Biomechanical analysis of retrograde intramedullary nail fixation in distal femoral fractures

The Knee
Shih-Hao ChenYuan-Chiao Lu

Abstract

This study employed both mechanical testing and finite element analysis to compare the stiffness variations among different intramedullary nail constructs used in the treatment of distal femoral fractures. Compressive and torsional experiments were conducted on a transversely, as well as an obliquely fractured sawbone femur restored with the retrograde intramedullary nail. Corresponding finite element models were established to evaluate the stress distributions around screw holes. The results showed that a perifracture screw could increase stiffness by 40% for the obliquely fractured femur, but that it played an insignificant role in stiffness improvement for the transverse fracture groups. Moreover, compared to proximal-screw fixation, distal-screw fixation could improve construct stiffness by 20%. The absence of one of the two distal screws would increase the screw-hole stress by 70%. Therefore, the distal screw around the metaphyseal region has a more important stabilizing effect in the femur-nail construct than does the proximal screw. A twisting stress pattern occurs on the unused screw holes of the metaphyseal region and induces a higher risk for fatigue fracture. The locking screw at the fracture site would be most effec...Continue Reading

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Citations

Aug 4, 2012·Medical Engineering & Physics·A Fethi Okyar, Riza Bayoglu
Nov 3, 2009·Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics·Matthias SchneiderGerd Richter
Apr 13, 2012·Orthopedics·Chi-Chuan Wu, Ching-Lung Tai
Jul 5, 2013·Orthopedics·Mustafa SeyhanArel Gereli
Apr 2, 2016·Medical & Biological Engineering & Computing·Nattapon ChantarapanichPongwit Siribodhi
Apr 9, 2016·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Shih-Hao ChenKeng-Chang Liu
Feb 3, 2009·Clinical Orthopaedics and Related Research·Mellick J ChehadeDonald W Howie
Apr 20, 2011·Surgical Innovation·Ely Liviu SteinbergElchanan Luger
Apr 27, 2012·Journal of Orthopaedic Trauma·David J PallerBruce D Beynnon
Jan 28, 2014·Journal of Orthopaedic Trauma·Marissa BonyunEmil H Schemitsch

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