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Biomechanical.comparison of distal.l.cking screws for distal.tibia fracture intramedul.ary nail.ng

Journal.of Biomedical.Science and Engineering 2011年第4期4卷 235-241页

作者： brennen l. lucas Al.xander C.M. Chong Bruce R. Buhr Teresa l. Jones Paul.H. Wool.y 不详

Background: Newer generation intramedul.ary (IM) tibial.nail. provide several.distal.interl.cking screw options. The objectives were to determine: 1) if the new obl.que interl.cking option provides superior stabil.ty, 2) which screw orientation/ configuration is the most biomechanical.y stabl., and 3) if three distal.interl.cking screws provide better stabil.ty. Methods: A prel.minary experiment was performed in torsion, compression, and bending tests with four different screw configurations: (I) one medial.to-l.teral.and one obl.que, (II) two me-dial.to-l.teral. (III) one medial.to-l.teral.and one anterior-to-posterior, and (IV) one medial.to-l.teral. one anterior-to-posterior and one obl.que in simu-l.ted distal.metaphyseal.fracture tibiae. Twenty- four Synthes EXPERT tibial.IM nail. were used for six specimens of each screw configuration. Parts I and II, tibial.IM nail. were l.cked with 5.0 mm in-terl.cking screws into simul.ted distal.tibiae (PVC and composite anal.gue tibia). Part III, the two most stabl. configurations were tested using five pairs of simul.ted cadaveric distal.tibiae metaphy-seal.fractures. Resul.s: Significant differences were attributabl. to distal.screw orientation for intrame- dul.ary nail.ng of distal.tibia fractures. Configura-tions II and IV were found to be more stabl. than the other two configurations. No significant differ-ence was detected in construct stabil.ty in al. modes of testing between Configurations II and IV. Dis-cussion: Configuration I did not provide superior stabil.ty for the distal.tibia fracture fixation. Con-figurations II and IV provided equival.nt stabil.ty. When choosing IM fixation for treatment of distal.tibia metaphyseal.fractures two medial.to-l.teral.screws provide the necessary stabil.ty for satisfac-tory fixation. Cl.nical.Rel.vance: This study indi-cated an option for operative treatment of distal.metaphyseal.tibia fracture fixation where preserva-tion of soft tissue and rigid stabil.zation are needed.

关键词： Biomechanical l.cking Screws Intramedul.ary Nail Distal Tibia

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