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Long-term stability of angle-stable versus conventional locked intramedullary nails in distal tibia fractures

Background: In the last years intramedullary nailing has become the treatment of choice for most displaced diaphyseal tibia fractures. In contrast intramedullary nailing of distal tibia fractures is accompanied by problems like decreased biomechanical stability. Nevertheless the indications for intramedullary nailing have been extended to include even more distal fractures. The purpose of this study was to compare long-term mechanical characteristics of angle-stable versus conventional locked intramedullary nails in the treatment of unstable distal tibia fractures. Therefore, the effect of time on the mechanical properties of biodegradable sleeves was assessed. Methods: 8 pairs of fresh, frozen porcine tibiae were used. The expert tibial nail (Synthes) was equipped with either three conventional locking screws (CL) or the angle-stable locking system (AS), consisting of a special ASLS screw and a biodegradable sleeve. Biomechanical testing included torsional and axial loading at different time-points over 12 weeks. Results: The AS group showed a significantly higher torsional stiffness at all time-points (at least 60%) compared to the CL group (p 0.05). For axial stiffness and range of motion significant differences were found in the AS group. Conclusions: The angle-stable locking system (ASLS) with the biodegradable sleeve provides significantly higher long-term stability. Especially the differences determined under torsional loading in this study may have clinical relevance. The ASLS permits the potential to decrease complications like secondary loss of reduction and mal-/non-union. 

Titel: Long-term stability of angle-stable versus conventional locked intramedullary nails in distal tibia fractures
Verfasser: Wähnert, Dirk GND
Stolarczyk, Yves
Hoffmeier, Konrad L.
Raschke, Michael J.
Hofmann, Gunther O.
Mückley, Thomas
Organisation: FB 05: Medizinische Fakultät
Dokumenttyp: Artikel
Medientyp: Text
Erscheinungsdatum: 20.02.2013
Publikation in MIAMI: 12.03.2013
Datum der letzten Änderung: 22.08.2014
Quelle: BMC Musculoskeletal Disorders 14 (2013) 66
Schlagwörter: Distal tibia fractures; Angular stability; Intramedullary nailing; ASLS; Biomechanics; Long-term
Fachgebiete: Medizin und Gesundheit
Lizenz: CC BY 2.0
Sprache: Englisch
Anmerkungen: Finanziert durch den Open-Access-Publikationsfonds 2012/2013 der Deutschen Forschungsgemeinschaft (DFG) und der Westfälischen Wilhelms-Universität Münster (WWU Münster).
Format: PDF-Dokument
URN: urn:nbn:de:hbz:6-87359459036
DOI: doi:10.1186/1471-2474-14-66