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Are Inflatable Nails an Alternative to Interlocked Nails in Tibial Fractures?

  • Original Article
  • Lower Extremity
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Recently developed inflatable nails avoid reaming and interlocking screws in tibial fractures and reflect a new principle for stabilization of long bone fractures. We asked if the bending stiffness, rotational rigidity, or play (looseness of rotation) differed between an inflatable versus large-diameter reamed interlocked nails, and whether the maximal torque to failure of the two bone-implant constructs differed. In a cadaveric model, we compared the biomechanical properties with those of an interlocked nail in eight pairs of fractured tibial bones. Bending stiffness, rotational rigidity, play (looseness in rotation), and torsional strength within 20° rotation were investigated using a biaxial servohydraulic testing system. For all biomechanical variables, we found a large interindividual variance between the pairs attributable to bone quality (osteoporosis) for both fixation methods. The inflatable nail had a higher bending stiffness, with a mean difference of 58 N/mm, and a lower torsional strength, with a mean difference of 13.5 Nm, compared with the locked nail. During torsional testing we noted slippage between the inflatable nail and bone. We observed no differences in play or rotational rigidity. Given the lower torsional strength we recommend caution with weightbearing until there are signs of fracture consolidation.

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Acknowledgments

We thank Stein Atle Lie, PhD, Department of Health, University Research Bergen, for assistance in the statistical analysis.

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Authors and Affiliations

  1. Department of Surgery, Haraldsplass Deaconess Hospital, Ulriksdal 8, 5009, Bergen, Norway

    Jesper Blomquist MD

  2. Department of Surgical Sciences, University of Bergen, Bergen, Norway

    Jesper Blomquist MD & Anders Mølster MD, PhD

  3. Department of Oral Sciences–Dental Biomaterials, University of Bergen, Bergen, Norway

    Odd J. Lundberg Ing & Nils R. Gjerdet DDS, PhD

  4. Department of Orthopaedics, Haukeland University Hospital, Bergen, Norway

    Anders Mølster MD, PhD

Authors
  1. Jesper Blomquist MD
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  2. Odd J. Lundberg Ing
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  3. Nils R. Gjerdet DDS, PhD
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  4. Anders Mølster MD, PhD
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Correspondence to Jesper Blomquist MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Blomquist, J., Lundberg, O.J., Gjerdet, N.R. et al. Are Inflatable Nails an Alternative to Interlocked Nails in Tibial Fractures?. Clin Orthop Relat Res 466, 1225–1231 (2008). https://doi.org/10.1007/s11999-008-0169-8

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  • DOI: https://doi.org/10.1007/s11999-008-0169-8

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