PMID- 19685060
OWN - NLM
STAT- MEDLINE
DCOM- 20100513
LR  - 20141120
IS  - 1434-3916 (Electronic)
IS  - 0936-8051 (Linking)
VI  - 129
IP  - 12
DP  - 2009 Dec
TI  - Double or triple interlocking when nailing proximal tibial fractures? A 
      biomechanical investigation.
PG  - 1715-9
LID - 10.1007/s00402-009-0954-1 [doi]
AB  - OBJECTIVES: To determine whether there are differences in stability between 
      double and triple interlocked intramedullary nails used for the fixation of 
      extraarticular proximal tibial fractures. DESIGN: Randomized in vitro 
      biomechanical-experimental laboratory investigation. SETTING: Biomechanics 
      laboratory of the Clinic for Trauma Surgery at the Johannes Gutenberg-University 
      Mainz. INTERVENTION: A 10-mm defect osteotomy was performed on six paired human 
      tibiae, and the proximal and distal ends were potted in polymethylmethacrylate 
      cement (PMMA). Each pair of bones was randomly stabilized with an intramedullary 
      nail (IM-nail) with two interlocking options (PTN 2s) in one tibia, and with an 
      IM-nail with three interlocking options (PTN 3s) in the corresponding 
      contralateral bone. A biomechanical test of the bone implant construct was then 
      performed with an axial force of 900 N. Displacement of bone fragments was 
      measured and depicted as a force-displacement diagram. MAIN OUTCOME MEASUREMENTS: 
      Biomechanical construction stiffness. RESULTS: The stiffness values for PTN 3s 
      were significantly higher than for PTN 2s. In the group of PTN 2s, two out of six 
      implants failed biomechanically with breakage of one proximal interlocking screw. 
      CONCLUSIONS: Given the parameters of this investigation, triple proximal 
      interlocking provides more stability in nailed proximal tibia fractures than 
      double proximal interlocking. Larger series with clinical follow-up after triple 
      proximal interlocking in tibial nailing should be undertaken to further clarify 
      these questions.
FAU - Hansen, Matthias
AU  - Hansen M
AD  - Clinic for Trauma Surgery, Klinikum Worms, Gabriel-Von-Seidl-Str. 81, 67550, 
      Worms, Germany. hansen-mainz@gmx.de
FAU - Blum, Jochen
AU  - Blum J
FAU - Mehler, Dorothea
AU  - Mehler D
FAU - Hessmann, Martin Henri
AU  - Hessmann MH
FAU - Rommens, Pol Maria
AU  - Rommens PM
LA  - eng
PT  - Journal Article
DEP - 20090814
PL  - Germany
TA  - Arch Orthop Trauma Surg
JT  - Archives of orthopaedic and trauma surgery
JID - 9011043
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Biomechanical Phenomena
MH  - *Bone Nails
MH  - Female
MH  - *Fracture Fixation, Intramedullary/methods
MH  - Humans
MH  - In Vitro Techniques
MH  - Male
MH  - Materials Testing
MH  - Middle Aged
MH  - Tibial Fractures/physiopathology/*surgery
EDAT- 2009/08/18 09:00
MHDA- 2010/05/14 06:00
CRDT- 2009/08/18 09:00
PHST- 2008/11/17 00:00 [received]
PHST- 2009/08/18 09:00 [entrez]
PHST- 2009/08/18 09:00 [pubmed]
PHST- 2010/05/14 06:00 [medline]
AID - 10.1007/s00402-009-0954-1 [doi]
PST - ppublish
SO  - Arch Orthop Trauma Surg. 2009 Dec;129(12):1715-9. doi: 10.1007/s00402-009-0954-1. 
      Epub 2009 Aug 14.