Torsional stability of intramedullary compression nails

Tibial osteotomy model

Nicholas A.T. Brown, Nathaniel A. Bryan, Peter M. Stevens

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Studies comparing intramedullary compression nailing to conventional dynamized intramedullary nailing contend that better clinical outcomes of intramedullary compression techniques result from greater rotational stability of fracture or osteotomy sites. However, there appears to be no experimental evidence that rotational stability is improved with intramedullary nail compression. This study evaluated the effect of intramedullary nail compression on cadaveric and composite tibial fragment rotation above and below a mid-tibial transverse osteotomy. Methods: Twelve composite and four matched pairs of human cadaveric tibiae were randomized into either a compression group or a non-compressed dynamized group. A bi-axial servo-hydraulic testing machine applied 5 N m of internal and external torque (2 N m/s) under constant axial loads of 375 N and 750 N. Rotation along each tibia and at the osteotomy site was recorded from the trajectories of infrared emitting diodes rigidly attached along the tibial shaft. Findings: In comparison to dynamized nails, intramedullary nail compression significantly reduced the rotation at the osteotomy site in both human (8.9° reduction; P = 0.007) and composite tibiae (2.5° reduction; P = 0.039) under 750 N of axial load. A similar result was noted for simulated half-body weight loads (375 N) for both composite (3.0° reduction; P = 0.009) and human tibiae (10.5° reduction; P = 0.003). Interpretation: Intramedullary nail compression more effectively reduced tibial fragment rotation about a mid-tibial osteotomy than conventional dynamized intramedullary nails because intramedullary nails created more osteotomy site compression than the application of body weight to tibiae instrumented with dynamized intramedullary nails.

Original languageEnglish
Pages (from-to)449-456
Number of pages8
JournalClinical Biomechanics
Volume22
Issue number4
DOIs
Publication statusPublished - 2007
Externally publishedYes

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Osteotomy
Nails
Tibia
Intramedullary Fracture Fixation
Body Weight
Torque

Cite this

Brown, Nicholas A.T. ; Bryan, Nathaniel A. ; Stevens, Peter M. / Torsional stability of intramedullary compression nails : Tibial osteotomy model. In: Clinical Biomechanics. 2007 ; Vol. 22, No. 4. pp. 449-456.
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Torsional stability of intramedullary compression nails : Tibial osteotomy model. / Brown, Nicholas A.T.; Bryan, Nathaniel A.; Stevens, Peter M.

In: Clinical Biomechanics, Vol. 22, No. 4, 2007, p. 449-456.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Torsional stability of intramedullary compression nails

T2 - Tibial osteotomy model

AU - Brown, Nicholas A.T.

AU - Bryan, Nathaniel A.

AU - Stevens, Peter M.

PY - 2007

Y1 - 2007

N2 - Background: Studies comparing intramedullary compression nailing to conventional dynamized intramedullary nailing contend that better clinical outcomes of intramedullary compression techniques result from greater rotational stability of fracture or osteotomy sites. However, there appears to be no experimental evidence that rotational stability is improved with intramedullary nail compression. This study evaluated the effect of intramedullary nail compression on cadaveric and composite tibial fragment rotation above and below a mid-tibial transverse osteotomy. Methods: Twelve composite and four matched pairs of human cadaveric tibiae were randomized into either a compression group or a non-compressed dynamized group. A bi-axial servo-hydraulic testing machine applied 5 N m of internal and external torque (2 N m/s) under constant axial loads of 375 N and 750 N. Rotation along each tibia and at the osteotomy site was recorded from the trajectories of infrared emitting diodes rigidly attached along the tibial shaft. Findings: In comparison to dynamized nails, intramedullary nail compression significantly reduced the rotation at the osteotomy site in both human (8.9° reduction; P = 0.007) and composite tibiae (2.5° reduction; P = 0.039) under 750 N of axial load. A similar result was noted for simulated half-body weight loads (375 N) for both composite (3.0° reduction; P = 0.009) and human tibiae (10.5° reduction; P = 0.003). Interpretation: Intramedullary nail compression more effectively reduced tibial fragment rotation about a mid-tibial osteotomy than conventional dynamized intramedullary nails because intramedullary nails created more osteotomy site compression than the application of body weight to tibiae instrumented with dynamized intramedullary nails.

AB - Background: Studies comparing intramedullary compression nailing to conventional dynamized intramedullary nailing contend that better clinical outcomes of intramedullary compression techniques result from greater rotational stability of fracture or osteotomy sites. However, there appears to be no experimental evidence that rotational stability is improved with intramedullary nail compression. This study evaluated the effect of intramedullary nail compression on cadaveric and composite tibial fragment rotation above and below a mid-tibial transverse osteotomy. Methods: Twelve composite and four matched pairs of human cadaveric tibiae were randomized into either a compression group or a non-compressed dynamized group. A bi-axial servo-hydraulic testing machine applied 5 N m of internal and external torque (2 N m/s) under constant axial loads of 375 N and 750 N. Rotation along each tibia and at the osteotomy site was recorded from the trajectories of infrared emitting diodes rigidly attached along the tibial shaft. Findings: In comparison to dynamized nails, intramedullary nail compression significantly reduced the rotation at the osteotomy site in both human (8.9° reduction; P = 0.007) and composite tibiae (2.5° reduction; P = 0.039) under 750 N of axial load. A similar result was noted for simulated half-body weight loads (375 N) for both composite (3.0° reduction; P = 0.009) and human tibiae (10.5° reduction; P = 0.003). Interpretation: Intramedullary nail compression more effectively reduced tibial fragment rotation about a mid-tibial osteotomy than conventional dynamized intramedullary nails because intramedullary nails created more osteotomy site compression than the application of body weight to tibiae instrumented with dynamized intramedullary nails.

KW - Bone healing

KW - Composite and cadaveric tibia

KW - Rotational osteotomy

KW - Torsional bone stability

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DO - 10.1016/j.clinbiomech.2006.11.009

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JO - Clinical Biomechanics

JF - Clinical Biomechanics

SN - 0268-0033

IS - 4

ER -