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- Author or Editor: Michael T. Sinnott x
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Abstract
Objective—To describe a novel interlocking nail (ILN) and locking system and compare the torsional properties of constructs implanted with the novel ILN or a standard 8-mm ILN (ILN8) by use of a gap-fracture model.
Sample Population—8 synthetic specimens modeled from canine tibiae.
Procedures—An hourglass-shaped ILN featuring a tapered locking mechanism was designed. A synthetic bone model was custom-made to represent canine tibiae with a 50-mm comminuted diaphyseal fracture. Specimens were repaired by use of a novel ILN or an ILN8 with screws. Specimens were loaded for torsional measurements. Construct compliance and angular deformation were compared.
Results—Compliance of the ILN8 was significantly smaller than that of the novel ILN. Mean ± SD maximum angular deformation of the ILN8 construct (23.12 ± 0.65°) was significantly greater, compared with that of the novel ILN construct (9.45 ± 0.22°). Mean construct slack for the ILN8 group was 15.15 ± 0.63°, whereas no slack was detected for the novel ILN construct. Mean angular deformation for the ILN8 construct once slack was overcome was significantly less, compared with that of the novel ILN construct.
Conclusions and Clinical Relevance—Analysis of results of this study suggests that engineering of the locking mechanism enabled the novel hourglass-shaped ILN system to eliminate torsional instability associated with the use of current ILNs. Considering the potential deleterious effect of torsional deformation on bone healing, the novel ILN may represent a biomechanically more effective fixation method, compared with current ILNs, for the treatment of comminuted diaphyseal fractures.
Abstract
Objective—To compare the bending properties of pantarsal arthrodesis constructs involving either a commercially available medial arthrodesis plate (MAP1) or a specially designed second-generation plate (MAP2) implanted in cadaveric canine limbs and evaluate the effect of calcaneotibial screw (CTS) augmentation on the structural properties of both constructs.
Sample Population—5 pairs of canine hind limbs.
Procedures—Within pairs, specimens were stabilized with an MAP1 or MAP2 and loaded to 80% of body weight, with and without CTS augmentation. Compliance, angular deformation (AD), and plate strains were compared.
Results—Construct compliance and AD did not differ between plates. Maximum plate strain was lower in the MAP2 than in the MAP1 (difference of approx 30%). Augmentation with a CTS reduced compliance, AD, and strains in MAP1 constructs but had no effect on those variables in MAP2 constructs.
Conclusions and Clinical Relevance—Because of lower peak strains, the MAP2 may be less susceptible to failure than the MAP1. Furthermore, CTS augmentation was unnecessary with MAP2s, which could minimize intra- and postoperative morbidity. Compared with what is known for dorsal plates, MAP2 constructs were associated with approximately 35% less AD. As a result of improved local stability, one might anticipate earlier fusion of the talocrural joint with an MAP2. In addition, plate peak strain was approximately 3.5 times lower in MAP2s than in dorsal plate constructs, which should result in greater fatigue resistance. The use of MAP2s may be a better alternative to both MAP1s and dorsal plates and could contribute to lower patient morbidity.
