科研之友
微信
新浪微博
Facebook
分享链接
摘要
Objectives: To compare mechanical stability of angle-stable locking construct with four screws with conventional five screw locking in intramedullary nailed distal tibia fractures under cyclic loading. Methods: Ten pairs of fresh-frozen human cadaveric tibiae were intramedullary nailed and assigned to either an angle-stable locking construct consisting of four screws or conventional five-screw locking. After simulating an unstable distal two-fragmental 42-A3.1 fracture, the specimens were mechanically tested under quasistatic and cyclic sinusoidal axial and torsional loading. Results: Bending stiffness of the angle-stable and the conventional fixation was 644.3 N/degrees and 416.5 N/degrees, respectively (P = 0.075, power 0.434). Torsional stiffness of the angle-stable locking (1.91 Nm/degrees) was significantly higher compared with the conventional one (1.13 Nm/degrees; P = 0.001, power 0.981). Torsional play of the angle-stable fixation (0.08 degrees) was significantly smaller compared with the conventional one (0.46 degrees; P = 0.002, power 0.965). The angle-stable locking revealed significantly less torsional deformation in the fracture gap after one cycle (0.74 degrees) than the conventional one (1.75 degrees; P = 0.005, power 0.915) and also after 1000 cycles (angle-stable: 1.56 degrees; conventional: 2.51 degrees; P = 0.042, power 0.562). Modes of failure were fracture of the distal fragment, loosening of distal locking screws, nail breakage, and their combination, equally distributed between the groups (P = 0.325). Conclusions: Both the angle-stable locking technique using four screws and conventional locking consisting of five screws showed high biomechanical properties. Hence, angle-stable locking reflects a potential to maintain fixation stability while reducing the number of locking screws compared with conventional locking in intramedullary nailed unstable distal tibia fractures.
- 出版日期2011-6
