Clinical Biomechanics
Volume 24, Issue 4 , Pages 379-384 , May 2009

Factors influencing interlocking screw failure in unreamed small diameter nails – A biomechanical study using a distal tibia fracture model

  • Patrick Weninger

      Affiliations

    • Trauma Center “Lorenz Boehler”, Donaueschingenstrasse 13, 1200 Vienna, Austria
    • Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Cluster for Tissue Regeneration, Vienna, Austria
    • Corresponding Author InformationCorresponding author. Address: Trauma Center “Lorenz Boehler”, Donaueschingenstrasse 13, 1200 Vienna, Austria.
    • ,
  • Michael Schueller

      Affiliations

    • Material Sciences Laboratory, E206-4, Technical University, Vienna, Austria
    • ,
  • Michael Jamek

      Affiliations

    • Material Sciences Laboratory, E206-4, Technical University, Vienna, Austria
    • ,
  • Stefanie Stanzl-Tschegg

      Affiliations

    • Institute of Physics and Materials Science, BOKU University of Natural Resources and Applied Life Sciences, Vienna, Austria
    • Laboratory for Material Sciences, Institute for Solid State Physics, Technical University, Vienna, Austria
    • ,
  • Heinz Redl

      Affiliations

    • Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Cluster for Tissue Regeneration, Vienna, Austria
    • ,
  • Elmar K. Tschegg

      Affiliations

    • Material Sciences Laboratory, E206-4, Technical University, Vienna, Austria

Received 27 April 2008 ,Accepted 13 January 2009.

References 

  1. Ali AM, Saleh M, Bolongaro S, Yang L. Experimental model of tibial plateau fracture for biomechanical testing. J. Biomech. 2006;39:1355–1360
  2. Bone LB, Sucato D, Stegemann PM, Rohrbacher BJ. Displaced isolated fractures of the tibial shaft treated with either a cast or intramedullary nailing. An outcome analysis of matched pairs of patients. J. Bone Joint Surg. Am. 1997;79:1336–1341
  3. Court-Brown CM. Reamed intramedullary tibial nailing: an overview and analysis of 1106 cases. J. Orthop. Trauma. 2004;18:96–101
  4. Gaebler C, Berger U, Schandelmaier P, Greitbauer M, Schauwecker HH, Applegate B, et al. Rates and odds ratios for complications in closed and open tibial fractures treated with unreamed, small diameter tibial nails: a multicenter analysis of 467 cases. J. Orthop. Trauma. 2001;15:415–423
  5. Gaebler C, Stanzl-Tschegg S, Heinze G, Holper B, Milne T, Berger G, et al. Fatigue strength of locking screws and prototypes used in small-diameter tibial nails: a biomechanical study. J. Trauma. 1999;47:379–384
  6. Gardner MJ, Griffith MH, Demetrakopoulos D, Brophy RH, Grose A, Helfet DL, et al. Hybrid locked plating of osteoporotic fractures of the humerus. J. Bone Joint Surg. Am. 2006;88:1962–1967
  7. Henley MB, Meier M, Tencer AF. Influences of some design parameters on the biomechanics of the unreamed tibial intramedullary nail. J. Orthop. Trauma. 1993;7:311–319
  8. Herndler, S., 2007. Steifigkeitsanalyse des Systems Tibia und Impantat. Untersuchung einer Tibia mit idealisierter distaler Fraktur versorgt durch einen unaufgebohrten verriegelten Tibiamarknagel unter zyklischer Belastung. Thesis. Institute for Applied Material Science, Technical University Vienna, Austria.
  9. Hooper GJ, Keddell RG, Penny ID. Conservative management or closed nailing for tibial shaft fractures. A randomised prospective trial. J. Bone Joint Surg. Br. 1991;73:83–85
  10. Im GI, Tae SK. Distal metaphyseal fractures of tibia: a prospective randomized trial of closed reduction and intramedullary nail versus open reduction and plate and screws fixation. J. Trauma. 2005;59:1219–1223
  11. Jones BG, Mehin R, Young D. Anatomical study of the placement of proximal oblique locking screws in intramedullary tibial nailing. J. Bone Joint Surg. Br. 2007;89:1495–1497
  12. Konrath G, Moed BR, Watson JT, Kaneshiro S, Karges DE, Cramer KE. Intramedullary nailing of unstable diaphyseal fractures of the tibia with distal intraarticular involvement. J. Orthop. Trauma. 1997;11:200–205
  13. Laflamme GY, Heimlich D, Stephen D, Kreder HJ, Whyne CM. Proximal tibial fracture stability with intramedullary nail fixation using oblique interlocking screws. J. Orthop. Trauma. 2003;17:496–502
  14. Metcalfe AJ, Saleh M, Yang L. Techniques for improving stability in oblique fractures treated by circular fixation with particular reference to the sagittal plane. J. Bone Joint Surg. Br. 2005;87:868–872
  15. Neptune RR, Kautz SA, Zajac FE. Contributions of the individual ankle plantar flexors to support, forward progression and swing initiation during walking. J. Biomech. 2001;34:1387–1398
  16. Nork SE, Schwartz AK, Agel J, Holt SK, Schrick JL, Winquist RA. Intramedullary nailing of distal metaphyseal tibial fractures. J. Bone Joint Surg. Am. 2005;87:1213–1221
  17. Petrisor B, Anderson S, Court-Brown CM. Infection after reamed intramedullary nailing of the tibia: a case series review. J. Orthop. Trauma. 2005;19:437–441
  18. Richmond J, Colleran K, Borens O, Kloen P, Helfet DL. Nonunions of the distal tibia treated by reamed intramedullary nailing. J. Orthop. Trauma. 2004;18:603–610
  19. Roberts JW, Grindel SI, Rebholz B, Wang M. Biomechanical evaluation of locking plate radial shaft fixation: unicortical locking fixation versus mixed bicortical and unicortical fixation in a sawbone model. J. Hand Surg. [Am.]. 2007;32:971–975
  20. Sanders R, Jersinovich I, Anglen J, DiPasquale T, Herscovici D. The treatment of open tibial shaft fractures using an interlocked intramedullary nail without reaming. J. Orthop. Trauma. 1994;8:504–510
  21. Schandelmaier P, Krettek C, Tscherne H. Biomechanical study of nine different tibia locking nails. J. Orthop. Trauma. 1996;10:37–44
  22. Schüller M, Herndler S, Weninger P, Jamek M, Redl H, Tschegg EK. Stiffness and permanent deformation of extra-articular distal tibia fractures treated with unreamed small diameter intramedullary nailing. Mater. Sci. Eng. C. 2008;28:1209–1216
  23. Schwartz M, Lakin G. The effect of tibial torsion on the dynamic function of the soleus during gait. Gait Posture. 2003;17:113–118
  24. Shannon FJ, Mullett H, O’Rourke K. Unreamed intramedullary nail versus external fixation in grade III open tibial fractures. J. Trauma. 2002;52:650–654
  25. Tielinen L, Lindahl JE, Tukiainen EJ. Acute unreamed intramedullary nailing and soft tissue reconstruction with muscle flaps for the treatment of severe open tibial shaft fractures. Injury. 2007;38:906–912
  26. Tschegg, E., Herndler, S., Weninger, P., Jamek, M., Stanzl-Tschegg, S., Redl, H., 2008. Stiffness analysis of tibia-implant system under cyclic loading. Mater. Sci. Eng. C 28, 1203–1208.
  27. Whittle AP, Wester W, Russell TA. Fatigue failure in small diameter tibial nails. Clin. Orthop. Relat. Res. 1995;119–128
  28. Wyrsch B, McFerran MA, McAndrew M, Limbird TJ, Harper MC, Johnson KD, et al. Operative treatment of fractures of the tibial plafond. A randomized, prospective study. J. Bone Joint Surg. Am. 1996;78:1646–1657

PII: S0268-0033(09)00017-5

doi: 10.1016/j.clinbiomech.2009.01.003

Clinical Biomechanics
Volume 24, Issue 4 , Pages 379-384 , May 2009

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