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      Controlled bending of proximal femoral nails used in fractures of bowed femurs: biomechanical study with clinical application

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      https://www.riss.kr/link?id=A108208795

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      다국어 초록 (Multilingual Abstract) kakao i 다국어 번역

      We aim to investigate whether the controlled bending of the commercially available nail could affect the nail’s biomechanical properties. We also report the clinical application using such method. A commercially available titanium proximal femoral nails were used for the current study. Using the custom made bending Jig, the portion distal to the bending point of the original nail was bent to varus curvature so that the alignment of the nail is equivalent to medial bowing of 1,000 mm radius. The biomechanical test was performed using the static four point bending test according to American Society for Testing and Materials (ASTM) standards. The measured biomechanical properties were compared between the original nail and the pre-bended nail.
      There was no significance difference between the original nail and the pre-bended nail in terms of mechanical properties we measured (p<0.05). Only 0.32% difference in bending strength was noticed between the two group which is considered to be negligible. The patient utilizing controlled bending nail showed early bone healing without complication. The result of the current study indicates that the additional bending of the commercially available intramedullary nail has only minimal effect on the biomechanical property of the nail. Therefore, we think controlled bending can be done on a commercially available intramedullary nail and can be used safely in the patient with severe anterolateral bowing.
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      We aim to investigate whether the controlled bending of the commercially available nail could affect the nail’s biomechanical properties. We also report the clinical application using such method. A commercially available titanium proximal femoral n...

      We aim to investigate whether the controlled bending of the commercially available nail could affect the nail’s biomechanical properties. We also report the clinical application using such method. A commercially available titanium proximal femoral nails were used for the current study. Using the custom made bending Jig, the portion distal to the bending point of the original nail was bent to varus curvature so that the alignment of the nail is equivalent to medial bowing of 1,000 mm radius. The biomechanical test was performed using the static four point bending test according to American Society for Testing and Materials (ASTM) standards. The measured biomechanical properties were compared between the original nail and the pre-bended nail.
      There was no significance difference between the original nail and the pre-bended nail in terms of mechanical properties we measured (p<0.05). Only 0.32% difference in bending strength was noticed between the two group which is considered to be negligible. The patient utilizing controlled bending nail showed early bone healing without complication. The result of the current study indicates that the additional bending of the commercially available intramedullary nail has only minimal effect on the biomechanical property of the nail. Therefore, we think controlled bending can be done on a commercially available intramedullary nail and can be used safely in the patient with severe anterolateral bowing.

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      참고문헌 (Reference)

      1 오현철 ; 박성진 ; 윤한국, "전방 및 외측 만곡을 가진 비전형적 대퇴골 골절에서 수술적 치료" 대한정형외과학회 49 (49): 485-489, 2014

      2 하상호 ; 이준영 ; 손홍문 ; 신민규, "원위 경골 간부 골절에서 최소 침습적 경피적 금속판 내고정술을 이용한 치료" 대한정형외과학회 39 (39): 386-390, 2004

      3 손홍문 ; 이광철 ; 임채원, "대전자부 삽입점을 이용한 대퇴 간부 골절의 골수강 내금속정 삽입 시 발생한 의인성 근위 대퇴부 골절" 대한정형외과학회 49 (49): 272-277, 2014

      4 변영수 ; 신동주 ; 박영보 ; 김민극 ; 구태회 ; 한재휘, "나선형 금속판을 이용한 상완골 근위 간부 골절의 치료" 대한정형외과학회 52 (52): 232-239, 2017

      5 Maehara T, "The morphology of the femur in elderly Japanese females:analysis using 3D-CT" 27 : 2309499018816488-, 2019

      6 Prasarn ML, "The effect of entry point on malalignment and iatrogenic fracture with the synthes lateral entry femoral nail" 24 : 224-229, 2010

      7 Park JH, "Surgical tips of intramedullary nailing in severely bowed femurs in atypical femur fractures : simulation with 3D printed model" 47 : 1318-1324, 2016

      8 Kim JW, "Surgical outcomes of intramedullary nailing for diaphyseal atypical femur fractures: is it safe to modify a nail entry in bowed femur?" 137 : 1515-1522, 2017

      9 이경재 ; 민병우, "Surgical Treatment of the Atypical Femoral Fracture: Overcoming Femoral Bowing" 대한고관절학회 30 (30): 202-209, 2018

      10 Egol KA, "Mismatch of current intramedullary nails with the anterior bow of the femur" 18 : 410-415, 2004

      1 오현철 ; 박성진 ; 윤한국, "전방 및 외측 만곡을 가진 비전형적 대퇴골 골절에서 수술적 치료" 대한정형외과학회 49 (49): 485-489, 2014

      2 하상호 ; 이준영 ; 손홍문 ; 신민규, "원위 경골 간부 골절에서 최소 침습적 경피적 금속판 내고정술을 이용한 치료" 대한정형외과학회 39 (39): 386-390, 2004

      3 손홍문 ; 이광철 ; 임채원, "대전자부 삽입점을 이용한 대퇴 간부 골절의 골수강 내금속정 삽입 시 발생한 의인성 근위 대퇴부 골절" 대한정형외과학회 49 (49): 272-277, 2014

      4 변영수 ; 신동주 ; 박영보 ; 김민극 ; 구태회 ; 한재휘, "나선형 금속판을 이용한 상완골 근위 간부 골절의 치료" 대한정형외과학회 52 (52): 232-239, 2017

      5 Maehara T, "The morphology of the femur in elderly Japanese females:analysis using 3D-CT" 27 : 2309499018816488-, 2019

      6 Prasarn ML, "The effect of entry point on malalignment and iatrogenic fracture with the synthes lateral entry femoral nail" 24 : 224-229, 2010

      7 Park JH, "Surgical tips of intramedullary nailing in severely bowed femurs in atypical femur fractures : simulation with 3D printed model" 47 : 1318-1324, 2016

      8 Kim JW, "Surgical outcomes of intramedullary nailing for diaphyseal atypical femur fractures: is it safe to modify a nail entry in bowed femur?" 137 : 1515-1522, 2017

      9 이경재 ; 민병우, "Surgical Treatment of the Atypical Femoral Fracture: Overcoming Femoral Bowing" 대한고관절학회 30 (30): 202-209, 2018

      10 Egol KA, "Mismatch of current intramedullary nails with the anterior bow of the femur" 18 : 410-415, 2004

      11 유현승 ; 조영호 ; 박영보 ; 하성수, "Lateral Femoral Bowing and the Location of Atypical Femoral Fractures" 대한고관절학회 29 (29): 127-132, 2017

      12 Park YC, "Intramedullary nailing for atypical femoral fracture with excessive anterolateral bowing" 99 : 726-735, 2017

      13 Dell RM, "Incidence of atypical nontraumatic diaphyseal fractures of the femur" 27 : 2544-2550, 2012

      14 노영호 ; 강기문 ; 김희중 ; 남광우, "Failure of Intramedullary Nailing for Subtrochanteric Atypical Femoral Fractures Caused by Endosteal Cortical Thickening" 대한골절학회 32 (32): 211-221, 2019

      15 Shon OJ, "Clinical outcomes of using contralateral-side laterally bent intramedullary nails in atypical femur fractures with femoral bowing" 141 : 1291-1296, 2021

      16 C09 Committee, "C33-03: Specification for concrete aggregates"

      17 Prasarn ML, "Bisphosphonate-associated femur fractures have high complication rates with operative fixation" 470 : 2295-2301, 2012

      18 Unnanuntana A, "Atypical femoral fractures : what do we know about them? : AAOS Exhibit Selection" 95 : e81-113, 2013

      19 Jones CB, "Atypical femoral fractures : an orthopaedic surgeon’s perspective" 2 : 91-98, 2013

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