Internal Fixation of Supracondylar Femoral Fractures: Comparative Biomechanical Performance of the 95-Degree Blade Plate and Two Retrograde Nails
- 1 May 1998
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Orthopaedic Trauma
- Vol. 12 (4), 259-266
- https://doi.org/10.1097/00005131-199805000-00008
Abstract
The biomechanical stability of supracondylar femoral fractures fixed with a condylar blade plate (plate), a Green Seligson Henry nail (GSHN), or a new retrograde unreamed supracondylar femoral nail (new nail) based on the AO unreamed femoral nail were compared. A standardized simulated comminuted supracondylar femoral fracture (segmental defect) in fresh frozen paired cadaveric femora was stabilized with one of the implants. The interfragmentary fracture site stiffness in three directions and axial strength of the fixator-bone construct were compared (pairwise). The plate versus the new nail was (a) axially 10 percent as stiff and 50 percent as strong (ultimate strength), (b) as stiff in A/P bending, and (c) five times more stiff in torsion. Varus angle at failure under axial load was significantly greater for the plate than for the new nail. There were no statistical differences in axial stiffness and ultimate strength between the new nail and the GSHN, but the new nail was 50 percent and 30 percent as stiff in A/P bending and torsion, respectively. The magnitude of deformation at failure under axial loading was similar. In fixation of extraarticular comminuted supracondylar distal femur fractures, results indicate that (a) the new nail provides equal or greater stability than does the plate, except when large torsional loads are anticipated, and (b) the new nail provides stability equal to the GSHN for axial loading and lesser stability against off-axis loads. As is evident in this and other studies, intramedullary implants are less torsionally stiff than are plates. The torsional stiffness of the new nail is expected to be sufficient because it is comparable to many available nails, and low torsional moments are expected for healing femoral supracondylar fractures.Keywords
This publication has 17 references indexed in Scilit:
- Distal Femoral Fixation: A Laboratory Comparison of the 95° Plate, Antegrade and Retrograde Inserted Reamed Intramedullary NailsJournal of Orthopaedic Trauma, 1996
- Mechanics of Retrograde Nail Versus Plate Fixation for Supracondylar Femur FracturesJournal of Orthopaedic Trauma, 1995
- Initial Experience with the Treatment of Supracondylar Femoral Fractures Using the Supracondylar Intramedullary Nail: A Preliminary ReportJournal of Orthopaedic Trauma, 1994
- Intramedullary Supracondylar Nailing of Femoral FracturesClinical Orthopaedics and Related Research, 1993
- Blade-Plating of Closed Displaced Supracondylar Fractures of the Distal Femur with the AO SystemJournal Of Trauma-Injury Infection and Critical Care, 1992
- Treatment of Supracondylar-Intracondylar Fractures of the Femur Using the Dynamic Condylar ScrewJournal of Orthopaedic Trauma, 1989
- Surgical Management of Complex Fractures of the Distal FemurPublished by Ovid Technologies (Wolters Kluwer Health) ,1989
- Complications of Surgically Treated Supracondylar Fractures of the FemurJournal Of Trauma-Injury Infection and Critical Care, 1987
- Joint forces in the human pelvis-leg skeleton during walkingJournal of Biomechanics, 1984
- A biomechanical comparison of various methods of stabilization of subtrochanteric fractures of the femurJournal of Orthopaedic Research, 1984