Interlocking

Krettek, Christian; Baumann, Andreas

doi:10.1007/978-1-4471-6612-2_4

Cited by 2 publications

(2 citation statements)

References 88 publications

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“…Operative techniques such as the backslap technique has also been found to be effective in correcting fracture diastasis and promoting fracture union during the index operation. 31 Exchange nails, dynamization, and plating techniques are secondary surgical interventions that can help treat nonunion fractures after IMN. [32][33][34] The results of our study should be considered in the context of its limitations.…”

Section: Discussionmentioning

confidence: 99%

Predictors of nonunion for transverse femoral shaft fractures treated with intramedullary nailing: a SIGN database study

Jones,

Cohoe,

Brown

et al. 2023

OTA International: The Open Access Journal of Orthopaedic Trauma

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Introduction: Nonunion is a common postfracture complication resulting in decreased quality of life for patients in resource-limited settings. This study aims to determine how age, sex, injury mechanism, and surgical intervention affect the rate of nonunion in transverse femur fractures treated with a SIGN intramedullary nail (IMN). Methods: A retrospective study was conducted using the SIGN online surgical database. All patients older than 16 years with simple transverse (<30 degrees), open or closed, femur fractures treated using a SIGN IMN between 2007 and 2021 were included. Our primary outcome of nonunion was measured with the modified Radiographic Union Scale for Tibial fractures (mRUST); scores ≤9 of 16 defined nonunion. The secondary outcome was squat depth. Outcomes were evaluated at follow-up appointments between 240 and 365 days postoperatively. Univariate and multivariate analysis were used for statistical comparison. Results: Inclusion criteria were met for 182 patients. The overall radiographic union rate was 61.0%, and a high proportion (84.4%) of patients could squat with their hips at or below the level of their knees. Older age, retrograde approach, and fracture distraction were associated with nonunion, but sex, injury mechanism, and other surgical variables were not. Conclusion: Poor reduction with fracture distraction was associated with a higher rate of nonunion. Loss of follow-up may have contributed to our overall union rate; however, we observed high rates of functional healing using the SIGN IMN. Level of evidence: IV.

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Section: Discussionmentioning

confidence: 99%

Predictors of nonunion for transverse femoral shaft fractures treated with intramedullary nailing: a SIGN database study

Jones,

Cohoe,

Brown

et al. 2023

OTA International: The Open Access Journal of Orthopaedic Trauma

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“…This locking mode was able to increase the loading of the fracture site and stimulate the healing. 43,50,67,71,72…”

Section: From Concept To Clinical Widespread Acceptancementioning

confidence: 99%

Intramedullary nailing biomechanics: Evolution and challenges

Rosa

Marta

Vaz

et al. 2019

Proc Inst Mech Eng H

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This article aims to review the biomechanical evolution of intramedullary nailing and describe the breakthrough concepts which allowed for nail improvement and its current success. The understanding of this field establishes an adequate background for forthcoming research and allows to infer on the path for future developments on intramedullary nailing. It was not until the 1940s, with the revolutionary Küntscher intramedullary nailing design, that this method was recognized as a widespread medical procedure. Such achievement was established based on the foundations created from intuitionbased experiments and the first biomechanical ideologies. The nail evolved from allowing alignment and stability through press-fit fixation with nail-cortical wall friction to the nowadays nail stability achieved through interlocking screws mechanical linkage between nail and bone. Important landmarks during nail evolution comprise the introduction of flexible reaming, the progress from slotted to non-slotted nails design, the introduction of nail 'dynamization' and the use of titanium alloys as a new nail material. Current biomechanical improvement efforts aim to enhance the boneintramedullary nail system stability. We suggested that benefit would be attained from a better understanding of the ideal mechano-biological environment at the fracture site, and future improvements will emerge from combining mechanics and biological tools.

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Interlocking

Cited by 2 publications

References 88 publications

Predictors of nonunion for transverse femoral shaft fractures treated with intramedullary nailing: a SIGN database study

Predictors of nonunion for transverse femoral shaft fractures treated with intramedullary nailing: a SIGN database study

Intramedullary nailing biomechanics: Evolution and challenges

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