Initial construct stability of long cephalomedullary nails with superior locking for a complex trochanteric fracture model AO31A2.2– a biomechanical study
Abstract Background Complex fractures of the trochanteric region, as well as fractures located in the directly subtrochanteric region, are controversially discussed around the world regarding the nail type to be used. A long nail is recommended by manufacturers but requires longer surgical and fluor...
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BMC
2024-11-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-024-05079-y |
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| author | Arndt-Peter Schulz Matthias Münch Tobias Barth Birgitt Kowald Jasper Frese Lina Behrends Maximilian Hartel |
| author_facet | Arndt-Peter Schulz Matthias Münch Tobias Barth Birgitt Kowald Jasper Frese Lina Behrends Maximilian Hartel |
| author_sort | Arndt-Peter Schulz |
| collection | DOAJ |
| description | Abstract Background Complex fractures of the trochanteric region, as well as fractures located in the directly subtrochanteric region, are controversially discussed around the world regarding the nail type to be used. A long nail is recommended by manufacturers but requires longer surgical and fluoroscopy times. A possible solution could be a nail with an appropriate length which can be locked in a minimally invasive manner by the main aiming device. We aimed to determine if such a nail model (DCN SL nail, SWEMAC, Linköping, Sweden) offers similar structural stability on biomechanical testing on artificial bone as a standard long nail when used to treat complex trochanteric fractures and compared it to long nails usually used in this setting. Methods An osteoporotic bone model was chosen. The Swemac Hansson DCN Nail System was used as osteosynthesis material. Two types of nails were chosen: a superior lock nail which can be implanted with a singular targeting device, and a long nail with distal locking using free-hand technique. AO31A2.2 fractures were simulated in a standardised manner. Axial height of the construct, varus collapse, and rotational deformity directly after nail insertion were simulated. A Universal Testing Machine was used. Measurements were made with a stereo-optic tracking system. Findings There was a detectable difference in the axial fracture movement resulting in narrowing of the fracture gap. There was no difference in varus collapse or rotational deformity between the nail variants Conclusion We conclude that there are small differences which are clinically insignificant and that a superior locking nail can safely be used to manage complex trochanteric fractures. |
| format | Article |
| id | doaj-art-cd010d3f59a24bcf9b8482c1a58ea4e6 |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
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| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-cd010d3f59a24bcf9b8482c1a58ea4e62024-11-10T12:34:48ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2024-11-0119111110.1186/s13018-024-05079-yInitial construct stability of long cephalomedullary nails with superior locking for a complex trochanteric fracture model AO31A2.2– a biomechanical studyArndt-Peter Schulz0Matthias Münch1Tobias Barth2Birgitt Kowald3Jasper Frese4Lina Behrends5Maximilian Hartel6BG Klinikum Hamburg, Zentrum Klinische ForschungBG Klinikum Hamburg, Zentrum Klinische ForschungBG Klinikum Hamburg, Zentrum Klinische ForschungBG Klinikum Hamburg, Zentrum Klinische ForschungBG Klinikum Hamburg, Zentrum Klinische ForschungFraunhofer Research Institution for Individualized and Cell-Based Medical Engineering IMTEBG Klinikum Hamburg, Zentrum Klinische ForschungAbstract Background Complex fractures of the trochanteric region, as well as fractures located in the directly subtrochanteric region, are controversially discussed around the world regarding the nail type to be used. A long nail is recommended by manufacturers but requires longer surgical and fluoroscopy times. A possible solution could be a nail with an appropriate length which can be locked in a minimally invasive manner by the main aiming device. We aimed to determine if such a nail model (DCN SL nail, SWEMAC, Linköping, Sweden) offers similar structural stability on biomechanical testing on artificial bone as a standard long nail when used to treat complex trochanteric fractures and compared it to long nails usually used in this setting. Methods An osteoporotic bone model was chosen. The Swemac Hansson DCN Nail System was used as osteosynthesis material. Two types of nails were chosen: a superior lock nail which can be implanted with a singular targeting device, and a long nail with distal locking using free-hand technique. AO31A2.2 fractures were simulated in a standardised manner. Axial height of the construct, varus collapse, and rotational deformity directly after nail insertion were simulated. A Universal Testing Machine was used. Measurements were made with a stereo-optic tracking system. Findings There was a detectable difference in the axial fracture movement resulting in narrowing of the fracture gap. There was no difference in varus collapse or rotational deformity between the nail variants Conclusion We conclude that there are small differences which are clinically insignificant and that a superior locking nail can safely be used to manage complex trochanteric fractures.https://doi.org/10.1186/s13018-024-05079-yTrochanteric fractureCephalomedullary nailHansson nailLong nailAO31A2.2Biomechanical |
| spellingShingle | Arndt-Peter Schulz Matthias Münch Tobias Barth Birgitt Kowald Jasper Frese Lina Behrends Maximilian Hartel Initial construct stability of long cephalomedullary nails with superior locking for a complex trochanteric fracture model AO31A2.2– a biomechanical study Journal of Orthopaedic Surgery and Research Trochanteric fracture Cephalomedullary nail Hansson nail Long nail AO31A2.2 Biomechanical |
| title | Initial construct stability of long cephalomedullary nails with superior locking for a complex trochanteric fracture model AO31A2.2– a biomechanical study |
| title_full | Initial construct stability of long cephalomedullary nails with superior locking for a complex trochanteric fracture model AO31A2.2– a biomechanical study |
| title_fullStr | Initial construct stability of long cephalomedullary nails with superior locking for a complex trochanteric fracture model AO31A2.2– a biomechanical study |
| title_full_unstemmed | Initial construct stability of long cephalomedullary nails with superior locking for a complex trochanteric fracture model AO31A2.2– a biomechanical study |
| title_short | Initial construct stability of long cephalomedullary nails with superior locking for a complex trochanteric fracture model AO31A2.2– a biomechanical study |
| title_sort | initial construct stability of long cephalomedullary nails with superior locking for a complex trochanteric fracture model ao31a2 2 a biomechanical study |
| topic | Trochanteric fracture Cephalomedullary nail Hansson nail Long nail AO31A2.2 Biomechanical |
| url | https://doi.org/10.1186/s13018-024-05079-y |
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