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Mehling I, Hoehle P, Sternstein W, et al. Nailing versus plating for comminuted fractures of the distal femur: a comparative biomechanical in vitro study of three implants. Eur J Trauma Emerg Surg. 2013;39(2):139-46doi: 10.1007/s00068-012-0247-1.
Mehling, I., Hoehle, P., Sternstein, W., Blum, J., & Rommens, P. M. (2013). Nailing versus plating for comminuted fractures of the distal femur: a comparative biomechanical in vitro study of three implants. European journal of trauma and emergency surgery : official publication of the European Trauma Society, 39(2), 139-46. https://doi.org/10.1007/s00068-012-0247-1
Mehling, I, et al. "Nailing versus plating for comminuted fractures of the distal femur: a comparative biomechanical in vitro study of three implants." European journal of trauma and emergency surgery : official publication of the European Trauma Society vol. 39,2 (2013): 139-46. doi: https://doi.org/10.1007/s00068-012-0247-1
Mehling I, Hoehle P, Sternstein W, Blum J, Rommens PM. Nailing versus plating for comminuted fractures of the distal femur: a comparative biomechanical in vitro study of three implants. Eur J Trauma Emerg Surg. 2013 Apr;39(2):139-46. doi: 10.1007/s00068-012-0247-1. Epub 2013 Jan 10. PMID: 26815070.
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Eur J Trauma Emerg Surg. 2013 Apr;39(2):139-46. doi: 10.1007/s00068-012-0247-1. Epub 2013 Jan 10.

Nailing versus plating for comminuted fractures of the distal femur: a comparative biomechanical in vitro study of three implants.

European journal of trauma and emergency surgery : official publication of the European Trauma Society

I Mehling, P Hoehle, W Sternstein, J Blum, P M Rommens

Affiliations

  1. Center for Muskuloskeletal Surgery, Department of Trauma Surgery, University Medical Center of the Johannes Gutenberg-University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany. [email protected].
  2. Center for Muskuloskeletal Surgery, Department of Trauma Surgery, University Medical Center of the Johannes Gutenberg-University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany. [email protected].
  3. Center for Muskuloskeletal Surgery, Department of Trauma Surgery, University Medical Center of the Johannes Gutenberg-University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany. [email protected].
  4. Trauma Surgery Department, Stadtkrankenhaus, Worms, Germany. [email protected].
  5. Center for Muskuloskeletal Surgery, Department of Trauma Surgery, University Medical Center of the Johannes Gutenberg-University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany. [email protected].

PMID: 26815070 DOI: 10.1007/s00068-012-0247-1

Abstract

PURPOSE: The purpose of our study was to determine the biomechanical properties of three different implants utilized for internal fixation of a supracondylar femur fracture. The retrograde supracondylar nail (SCN), the less invasive stabilization system plate (LISS) and the distal femoral nail (DFN) were tested and their biomechanical properties compared.

METHODS: Twenty pairs of fresh-frozen human femura were used. Each femur was osteotomised to simulate a comminuted supracondylar fracture (AO/OTA 33.A3) and then randomized to fracture fixation with either SCN (n=9) or LISS (n=9). Each contralateral femur was stabilized with DFN as a control (n=18). Two femur pairs were spent on pretesting. All femura were subjected to axial (10-500 N) and torsional (0.1-14 Nm) loading.

RESULTS: Eighteen matched femur pairs were analyzed. The post-loading median residual values were 49.78, 41.25 and 33.51% of the axial stiffness of the intact femur and 59.04, 62.37 and 46.72% of the torsional stiffness of the intact femur in the SCN, LISS and DFN groups. There were no significant differences between the three implants concerning axial and torsional stiffness.

CONCLUSIONS: All implants had sufficient biomechanical stability under physiological torsional and axial loading. All three implants have different mechanisms for distal locking. The SCN nail with the four-screw distal interlocking had the best combined axial and torsional stiffness whereas the LISS plate had the highest torsional stiffness.

Keywords: Angle stable plating; Biomechanics; Cadaver; Distal femur; Fracture fixation; Fractures; Retrograde intramedullary nailing

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