A case study of subsequential intramedullary nails failure

Griza, Sandro; Zimmer, Cínthia Gabriely; Reguly, Afonso; Strohaecker, Telmo Roberto

doi:10.1016/j.engfailanal.2008.06.015

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…In Kyle [44], the mechanical failure of IM nails has been attributed to two modes: plastic collapse and fatigue fracture. Nail failures have also been reported in Griza and co-workers [4][5][6]. Griza et al [4] compared the failure modes of a slotted and an unslotted nail.…”

Section: Casesmentioning

confidence: 89%

“…Although intramedullary nailing has become a standard approach to stabilize fractured bone fragments, failures are still encountered as reported in several studies, emphasizing especially interlocking screw failures due to excessive bending and fatigue [1,2], bone refracture and nail failure [3][4][5][6]. With a need for improving these devices, it is imperative that the deflections of the implanted femur, stresses in the nail and screws, and the femoral strains be accurately predicted.…”

Section: Introductionmentioning

confidence: 99%

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Implementation of boundary conditions in modeling the femur is critical for the evaluation of distal intramedullary nailing

Bayoğlu

Okyar

2015

Medical Engineering & Physics

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Section: Casesmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Implementation of boundary conditions in modeling the femur is critical for the evaluation of distal intramedullary nailing

Bayoğlu

Okyar

2015

Medical Engineering & Physics

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“…Though there may be multiple successful combinations for a given case, each configuration has a relatively higher risk of failure when compared to a theoretically optimal construct . In the case of the IM nail fixation, clinical failures are reported in up to 14% of patients via, most commonly, fixation screw bending and fatigue, cut‐out, and nail failure . Excessive interfragmentary motion at the fracture site resulting from instability can result in high strain and disrupt healing, leading to nonunion .…”

mentioning

confidence: 99%

“…5 In the case of the IM nail fixation, clinical failures are reported in up to 14% of patients 6 via, most commonly, fixation screw bending and fatigue, 7 cut-out, and nail failure. [8][9][10] Excessive interfragmentary motion at the fracture site resulting from instability can result in high strain and disrupt healing, leading to nonunion. 11 However, especially for patients with unstable fractures or compromised healing capacity, an optimized fixation construct can reduce the time required to achieve union and mitigate the risk of implant failure and nonunion events.…”

mentioning

confidence: 99%

Parametric Finite Element Analysis of Intramedullary Nail Fixation of Proximal Femur Fractures

Tucker

Wee

Fox

et al. 2019

Journal Orthopaedic Research

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Proximal femur fracture fixation with intramedullary nailing relies on stability at the fracture site and integrity of the fixation construct to achieve union. The biomechanics that dictate fracture site stability and implant stress depend on fracture type as well as implant features such as nail length, nail diameter, presence of distal fixation screws, and material composition of the implant. When deciding how to fix a fracture, surgeons have choices in these implant‐related design variables. This study models all combinations of a range of implant variables for nine standard AO/OTA proximal femur fractures using finite element analysis. Under simulated maximum load during gait, the maximum stress in the implant and screws as well as interfragmentary motions at the fracture site in the axial and shear directions were computed. The results were separated by fracture type to show the influence of each design variable on measured biomechanical outcomes. Filling the reamed canal with the largest fitting nail diameter reduced axial and shear interfragmentary motion for all fracture types. Nail length was less predictive of shear interfragmentary motion for most simulated fracture types than other construct variables. Furthermore, gapping at the fracture site predisposed the construct to higher implant stresses and larger interfragmentary motions. Clinical significance: Biomechanical outcomes from this computational study can aid in surgical decision‐making for optimizing hip fracture fixation with IM nailing. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2358–2366, 2019

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“…Even if the optimal treatment for severe bone fractures represents a debated question [3], stabilization of long bones fractures has been obtained more and more through intramedullary nails. That because this kind of approach is minimally invasive thus allowing patient early full weigh-bearing and reduces the long time immobilization problems [4]. Intramedullary nails, moreover, compared with other types of fixator, like the external implants (plates for osteosynthesis [5], present the advantage of reducing trauma to the soft tissues [6].…”

Section: Introductionmentioning

confidence: 99%

Virtual prototyping of a new intramedullary nail for tibial fractures

Ingrassia¹,

Mancuso²

2012

Int J Interact Des Manuf

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In this work a new distal interlocking system has been developed which is easy to use, allows a reduction of the operating time and consequently the exposure to radiations both for surgeon and patient. The main goal of this study has been the design of a new intramedullary nail for tibial fractures able to simplify and speed up the distal locking operation phases. After a preliminary stage during which several candidate concepts have been proposed and analysed, the best solution has been developed and deeply investigated. The new system, called "expansion nail", has been firstly modelled by setting up a full parametric CAD model and, then, tested by running non linear FEM analyses to evaluate stresses and stability of the joining during normal working conditions. The new design has shown very high mechanical stability in the axial compression and torsional load cases. Since its very simple self-locking system, the new expansion intramedullary nail would reduce the operating time and the exposure to radiations for the surgeons as well as the patients.

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A case study of subsequential intramedullary nails failure

Cited by 8 publications

References 13 publications

Implementation of boundary conditions in modeling the femur is critical for the evaluation of distal intramedullary nailing

Implementation of boundary conditions in modeling the femur is critical for the evaluation of distal intramedullary nailing

Parametric Finite Element Analysis of Intramedullary Nail Fixation of Proximal Femur Fractures

Virtual prototyping of a new intramedullary nail for tibial fractures

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