TITLE

Nailing versus plating for comminuted fractures of the distal femur: a comparative biomechanical in vitro study of three implants

AUTHOR(S)
Mehling, I.; Hoehle, P.; Sternstein, W.; Blum, J.; Rommens, P.
PUB. DATE
April 2013
SOURCE
European Journal of Trauma & Emergency Surgery;Apr2013, Vol. 39 Issue 2, p139
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose: The purpose of our study was to determine the biomechanical properties of three different implants utilized for internal fixation of a supracondylar femur fracture. The retrograde supracondylar nail (SCN), the less invasive stabilization system plate (LISS) and the distal femoral nail (DFN) were tested and their biomechanical properties compared. Methods: Twenty pairs of fresh-frozen human femura were used. Each femur was osteotomised to simulate a comminuted supracondylar fracture (AO/OTA 33.A3) and then randomized to fracture fixation with either SCN ( n=9) or LISS ( n=9). Each contralateral femur was stabilized with DFN as a control ( n=18). Two femur pairs were spent on pretesting. All femura were subjected to axial (10-500 N) and torsional (0.1-14 Nm) loading. Results: Eighteen matched femur pairs were analyzed. The post-loading median residual values were 49.78, 41.25 and 33.51% of the axial stiffness of the intact femur and 59.04, 62.37 and 46.72% of the torsional stiffness of the intact femur in the SCN, LISS and DFN groups. There were no significant differences between the three implants concerning axial and torsional stiffness. Conclusions: All implants had sufficient biomechanical stability under physiological torsional and axial loading. All three implants have different mechanisms for distal locking. The SCN nail with the four-screw distal interlocking had the best combined axial and torsional stiffness whereas the LISS plate had the highest torsional stiffness.
ACCESSION #
86418954

 

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