Proximal Tibial Fracture Stability With Intramedullary Nail Fixation Using Oblique Interlocking Screws
OBJECTIVESThe purpose of this study was to evaluate the mechanical stability of oblique interlocking screws in supplementing intramedullary nail fixation of high proximal tibial fractures. DESIGNIn vitro experimental testing. SETTINGOrthopaedic biomechanics laboratory, Sunnybrook and Women's Co...
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| Veröffentlicht in: | Journal of orthopaedic trauma 2003-08, Vol.17 (7), p.496-502 |
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| creator | Laflamme, G Y Heimlich, D Stephen, D Kreder, H J Whyne, C M |
| description | OBJECTIVESThe purpose of this study was to evaluate the mechanical stability of oblique interlocking screws in supplementing intramedullary nail fixation of high proximal tibial fractures.
DESIGNIn vitro experimental testing.
SETTINGOrthopaedic biomechanics laboratory, Sunnybrook and Women's College Health Sciences Center.
PARTICIPANTSTen paired fresh-frozen human cadaver tibiae.
INTERVENTIONOne tibia of each pair was randomized to be instrumented with an intramedullary nail (M/DN; Zimmer, Warsaw, Indiana), while the other was stabilized with a 13-hole stainless steel lateral tibial head plate (Synthes AO/ASIF). Specimens were tested in varus-valgus (v/v), flexion-extension (f/e) and torsion, before and after a 2-cm gap osteotomy was performed in the proximal segment. Testing of the nailed tibiae was performed with and without oblique proximal screws. Bone density was physically determined by removing a core of trabecular bone from the distal end of each tibia following testing.
MAIN OUTCOME MEASUREMENTBiomechanical construct stability.
RESULTSThe addition of the proximally placed oblique screws increased the stability of the nail construct in v/v by 50% (6.8 mm, P < 0.05), in f/e by 47% (7.2 mm, P < 0.05), and in torsion by 18% (3.0°, P < 0.05). There was no significant difference observed between the stability of the intramedullary nail construct with oblique screws and the plated construct. Trabecular bone density had a significant effect in reducing stability (P < 0.05) in nail and plate fixation.
CONCLUSIONThe addition of oblique interlocking screws significantly improves the stability of a nailed proximal tibia fracture and provides comparable stability to a plate osteosynthesis. |
| doi_str_mv | 10.1097/00005131-200308000-00004 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_73531506</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>73531506</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4154-65211e954c26ec9dffa8b50fcc8c57671be4dfd06bbe40f21fec3cf4896ad5123</originalsourceid><addsrcrecordid>eNp1kc9PwjAUgBujEUT_BbOL3qZtt-7H0RhREiImQDw2XddKpWzYbgH-e98E5WQPfe3L9_peviIUEHxHcJ7eY1iMRCSkGEc4g1vYpeIT1CesS9OcnKI-znIcsijKe-jC-08gMkzpOeoRmmOaZmkf6TdXb81K2GBmCgNh6IRsWqeCaSMKY02zC95NswhGVePESpWttcLtgldhgDVb0Zi6CubeVB_BpLDmq1Udqpyt5bJLTqVTG3-JzrSwXl0d4gDNh0-zx5dwPHkePT6MQxkTFocJo4SonMWSJkrmpdYiKxjWUmaSpUlKChWXusRJAQesKdFKRlLHWZ6IkhEaDdDt_t21q2EU3_CV8VLBzJWqW8_TCPQwnACY7UHpau-d0nztQIPbcYJ555j_OuZ_jn9SMZReH3q0BQg5Fh6kAnBzAISXwmonKmn8kev6wwZcvOc2tQVjfmnbjXJ8oYRtFvy_P46-Ab8dlPk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>73531506</pqid></control><display><type>article</type><title>Proximal Tibial Fracture Stability With Intramedullary Nail Fixation Using Oblique Interlocking Screws</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Laflamme, G Y ; Heimlich, D ; Stephen, D ; Kreder, H J ; Whyne, C M</creator><creatorcontrib>Laflamme, G Y ; Heimlich, D ; Stephen, D ; Kreder, H J ; Whyne, C M</creatorcontrib><description>OBJECTIVESThe purpose of this study was to evaluate the mechanical stability of oblique interlocking screws in supplementing intramedullary nail fixation of high proximal tibial fractures.
DESIGNIn vitro experimental testing.
SETTINGOrthopaedic biomechanics laboratory, Sunnybrook and Women's College Health Sciences Center.
PARTICIPANTSTen paired fresh-frozen human cadaver tibiae.
INTERVENTIONOne tibia of each pair was randomized to be instrumented with an intramedullary nail (M/DN; Zimmer, Warsaw, Indiana), while the other was stabilized with a 13-hole stainless steel lateral tibial head plate (Synthes AO/ASIF). Specimens were tested in varus-valgus (v/v), flexion-extension (f/e) and torsion, before and after a 2-cm gap osteotomy was performed in the proximal segment. Testing of the nailed tibiae was performed with and without oblique proximal screws. Bone density was physically determined by removing a core of trabecular bone from the distal end of each tibia following testing.
MAIN OUTCOME MEASUREMENTBiomechanical construct stability.
RESULTSThe addition of the proximally placed oblique screws increased the stability of the nail construct in v/v by 50% (6.8 mm, P < 0.05), in f/e by 47% (7.2 mm, P < 0.05), and in torsion by 18% (3.0°, P < 0.05). There was no significant difference observed between the stability of the intramedullary nail construct with oblique screws and the plated construct. Trabecular bone density had a significant effect in reducing stability (P < 0.05) in nail and plate fixation.
CONCLUSIONThe addition of oblique interlocking screws significantly improves the stability of a nailed proximal tibia fracture and provides comparable stability to a plate osteosynthesis.</description><identifier>ISSN: 0890-5339</identifier><identifier>EISSN: 1531-2291</identifier><identifier>DOI: 10.1097/00005131-200308000-00004</identifier><identifier>PMID: 12902787</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Aged ; Aged, 80 and over ; Biological and medical sciences ; Biomechanical Phenomena ; Bone Screws - adverse effects ; Female ; Fracture Fixation, Intramedullary - adverse effects ; Fracture Fixation, Intramedullary - methods ; Humans ; In Vitro Techniques ; Joint Instability - physiopathology ; Knee Joint - physiopathology ; Knee Joint - surgery ; Male ; Medical sciences ; Middle Aged ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Technology. Biomaterials. Equipments ; Tibial Fractures - physiopathology ; Tibial Fractures - surgery</subject><ispartof>Journal of orthopaedic trauma, 2003-08, Vol.17 (7), p.496-502</ispartof><rights>2003 Lippincott Williams & Wilkins, Inc.</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4154-65211e954c26ec9dffa8b50fcc8c57671be4dfd06bbe40f21fec3cf4896ad5123</citedby><cites>FETCH-LOGICAL-c4154-65211e954c26ec9dffa8b50fcc8c57671be4dfd06bbe40f21fec3cf4896ad5123</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15063150$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12902787$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Laflamme, G Y</creatorcontrib><creatorcontrib>Heimlich, D</creatorcontrib><creatorcontrib>Stephen, D</creatorcontrib><creatorcontrib>Kreder, H J</creatorcontrib><creatorcontrib>Whyne, C M</creatorcontrib><title>Proximal Tibial Fracture Stability With Intramedullary Nail Fixation Using Oblique Interlocking Screws</title><title>Journal of orthopaedic trauma</title><addtitle>J Orthop Trauma</addtitle><description>OBJECTIVESThe purpose of this study was to evaluate the mechanical stability of oblique interlocking screws in supplementing intramedullary nail fixation of high proximal tibial fractures.
DESIGNIn vitro experimental testing.
SETTINGOrthopaedic biomechanics laboratory, Sunnybrook and Women's College Health Sciences Center.
PARTICIPANTSTen paired fresh-frozen human cadaver tibiae.
INTERVENTIONOne tibia of each pair was randomized to be instrumented with an intramedullary nail (M/DN; Zimmer, Warsaw, Indiana), while the other was stabilized with a 13-hole stainless steel lateral tibial head plate (Synthes AO/ASIF). Specimens were tested in varus-valgus (v/v), flexion-extension (f/e) and torsion, before and after a 2-cm gap osteotomy was performed in the proximal segment. Testing of the nailed tibiae was performed with and without oblique proximal screws. Bone density was physically determined by removing a core of trabecular bone from the distal end of each tibia following testing.
MAIN OUTCOME MEASUREMENTBiomechanical construct stability.
RESULTSThe addition of the proximally placed oblique screws increased the stability of the nail construct in v/v by 50% (6.8 mm, P < 0.05), in f/e by 47% (7.2 mm, P < 0.05), and in torsion by 18% (3.0°, P < 0.05). There was no significant difference observed between the stability of the intramedullary nail construct with oblique screws and the plated construct. Trabecular bone density had a significant effect in reducing stability (P < 0.05) in nail and plate fixation.
CONCLUSIONThe addition of oblique interlocking screws significantly improves the stability of a nailed proximal tibia fracture and provides comparable stability to a plate osteosynthesis.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Biomechanical Phenomena</subject><subject>Bone Screws - adverse effects</subject><subject>Female</subject><subject>Fracture Fixation, Intramedullary - adverse effects</subject><subject>Fracture Fixation, Intramedullary - methods</subject><subject>Humans</subject><subject>In Vitro Techniques</subject><subject>Joint Instability - physiopathology</subject><subject>Knee Joint - physiopathology</subject><subject>Knee Joint - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Technology. Biomaterials. Equipments</subject><subject>Tibial Fractures - physiopathology</subject><subject>Tibial Fractures - surgery</subject><issn>0890-5339</issn><issn>1531-2291</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9PwjAUgBujEUT_BbOL3qZtt-7H0RhREiImQDw2XddKpWzYbgH-e98E5WQPfe3L9_peviIUEHxHcJ7eY1iMRCSkGEc4g1vYpeIT1CesS9OcnKI-znIcsijKe-jC-08gMkzpOeoRmmOaZmkf6TdXb81K2GBmCgNh6IRsWqeCaSMKY02zC95NswhGVePESpWttcLtgldhgDVb0Zi6CubeVB_BpLDmq1Udqpyt5bJLTqVTG3-JzrSwXl0d4gDNh0-zx5dwPHkePT6MQxkTFocJo4SonMWSJkrmpdYiKxjWUmaSpUlKChWXusRJAQesKdFKRlLHWZ6IkhEaDdDt_t21q2EU3_CV8VLBzJWqW8_TCPQwnACY7UHpau-d0nztQIPbcYJ555j_OuZ_jn9SMZReH3q0BQg5Fh6kAnBzAISXwmonKmn8kev6wwZcvOc2tQVjfmnbjXJ8oYRtFvy_P46-Ab8dlPk</recordid><startdate>200308</startdate><enddate>200308</enddate><creator>Laflamme, G Y</creator><creator>Heimlich, D</creator><creator>Stephen, D</creator><creator>Kreder, H J</creator><creator>Whyne, C M</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200308</creationdate><title>Proximal Tibial Fracture Stability With Intramedullary Nail Fixation Using Oblique Interlocking Screws</title><author>Laflamme, G Y ; Heimlich, D ; Stephen, D ; Kreder, H J ; Whyne, C M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4154-65211e954c26ec9dffa8b50fcc8c57671be4dfd06bbe40f21fec3cf4896ad5123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Biomechanical Phenomena</topic><topic>Bone Screws - adverse effects</topic><topic>Female</topic><topic>Fracture Fixation, Intramedullary - adverse effects</topic><topic>Fracture Fixation, Intramedullary - methods</topic><topic>Humans</topic><topic>In Vitro Techniques</topic><topic>Joint Instability - physiopathology</topic><topic>Knee Joint - physiopathology</topic><topic>Knee Joint - surgery</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Technology. Biomaterials. Equipments</topic><topic>Tibial Fractures - physiopathology</topic><topic>Tibial Fractures - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Laflamme, G Y</creatorcontrib><creatorcontrib>Heimlich, D</creatorcontrib><creatorcontrib>Stephen, D</creatorcontrib><creatorcontrib>Kreder, H J</creatorcontrib><creatorcontrib>Whyne, C M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of orthopaedic trauma</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Laflamme, G Y</au><au>Heimlich, D</au><au>Stephen, D</au><au>Kreder, H J</au><au>Whyne, C M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Proximal Tibial Fracture Stability With Intramedullary Nail Fixation Using Oblique Interlocking Screws</atitle><jtitle>Journal of orthopaedic trauma</jtitle><addtitle>J Orthop Trauma</addtitle><date>2003-08</date><risdate>2003</risdate><volume>17</volume><issue>7</issue><spage>496</spage><epage>502</epage><pages>496-502</pages><issn>0890-5339</issn><eissn>1531-2291</eissn><abstract>OBJECTIVESThe purpose of this study was to evaluate the mechanical stability of oblique interlocking screws in supplementing intramedullary nail fixation of high proximal tibial fractures.
DESIGNIn vitro experimental testing.
SETTINGOrthopaedic biomechanics laboratory, Sunnybrook and Women's College Health Sciences Center.
PARTICIPANTSTen paired fresh-frozen human cadaver tibiae.
INTERVENTIONOne tibia of each pair was randomized to be instrumented with an intramedullary nail (M/DN; Zimmer, Warsaw, Indiana), while the other was stabilized with a 13-hole stainless steel lateral tibial head plate (Synthes AO/ASIF). Specimens were tested in varus-valgus (v/v), flexion-extension (f/e) and torsion, before and after a 2-cm gap osteotomy was performed in the proximal segment. Testing of the nailed tibiae was performed with and without oblique proximal screws. Bone density was physically determined by removing a core of trabecular bone from the distal end of each tibia following testing.
MAIN OUTCOME MEASUREMENTBiomechanical construct stability.
RESULTSThe addition of the proximally placed oblique screws increased the stability of the nail construct in v/v by 50% (6.8 mm, P < 0.05), in f/e by 47% (7.2 mm, P < 0.05), and in torsion by 18% (3.0°, P < 0.05). There was no significant difference observed between the stability of the intramedullary nail construct with oblique screws and the plated construct. Trabecular bone density had a significant effect in reducing stability (P < 0.05) in nail and plate fixation.
CONCLUSIONThe addition of oblique interlocking screws significantly improves the stability of a nailed proximal tibia fracture and provides comparable stability to a plate osteosynthesis.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>12902787</pmid><doi>10.1097/00005131-200308000-00004</doi><tpages>7</tpages></addata></record> |
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| ispartof | Journal of orthopaedic trauma, 2003-08, Vol.17 (7), p.496-502 |
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| subjects | Aged Aged, 80 and over Biological and medical sciences Biomechanical Phenomena Bone Screws - adverse effects Female Fracture Fixation, Intramedullary - adverse effects Fracture Fixation, Intramedullary - methods Humans In Vitro Techniques Joint Instability - physiopathology Knee Joint - physiopathology Knee Joint - surgery Male Medical sciences Middle Aged Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Technology. Biomaterials. Equipments Tibial Fractures - physiopathology Tibial Fractures - surgery |
| title | Proximal Tibial Fracture Stability With Intramedullary Nail Fixation Using Oblique Interlocking Screws |
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