangju, Korea

    Kyungho Park, Kwanwoo Kim & Y. S. Choi

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  1. Kyungho Park
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  2. Kwanwoo Kim
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  3. Y. S. Choi
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Correspondence to Y. S. Choi.

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Park, K., Kim, K. & Choi, Y.S. Comparison of mechanical rigidity between plate augmentation leaving the nail in situ and interlocking nail using cadaveric fracture model of the femur. International Orthopaedics (SICOT) 35, 581–585 (2011). https://doi.org/10.1007/s00264-010-0983-y

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  • DOI: https://doi.org/10.1007/s00264-010-0983-y

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