Percutaneous osteoplasty with a bone marrow nail for fractures of long bones: experimental study.
OBJECTIVE
To develop percutaneous osteoplasty with the use of a bone marrow nail for fixation of long-bone fractures, and to evaluate its feasibility and safety in vivo and in vitro.


METHODS
Six long bones in three healthy swine were used in the in vivo study. Acrylic cement was injected through an 11-gauge bone biopsy needle and a catheter into a covered metallic stent placed within the long bone, creating a bone marrow nail. In the in vitro study, we determined the bending, tug, and compression strengths of the acrylic cement nails 9 cm long and 8 mm in diameter (N = 10). The bending strength of the artificially fractured bones (N = 6) restored with the bone marrow nail and cement augmentation was then compared with that of normal long bones (N = 6).


RESULTS
Percutaneous osteoplasty with a bone marrow nail was successfully achieved within 1 hour for all swine. After osteoplasty, all swine regained the ability to run until they were euthanized. Blood tests and pathologic findings showed no adverse effects. The mean bending, tug, and compression strengths of the nail were 91.4 N/mm(2) (range, 75.0-114.1 N/mm(2)), 20.9 N/mm(2) (range, 6.6-30.4 N/mm(2)), and 103.0 N/mm(2) (range, 96.3-110.0 N/mm(2)), respectively. The bending strength ratio of artificially fractured bones restored with bone marrow nail and cement augmentation to normal long bone was 0.32.


CONCLUSIONS
Percutaneous osteoplasty with use of a bone marrow nail and cement augmentation appears to have potential in treating fractures of non-weight-bearing long bones.
Nakata
Kouhei
K
Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama 641-8510, Japan.
Kawai
Nobuyuki
N
Sato
Morio
M
Cao
Guang
G
Sahara
Shinya
S
Tanihata
Hirohiko
H
Takasaka
Isao
I
Minamiguchi
Hiroyuki
H
Nakai
Tomoki
T
D000818:Animals; D001696:Biomechanical Phenomena; D001706:Biopsy / Q000295:instrumentation; D001843:Bone Cements / Q000494:pharmacology*; D001853:Bone Marrow / Q000601:surgery*; D001858:Bone Nails; D002404:Catheterization; D057785:Catheters; D004195:Disease Models, Animal; D005240:Feasibility Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008422:Materials Testing; D020366:Methylmethacrylate / Q000494:pharmacology*; D009339:Needles; D011474:Prosthesis Design; D011859:Radiography; D015607:Stents; D013314:Stress, Mechanical; D013552:Swine; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors
D001843:Bone Cements; D020366:Methylmethacrylate