Biomechanical Comparison of Intramedullary Versus Extramedullary Implants for Fixation of Simple Pertrochanteric Fractures : Journal of Orthopaedic Trauma

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Original Article

Biomechanical Comparison of Intramedullary Versus Extramedullary Implants for Fixation of Simple Pertrochanteric Fractures

Schader, Jana F. MDa,b; Zderic, Ivan PhDa; Dauwe, Jan MD, PhDa,c; Sommer, Christoph MDb; Gueorguiev, Boyko PhDa; Stoffel, Karl MD, PhDd,e

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Journal of Orthopaedic Trauma 37(5):p 243-248, May 2023. | DOI: 10.1097/BOT.0000000000002552

Abstract

Objectives: 

To evaluate the biomechanical performance of the intramedullary TFN-ADVANCED Proximal Femoral Nailing System (TFNA) versus the extramedullary Femoral Neck System (FNS) for fixation of simple pertrochanteric fractures in a human cadaveric model.

Methods: 

Ten human cadaveric femoral pairs were implanted pairwise with either TFNA or FNS. A simple pertrochanteric fracture OTA/AO 31-A1 was created and all specimens were biomechanically tested under progressively increasing cyclic loading until failure. Interfragmentary and bone-implant movements were monitored by motion tracking.

Results: 

Axial stiffness was comparable between TFNA and FNS, P = 0.34. Similarly, varus deformation, femoral head rotation around neck axis and implant migration remained without significant differences between TFNA and FNS after 3000 cycles (800 N peak load), P ≥ 0.10. However, cycles to 15-mm leg shortening were significantly higher for TFNA versus FNS, P < 0.01.

Conclusions: 

From a biomechanical perspective, with its current design, FNS does not seem to be a valid alternative to TFNA for treatment of simple pertrochanteric fractures.

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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