Fixation of proximal tibia fractures by a retrograde nail : a biomechanical investigation

Surgical treatment of proximal tibial fractures requires open reduction and internal fixation. The operative exposure causes additional soft-tissue injury and reduces the blood supply to the bone. A cephalograde tibial nail should offer comparable mechanical stability without these disadvantages. We...

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Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 2000, Vol.120 (3-4), p.212-214
Main Authors: POMMER, A, WIESER, A, HAHN, M. P, DAVID, A, MUHR, G
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biomechanical Phenomena
Bone Nails - adverse effects
Bone Plates - adverse effects
Cadaver
Fracture Fixation, Internal - instrumentation
Fractures
Humans
Knee
Medical sciences
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Technology. Biomaterials. Equipments
Tibial Fractures - surgery
Transplants & implants
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Summary:Surgical treatment of proximal tibial fractures requires open reduction and internal fixation. The operative exposure causes additional soft-tissue injury and reduces the blood supply to the bone. A cephalograde tibial nail should offer comparable mechanical stability without these disadvantages. We compared the stability of both osteosyntheses in a fracture model with 12 fresh-frozen cadaver bones. While both implants exhibited comparable stiffness under sagittal loading, the plate had a higher rotational and varus stiffness. Despite this higher stiffness, rotational displacements at the fracture gap were nearly twice as large for this implant during loading. We conclude that the retrograde nail provides similar mechanical stability to plate fixation for proximal tibial fractures, while the closed reduction and soft-tissue preservation of this new technique are definite advantages.
ISSN:0936-8051
1434-3916
DOI:10.1007/s004020050047