Combination of anatomical locking plate and retrograde intramedullary nail in distal femoral fractures: comparison of mechanical stability.
OBJECTIVE
This study aims is to investigate mechanical properties of intramedullary (IM) nailing and anatomical locking plate in a bone model based on the hypothesis that their combined usage increases safety of fixation stabilization.


METHODS
Twenty-one left distal femoral fracture models were used in the study. Bones were divided into three equal groups. Group 1 specimens were fixed laterally by distal femoral anatomical locking plate. Group 2 specimens were fixed with retrograde distal femoral IM nail. Group 3 specimens were fixed with both distal femoral anatomical locking plate and retrograde distal femoral IM nail. In mechanical tests, alterations in axial loading, torsion angles, and load to failure values were measured and compared between groups.


RESULTS
Compared to group 1, group 2 was relatively more resistant in axial load tests (p=0.225), and significantly more resistant in load to failure tests (p=0.048). Group 1 was relatively more resistant in torsional load tests (p=0.949) compared to group 2. Group 3 was significantly more resistant than group 1 in axial (p=0.001), torsional (p=0.012) load tests and load to failure tests (p=0.008). Group 3 was significantly more resistant compared to group 2 in axial (p=0.003), torsional (p=0.008) load tests, and relatively more resistant (p=0.059) in load to failure tests.


CONCLUSIONS
Thanks to its high mechanical strength and early mobilization capability, distal femoral anatomical locking plate and IM nail combination might be a choice of treatment in complicated osteoporotic or distal femoral fractures from high-energy trauma in young adults.
Department of Orthopedics and Traumatology, Medical Faculty of Dokuz Eylül University, 35210 Alsancak, İzmir, Turkey. dronurbasci@gmail.com.
Onur
O
Başcı
Ahmet
A
Karakaşlı
Erdem
E
Kumtepe
Ortaç
O
Güran
Hasan
H
Havıtçıoğlu
D000328:Adult; D001696:Biomechanical Phenomena; D001858:Bone Nails; D001860:Bone Plates; D002102:Cadaver; D005260:Female; D005264:Femoral Fractures / Q000503:physiopathology / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D013718:Tensile Strength