Effect on Dynamic Mechanical Stability and Interfragmentary Movement of Angle-Stable Locking of Intramedullary Nails in Unstable Distal Tibia Fractures: A Biomechanical Study

摘要: Background Unstable distal tibia fractures are challenging injuries that require surgery. Increasingly, intramedullary nails being used. However, fracture site anatomy may cause distal-fragment stabilization and fixation problems lead to malunion/nonunion. We studied the influence of angle-stable nail locking on gap movement other biomechanical parameters. Methods Eight pairs fresh human cadaver tibiae were The bone mineral density (BMD) was determined. All nailed with a Synthes Expert tibial nail. Within each pair, one randomized receive conventional screws; other, screws sleeves. A 7-mm osteotomy created 10 mm above upper screw, simulate an AO 42-A3 fracture. Biomechanical testing involved nondestructive mediolateral anteroposterior pure bending, followed by cyclic combined axial torsional loading catastrophic failure. neutral zone Fracture monitored 3-D motion tracking. Results locked constructs had significantly smaller (mean: 0.04 degree; p=0.039) angulation (p=0.043). number cycles failure did not differ between configurations. BMD significant covariate affecting (p=0.008). over first 20,000 cycles, there no correlation in construct. Conclusions Angle-stable associated reduction movement. also reduced cycles.