The effect of single-pass reaming on tibial nail insertion load and stress.
This biomechanical study evaluated and compared the longitudinal and perpendicular stresses generated and the applied load required during the insertion of a tibial nail with three different insertion techniques. Insertion of a narrow-diameter nail using an unreamed technique generated significantly greater stress and required significantly greater applied load than either the single-pass reamed technique or a reamed technique. The single-pass reamed technique and the standard reamed technique were not significantly different from each other. This study biomechanically justifies the use of the single-pass reaming technique during the insertion of a narrow-diameter intramedullary nail in severe open tibial fractures. The use of this technique cannot be advocated until the biologic effect of single-pass reaming is more clearly defined.
Department of Orthopaedics, Medical College of Wisconsin, Milwaukee 53226, USA.
G J
GJ
Schmeling
S
S
McCallum
R
R
Havey
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D001858:Bone Nails; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D013314:Stress, Mechanical; D013978:Tibial Fractures / Q000503:physiopathology / Q000601:surgery*; D016474:Weight-Bearing