Using flexible nails to improve stabilization of proximal femur fractures in adolescents.
Intramedullary fixation as a treatment for adolescent femur fractures has increased in popularity. We investigated the varus stability of 3 fixation techniques--the standard 2-nail configuration (2 retrograde nails), a 3-nail configuration (standard 2-nail configuration plus 1 antegrade nail), and a retrograde/antegrade 2-nail configuration--in synthetic femurs with 2 simulated fracture patterns (transverse, butterfly). A varus moment was applied to the specimens until 20 degrees of varus angulation was obtained. The varus angular stiffness of the construct defined varus stability. The 3-nail configuration had the most varus angular stiffness with both fracture patterns. The varus stability of the 3-nail configuration was statistically higher than that of the standard 2-nail configuration with the transverse fracture pattern only. Adding 1 antegrade nail to 2 retrograde nails significantly increased resistance to varus deformity of reduced proximal-third transverse femur fractures in the synthetic femur model.
Orthopaedic Surgery Residency Program, University of Missouri-Columbia, Department of Orthopaedic Surgery, One Hospital Drive, MC213 Columbia, MO 65212, USA. cristb@health.missouri.edu
Brett D
BD
Crist
Bradley R
BR
Dart
Peter J
PJ
Czuwala
Brad W
BW
Olney
Charles D
CD
Pence
D000293:Adolescent; D001696:Biomechanical Phenomena; D001858:Bone Nails; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008953:Models, Anatomic; D016544:Patient Simulation; D011859:Radiography; D018570:Risk Assessment; D012680:Sensitivity and Specificity