Foot & ankle international · 2017
Biomechanical Comparison of Intramedullary Fibular Nail Versus Plate and Screw Fixation.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Smith George, Mackenzie Samuel Peter, Wallace Robert James, Carter Tom, White Timothy Oliver
Аннотация
BACKGROUND: Clinical evidence has shown that percutaneous ankle fracture fixation using an intramedullary fibular nail results in good outcomes at 1 year and reduces postoperative wound complications in patients with vulnerable soft tissues. Confirmatory biomechanical evidence of its strength when used to secure a supination external rotation (SER) IV (AO/OTA 44B-type) fracture, compared with traditional plates and screws, is currently lacking.
METHODS: Twenty cadaveric lower limbs (10 cadavers) had a SER IV injury surgically created. One leg was randomly allocated to fixation with a fibular nail and the other a lag screw and neutralization plate. A mechanical testing apparatus subjected all lower limbs to an axially loaded supination external rotation force to failure.
RESULTS: Superior ultimate torque to failure was demonstrated with a trend toward increased energy absorption in the nail group ( P = .28 and .07, respectively). No difference was demonstrated in angle at failure. All specimens in the plate group lost reduction at the bone-metal interface as a result of screw pullout. In contrast, all specimens in the nail group failed because of disruption of the lateral ligaments.
CONCLUSIONS: This study demonstrated greater torque to failure and better maintenance of the fibular construct for the intramedullary fibular nail compared to standard plating.
CLINICAL RELEVANCE: These results suggest that the previously documented clinical benefits of the fibular nail are complemented by biomechanical properties that compare favorably to standard techniques.
METHODS: Twenty cadaveric lower limbs (10 cadavers) had a SER IV injury surgically created. One leg was randomly allocated to fixation with a fibular nail and the other a lag screw and neutralization plate. A mechanical testing apparatus subjected all lower limbs to an axially loaded supination external rotation force to failure.
RESULTS: Superior ultimate torque to failure was demonstrated with a trend toward increased energy absorption in the nail group ( P = .28 and .07, respectively). No difference was demonstrated in angle at failure. All specimens in the plate group lost reduction at the bone-metal interface as a result of screw pullout. In contrast, all specimens in the nail group failed because of disruption of the lateral ligaments.
CONCLUSIONS: This study demonstrated greater torque to failure and better maintenance of the fibular construct for the intramedullary fibular nail compared to standard plating.
CLINICAL RELEVANCE: These results suggest that the previously documented clinical benefits of the fibular nail are complemented by biomechanical properties that compare favorably to standard techniques.