End caps prevent nail migration in elastic stable intramedullary nailing in paediatric femoral fractures: a biomechanical study using synthetic and cadaveric bones.

Windolf, M; Fischer, M F; Popp, Albrecht; Matthys, R; Schwieger, K; Gueorguiev, B; Hunter, J B; Slongo, Theddy (2015). End caps prevent nail migration in elastic stable intramedullary nailing in paediatric femoral fractures: a biomechanical study using synthetic and cadaveric bones. The Bone & Joint Journal, 97-B(4), pp. 558-563. British Editorial Society of Bone and Joint Surgery 10.1302/0301-620X.97B4.34169

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End caps are intended to prevent nail migration (push-out) in elastic stable intramedullary nailing. The aim of this study was to investigate the force at failure with and without end caps, and whether different insertion angles of nails and end caps would alter that force at failure. Simulated oblique fractures of the diaphysis were created in 15 artificial paediatric femurs. Titanium Elastic Nails with end caps were inserted at angles of 45°, 55° and 65° in five specimens for each angle to create three study groups. Biomechanical testing was performed with axial compression until failure. An identical fracture was created in four small adult cadaveric femurs harvested from two donors (both female, aged 81 and 85 years, height 149 cm and 156 cm, respectively). All femurs were tested without and subsequently with end caps inserted at 45°. In the artificial femurs, maximum force was not significantly different between the three groups (p = 0.613). Push-out force was significantly higher in the cadaveric specimens with the use of end caps by an up to sixfold load increase (830 N, standard deviation (SD) 280 vs 150 N, SD 120, respectively; p = 0.007). These results indicate that the nail and end cap insertion angle can be varied within 20° without altering construct stability and that the risk of elastic stable intramedullary nailing push-out can be effectively reduced by the use of end caps.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Osteoporosis
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Surgery

UniBE Contributor:

Popp, Albrecht and Slongo, Theddy

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2049-4394

Publisher:

British Editorial Society of Bone and Joint Surgery

Language:

English

Submitter:

Christoph Steffen

Date Deposited:

01 Jun 2015 14:06

Last Modified:

05 Jul 2018 14:02

Publisher DOI:

10.1302/0301-620X.97B4.34169

PubMed ID:

25820898

Uncontrolled Keywords:

elastic stable intramedullary nailing (ESIN); end cap; nail migration; paediatric femoral fracture

BORIS DOI:

10.7892/boris.69220

URI:

https://boris.unibe.ch/id/eprint/69220

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