title: Unlocked and locked elastic stable intramedullary nailing in an ovine tibia fracture model: a biomechanical study.
abstract: In the present study, four different systems of elastic stable intramedullary nails (unlocked, Ender stainless steel nails locked with 3-mm screws, titanium nails locked with end caps, titanium nails locked with plugs and 3-mm screws) were implanted in cadaveric ovine tibiae. Fractures were simulated by a transverse diaphyseal osteotomy. The specimens were subjected to simultaneous axial and torsional fatigue loading of 5000 and 1000 cycles, respectively. The unlocked systems failed at an axial load of 200 N peak amplitude. End caps systems withstood axial loads up to 800 N for 1000 cycles, and ender nails and plugs lasted up to 1000 N for 1000 cycles. All systems showed a decrease of axial stiffness with higher loads and endured cycles. Ender nails and nails locked with plugs failed by penetration of the distal epiphysis rather than by loosening of the interlocking system. Overall, the titanium nails locked with plugs and 3-mm screws exhibited superior test results.
authors.affiliation: Institute of Building Construction and Technology, Vienna University of Technology, Karlsplatz 13/206-4, 1040 Vienna, Austria. Electronic address: leopold.berger@tuwien.ac.at.
authors.forename: Leopold
authors.initials: L
authors.lastname: Berger
authors.affiliation: Department of Orthopedics and Orthopedic Surgery, Medical University of Graz, Auenbruggerplatz 5/6, 8036 Graz, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Fischerauer
authors.affiliation: Institute of Building Construction and Technology, Vienna University of Technology, Karlsplatz 13/206-4, 1040 Vienna, Austria.
authors.forename: Barbara
authors.initials: B
authors.lastname: Weiß
authors.affiliation: Institute of Building Construction and Technology, Vienna University of Technology, Karlsplatz 13/206-4, 1040 Vienna, Austria.
authors.forename: Anna
authors.initials: A
authors.lastname: Celarek
authors.affiliation: Department of Pediatric and Adolescence Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Castellani
authors.affiliation: Department of Orthopedics and Orthopedic Surgery, Medical University of Graz, Auenbruggerplatz 5/6, 8036 Graz, Austria.
authors.forename: Annelie-Martina
authors.initials: AM
authors.lastname: Weinberg
authors.affiliation: Institute of Building Construction and Technology, Vienna University of Technology, Karlsplatz 13/206-4, 1040 Vienna, Austria.
authors.forename: Elmar
authors.initials: E
authors.lastname: Tschegg
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D001858:Bone Nails; D004548:Elasticity; D005594:Fracture Fixation, Intramedullary; D006245:Hardness Tests; D008954:Models, Biological; D012756:Sheep; D013978:Tibial Fractures / Q000628:therapy*; D014025:Titanium / Q000737:chemistry
chemical_list: D014025:Titanium
keywords: Bone; Elastic stable intramedullary nailing (ESIN); Fatigue; Fracture; Long bone; Pediatric