Biomechanics of femoral interlocking nails

Injury. 2000 Jul;31(6):437-43. doi: 10.1016/s0020-1383(00)00019-x.

Abstract

Today there is a variety of different interlocking intramedullary nail designs available for the femur. We compared different nail types in the bone implant complex (BIC) of four unreamed solid nails and a slotted reamed nail with simulated comminuted mid shaft fractures to see if there are major differences in stiffness for axial load, bending and torsion. The fractures were simulated by a 2 cm defect osteotomy in paired human cadaver femora. Each bone was tested intact in a universal testing machine, osteotomy and osteosynthesis were performed, and the BIC was tested. Relative stiffness was calculated. In torque testing the unslotted solid nail showed significantly more stiffness (0.6-1.8 Nm/degrees) compared to the slotted nail (0.2 Nm/degrees). Compared to intact bone (6.9 Nm/degrees), both groups of nails were significantly less stiff (relative stiffness 2-20%). In axial load and bending testing the large diameter unreamed nail showed significantly higher stiffness (32-68%). This study shows that stiffness of bone implant complex in interlocking femoral nails is more dependent on nail profile than on the pressfit of nails in the medullary canal.

MeSH terms

  • Adult
  • Biomechanical Phenomena
  • Bone Nails*
  • Cadaver
  • Diaphyses
  • Femoral Fractures / physiopathology*
  • Fracture Fixation, Intramedullary / instrumentation*
  • Humans
  • Middle Aged