Fatigue Study of Six and Eight mm Diameter Interlocking Nails with Screw Holes of Variable Size and Number

R. T. Dueland; R. Vanderby Jr; R. P. McCabe

doi:10.1055/s-0038-1632595

Veterinary and Comparative Orthopaedics and Traumatology, Inhaltsverzeichnis

Vet Comp Orthop Traumatol 1997; 10(04): 194-199
DOI: 10.1055/s-0038-1632595

Original Research

Schattauer GmbH

Fatigue Study of Six and Eight mm Diameter Interlocking Nails with Screw Holes of Variable Size and Number

R. T. Dueland

¹From the Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.

,

R. Vanderby Jr

¹From the Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.

,

R. P. McCabe

¹From the Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.

› Institutsangaben

Abstract

Summary

Clinical fatigue failure of 6 mm diameter interlocked nails (ILN) with holes accommodating 3.5 mm screws has been reported. This problem was investigated by testing eight different designs of 6 mm and 8 mm diameter ILN with a 2 plus 2 screw hole pattern and a multiple holed pattern. Interlocking nails with holes to accommodate 3.5 and 4.5 mm screws in 8 mm ILN and 2.7 and 3.5 mm screws in 6 mm diameter ILN were used. A rotating beam testing device produced uniform bending moments across a test region of the ILN containing at least two holes. These moments fully reversed with each cycle. Fatigue failure occurred through screw holes. Using statistical modeling, reduction of the 6 mm ILN hole size from accommodating 3.5 screws to 2.7 mm screws increased the estimated fatigue life (EFL) of the latter by 52 times, comparable to the EFL of the 8 mm ILN with 4.5 screw holes. Reducing the 8 mm ILN screw hole size from accommodating 4.5 screws to 3.5 mm screws increased the comparative EFL by eight times. Fatigue testing is a good method to compare fatigue behavior of various implant designs. This gives a surgeon more information when selecting an ILN for fracture fixation.

Occasional breakage of interlocking nails (ILN) in clinical cases prompted fatigue testing of original ILN and new designs of ILN. This study documented base line fatigue resistance information of the various ILN designs. Results indicated smaller screw holes markedly increased the fatigue resistance of both 6 mm and 8 mm diameter ILN. This information will aid the surgeon in planning fracture treatment.

Keywords

Interlocking nail - fatigue failure - fatigue testing - fracture repair

Volltext

Referenzen

REFERENCES
1 Klemm KW, Börner M. Interlocking nailing of complex fractures of the femur and tibia. Clin Orthop Rel Res 1985; 212: 89-100.
2 Winquist RA, Hansen ST, Clawson DK. Closed intramedullary nailing of femoral fractures. A report of five hundred and twenty cases. J Bone Joint Surg 1984; 66 A: 529-39.
3 Wiss DA. (ed). Symposium - Intramedullary fixation of long bone. Clin Orthop Rel Res 1986; 212: 2-218.
4 Whittle AP, Russell TA, Taylor JC. et al. Treatment of open fractures of the tibial shaft with the use of interlocking nailing without reaming. J Bone Joint Surg 1992; 74-A: 1162-71.
5 Dueland RT, Johnson KA. Interlocking nail fixation of diaphyseal fractures in the dog. A multi-center study of 1991-92 cases. J Vet Surg 1993; 22: 377.
6 Muir P, Parker RB, Goldsmid SE. et al. Interlocking intramedullary nail stabilization of a diaphyseal tibial fracture. J Sm Anim Prac 1993; 34: 26-30.
7 Durall I, Diaz MC, Morales I. Interlocking nail stabilization of humeral fractures. Initial experience in seven clinical cases. Vet Comp Orthop Traumatol 1994; 7: 3-8.
8 Durall I, Diaz MC. Early experience with the use of an interlocking nail for repair of canine femoral shaft fractures. Vet Surg 1996; 25: 397-406.
9 Duhautois B. L'enclouage verrouillé, vétérinaire: étude clinique rétrospective sur 45 cas. Prat Med Chir Anim Comp 1995; 5: 613-30.
10 Hay CW, Johnson KA. Interlocking nail fixation of an opening wedge corrective osteotomy for femoral malunion in a dog. Vet Comp Orthop Traumatol 1995; 8: 218-21.
11 Muir P, Parker RB, Goldsmid SE, Johnson KA. Interlocking intramedullary nail stabilization of a diaphyseal tibial fracture. J Sm Anim Pract 1993; 34: 26-30.
12 Dueland RT, Johnson KA, Roe SC. et al. Five year multicenter experience with interlocked nailing of femoral, tibial and humeral fractures in the dog. Proc Vet Orth Soc, Big Sky MT 1997: 45.
13 Muir P, Johnson KA, Markel MD. Area moment of inertia for comparison of implant cross-sectional geometry and bending stiffness. Vet Comp Orthop Traumatol 1995; 8: 146-52.
14 Roe SC. Biomechanics of interlocking nail fixation. Am Coll Vet Surg Sympos. Chicago: IL; 1995: 280-1.
15 Dueland RT, Berglund L, Vanderby Jr R, Chao EYS. Structural properties of interlocking nails, canine femora, and femurinterlocking nail constructs. Vet Surg 1996; 25: 386-96.
16 Bucholz RW, Ross SE, Lawrence KL. Fatigue fracture of the interlocking nail in the treatment of fractures of the distal part of the femoral shaft. J Bone Joint Surg 1987; 69-A: 1391-9.
17 Schneider E, Michel MC, Genge M, Perren SM. Loads acting on an intramedullary femoral nail. In: Implantable Telemetry in Orthopaedics. Bergmann, Craichen, Rohlmann (eds). Forschungsvermittlung der FU; Berlin: 1990: 221-7.
18 Rumph PF, Lander JE, Kincaid SA. et al. Ground reaction force profiles from force platform gait analyses of clinically normal mesomorphic dogs at the trot. Am J Vet Res 1994; 55: 756-61.
19 Budsberg SC, Verstraete MC, Soutas-Little RW. Force plate analysis of the walking gait in healthy dogs. Am J Vet Res 1987; 48: 915-8.
20 Adrian MJ, Roy WE, Karpovich PV. Normal gait of the dog: An electrogoniometric study. Am J Vet Res 1966; 27: 90-5.
21 Hottinger HA, DeCamp CE, Olivier NB. et al. Noninvasive kinematic analysis of the walk in healthy large-breed dogs. Am J Vet Res 1996; 57: 381-8.
22 Cochran GVB. Biomechanics of orthopaedic materials. In: A Primer of Orthopaedic Biomechanics, Churchill Livingstone 1982: 90.
23 Pohler OE, M, Straumann F. Mechanical properties of implants. In: Manual of internal fixation in small animals.. Brinker WO, Hohn RB, Prieur WD. (eds). Springer-Verlag: 1984: 94.
24 Keating JF, O' Brien PJ, Blachut PA. et al. Locking intramedullary nailing with and without reaming for open fractures of the tibial shaft. J Bone Jt Surg 1997; 79 A: 334-41.
25 Yanoff SR, Hulse DA, Hogan HA. et al. Measurements of vertical ground reaction force in jumping dogs. Vet Comp Orthop Traumatol 1992; 5: 44-50.
26 Gardner TN, Evans M, Hardy J, Kenwright J. Dynamic interfragmentary motion in fractures during routine patient activity. CI Orth Rel Res 1997; 336: 216-5.