A25 A five year experience in using poller screws in lower limb im nailing in a military hospital in Greece

Savvidis, M.; Bisbinas, Ilias; Georgiannos, Dimitrios; Gouvas, G.

doi:10.1016/s0020-1383(11)70042-0

Cited by 2 publications

(2 citation statements)

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“…Their results demonstrated that in order to increase the stability of the bone–nail constructure, the placement of the BS should be as close to the fracture site as possible. BSs are predominantly used for femur and tibia fractures at the metaphyseal–diaphyseal junction to assist fracture reduction and stabilize the bone–implant construct through the provision of a third fixation point 9 , 10 , 11 , 12 , 13 , 14 . A systematic review containing 13 studies with a total of 371 participants and 376 fractures showed that, compared with nailing alone, IM nailing with a BS has lower rates of nonunion and coronal malalignment when treating metaphyseal fractures 15 .…”

Section: Introductionmentioning

confidence: 99%

“…Meanwhile, additional BSs can also decrease tibial callus formation 16 owing to increased bone‐nail construct stability while treating the delayed union of proximal tibial shaft fractures via nailing 17 . These important advantages mainly depend on accurate BS positioning 10 , 12 , 13 , 14 , 15 , 16 , 17 , 18 . Accurate placement also enables three‐point fixation principles, which help to overcome the mismatch of bone and nail at the diaphyseal‐metaphyseal junction or the metaphyseal that is responsible for the associated axial displacement.…”

Section: Introductionmentioning

confidence: 99%

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A New Technique for Placement of Blocking Screws and its Mechanical Effect on Stability of Tibia Fractures with Distal Fragments after Insertion of Small‐Diameter Intramedullary Nails

Zhang

Sun

Wang

et al. 2021

Orthopaedic Surgery

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Objective: To design a novel blocking screws (BSs) geometry and insertion method to treat distal tibia fracture with nailing and comparison of mechanical properties of novel and traditional screws.Methods: Twenty-one synthetic left tibiae were sectioned to obtain 21 distal segments measuring 55 mm. Intramedullary (IM) 9-mm tibial nails were advanced to 6 mm from the ankle joint. Two transverse and one anteriorposterior (AP) locking screws were inserted. Both medial-lateral (ML) BSs were placed 10 mm from the topmost interlocking screw. A custom-made jig assisted in placing the novel and traditional BSs. The time spent in placing each BS was recorded. All the samples were repaired with an IM nail and without BSs, with two traditional BSs, and with two novel BSs. An initial loading from À150 to +150 N was applied to specimens in the ML direction at 185 mm from the nail end, followed by cyclic loading of the same for 10,000 cycles with failure-to-test loading of 350 N in the ML direction. The maximum displacement was measured at 80 mm from the nail end and recorded under initial loading. The damage of two kinds of BSs to the nail was recorded.Results: Compared with average 5.21 min of the time of placing a traditional BS, the time spent in positioning a novel BS on the fracture model was 2.53 min. In the distal bone-implant constructs (BICs), the addition of traditional BSs decreased the maximum displacement of the BICs by 26.2%. The addition of the novel BSs decreased the displacement by 28.9%. All constructs survived 10,000 cycles without hardware deformation. The failure rate of the control group was significantly greater than that of the traditional group; however, the novel group was similar to the traditional group. The damage of the traditional BS to the nail was greater than that of the novel one. Conclusions:The novel and traditional BSs are comparably effective for increasing the primary mechanical stability of distal metaphyseal fractures after nailin. However, compared to the placement of a traditional BS, implanting a novel BS took more less time and caused less damage to the nail. Additionally, the most obvious advantage of the novel BS design and insertion technology was that the pressure and distance between it and the IM nail could be controlled by rotating the screw. These advantages of the novel BS will be beneficial for clinical application.

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