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research-article

Comparative evaluation of a positive-locking antirotation mechanism in the design of telescopic nails for patients in the period of growth

[+] Author and Article Information
Jens Lakomy

Muenster University Hospital, Dept. of Orthopedics and Tumor Orthopedics Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
jens.lakomy@t-online.de

Bjoern Vogt

Muenster University Hospital, Dept. of Orthopedics and Tumor Orthopedics Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
bjoern.vogt@ukmuenster.de

Georg Gosheger

Muenster University Hospital, Dept. of Orthopedics and Tumor Orthopedics Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
ortho@ukmuenster.de

Robert Rödl

Muenster University Hospital Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
kinderorthopaedie@uni-muenster.de

Dirk Wähnert

University Hospital Muenster
Dirk.waehnert@ukmuenster.de

Frank Schiedel

Clemenshospital Muenster, Department of Pediatric Orthopedics and Deformity Correction Duesbergweg 124, 48153 Muenster, Germany
frank.schiedel@t-online.de

1Corresponding author.

ASME doi:10.1115/1.4036650 History: Received September 15, 2016; Revised April 07, 2017

Abstract

Aim of this study was to develop an rotationally stable intramedullary telescopic nail that is firmly anchored in the bone proximally and distally, without containing any extraosseous components that may alter the surrounding soft tissue. Three prototypes for a positive-locking adapted telescopic intramedullary nail (PLATIN) were developed. In a series of biomechanical tests, the prototypes were compared with two Fassier-Duval telescopic nails, which represent the clinical standard. Axial pressure, torsion and four-point bending measurements were carried out in a materials testing machine, with the telescopic nails implanted into composite bone. Tests were conducted without failure and up to failure. Specifically, the force required for telescoping, as well as torsional stiffness and bending stiffness, were investigated. Taking into account differences that were inherent to the materials, the prototypes showed similar results in the four-point bending tests. In the pressure tests the prototypes required greater forces than the Fassier-Duval nails. The torsional stiffness was between 0.020 Nm/° and 0.135 Nm/°, depending on the diameter of the nail. Positive-locking effect was achieved by a hexagonal shape of an inner rod part and a hexagonal form-fitting outer tube part. Proximal and distal locking of the telescopic nail in the bone was performed by usage of K-Wires in specific arranged drill holes at the end of both parts. Based on these satisfactory results, clinical application of positive-locking irrotational telescopic nails can be expected, furthermore redesign for existing telescopic nails is recommended.

Copyright (c) 2017 by ASME
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