title: Biomechanical study of nine different tibia locking nails.
abstract: We compared different nail types within the Bone/Implant-Complex to look for differences in stiffness for axial load, bending and torsion of the System. We simulated comminuted mid shaft fractures by a 2-cm defect osteotomy in paired human cadaver tibiae. We fixed tibiae with one of nine different interlocking nails [AO Unreamed Tibial Nail 9 mm (UTN9), AO Unreamed Tibial Nail 8 mm (UTN8), Russell & Taylor Delta Tibial Nail 9 mm (RTD), Russell & Taylor Reconstruction Tibial Nail 11 mm (RTR), Brooker & Wills Tibial Nail 11 mm (B&W), Grosse & Kempf Tibial Nail 11 mm (G&K), AO Universal Tibial Nail 11 mm (AOU), Klemm & Schellmann Tibial Nail 11 mm (K&S), and Börner & Mattheck Tibial Nail 11 mm (B-M)] according to the manufacturer's recommendations. In torque testing the unslotted nails (UTN9, UTN8, RTD, RTR, B&W) showed significantly higher stiffness compared to the slotted nails (G&K, AOU, K&S, B-M). Compared to intact bone, both groups of nails were significantly less stiff. In axial load testing large diameter nails interlocked by large diameter interlocking bolts (G&K, K&S, B-M) showed significantly higher stiffness. For A-P bending no significant differences between implants were found, but isolated bones showed significantly higher A-P bending stiffness. In varus-valgus bending large diameter nails (RTR, G&K, K&S, B-M) showed significantly higher bending stiffness compared to low diameter (UTN8, B&W) implants.
authors.affiliation: Trauma Department, Medizinische Hochschule Hannover, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Schandelmaier
authors.forename: C
authors.initials: C
authors.lastname: Krettek
authors.forename: H
authors.initials: H
authors.lastname: Tscherne
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D001858:Bone Nails / Q000592:standards*; D002102:Cadaver; D004867:Equipment Design; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006801:Humans; D008422:Materials Testing; D008875:Middle Aged; D013978:Tibial Fractures / Q000503:physiopathology / Q000601:surgery*