Different modes of augmentative plating for femoral shaft nonunion after intramedullary nailing: a biomechanical comparison
10.3760/cma.j.cn115530-20200108-00015
- VernacularTitle:不同附加钢板治疗股骨干髓内钉固定术后骨不连的生物力学比较研究
- Author:
Wei ZHANG
1
;
Shaobo NIE
;
Taoguang WU
;
Jiantao LI
;
Peifu TANG
;
Hua CHEN
Author Information
1. 解放军总医院骨科医学部，国家骨科与运动康复临床医学研究中心，北京 100853
- From:
Chinese Journal of Orthopaedic Trauma
2020;22(9):788-792
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the anti-rotation stability between different modes of augmentative plating for femoral shaft nonunion after intramedullary nailing.Methods:Fifteen artificial synthetic femurs were used to create models of femoral shaft nonunion with rotational instability after intramedullary nailing. They were randomly divided into 3 groups ( n=5). Control group 1 was fixated with lateral locking compression plate (LCP), control group 2 with anterior LCP, and the experimental group with anterior multi-dimensional cross locking plate (MDC-LP). After fixation, all the groups were subjected to a torsional loading test, with the torsional loading starting from 0 N·m till 10 N·m and a loading speed of 6°/min. The 3 model groups were compared in terms of torsional angle and stiffness. Results:Under the torsion loading, the torsional angles for control group 1, control group 2 and the experimental group were 9.69°±0.34°, 7.15°±0.20° and 1.59°±0.02°, respectively, showing significant differences ( P=0.002); the torsional angle for the experi mental group was significantly smaller than that for control group 1 ( P<0.05). The torsion stiffness for control group 1, control group 2 and the experimental group was respectively 1.02 N·m/° ±0.04 N·m/°, 1.39 N·m/° ± 0.04 N·m/° and 6.16 N·m/° ± 0.06 N·m/°, showing significant differences ( P=14 886.140, P<0.001); there was a significant difference between any 2 groups ( P< 0.05). Conclusions:In the management of femoral shaft nonunion after intramedullary nailing, anterior augmentative plating can provide better anti-torsional stability than lateral augmentative plating, and MDC-LP can also provide better anti-torsional stability than a conventional LCP because it leads to bicortical fixation of the screws.
