1. Intramedullary nailing vs. palmar locked plating for unstable dorsally comminuted distal radius fractures: a biomechanical study.
- Author
-
Burkhart KJ, Nowak TE, Gradl G, Klitscher D, Mehling I, Mehler D, Mueller LP, and Rommens PM
- Subjects
- Biomechanical Phenomena, Fractures, Comminuted physiopathology, Humans, In Vitro Techniques, Radius Fractures physiopathology, Bone Plates, Fracture Fixation, Internal, Fracture Fixation, Intramedullary, Fractures, Comminuted surgery, Radius Fractures surgery
- Abstract
Background: The purpose of this study was to compare the stability of a 2.4mm palmar locking compression plate and a new intramedullary nail-plate-hybrid Targon DR for dorsally comminuted distal radius fractures., Methods: An extraarticular 10mm dorsally open wedge osteotomy was created in 8 pairs of fresh frozen human radii to simulate an AO-A3-fracture. The fractures were stabilized using one of the fixation methods. The specimens were loaded axially with 200 N and dorsal-excentrically with 80 N. 2000cycles of dynamic loading and axial loading-to-failure were performed., Findings: Axial loading revealed that intramedullary osteosynthesis (Targon DR: 369 N/mm) was significantly (p=0.017) stiffer than plate osteosynthesis (Locking compression plate: 131 N/mm). With 214 N/mm the intramedullary nail also showed higher stability during dorsal excentric loading than the Locking compression plate with 51 N/mm (p=0.012). After 2000 cycles of axial loading with 80 N the Targon DR-group was significantly stiffer than the Locking compression plate-group under both loading patterns. Neither group showed significant changes in stiffness after 2000 cycles. Under dorsal excentric loading the Targon DR-group was still significantly stiffer with 212 N/mm than the Locking compression plate-group with 45 N/mm (p=0.012). The load to failure tests demonstrated higher stability of intramedullary nailing (625 N) when compared to plate osteosynthesis (403 N) (p<0.025)., Interpretation: The study shows that intramedullary fixation of a distal AO-A3 radial fracture is biomechanically more stable than volar fixed-angle plating under axial and dorsal-excentric loading in an experimental setup., (2010 Elsevier Ltd. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF