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COMPARATIVE BIOMECHANICAL ANALYSIS OF A LOCKING CONDYLAR PLATE AND A RETROGRADE INTRAMEDULLARY NAIL FOR SUPRACONDYLAR FEMUR FRACTURE FIXATION



Abstract

Four matched pairs of fresh frozen human femora were used to compare the biomechanical properties in axial and torsional loading of a Locking Condylar Plate and a retrograde intramedullary nail. One-centimeter gap osteotomy was created in the supracondylar region to simulate an AO/OTA 33-A3 fracture. The instrumented specimens were then mechanically tested under physiologic conditions in axial and torsional loading to determine the stability of the constructs. This laboratory study enhances the biomechanical advantages of the Locking Condylar Plate when fixation stiffness is essential. Devices with head locking screws provide angular rigidity and maximize fixation stability in osteopenic bone.

To compare the biomechanical properties in axial and torsional loading of a Locking Condylar Plate and a retrograde intramedullary nail. To determine the modes of failure of these two devices under axial loading.

Four matched pairs of fresh frozen human femora were used. Plain film radiographs and Dexa scanning were performed to evaluate bone quality and to screen for pathologic lesions. For each pair, one femur was stabilized with the Locking Condylar Plate and the other with a retrograde nail.

One-centimeter gap osteotomy was created in the supracondylar region to simulate an AO/OTA 33-A3 fracture. Radiographs were obtained to exclude iatro-genic fractures before mechanical testing. The instrumented specimens were then mechanically tested under physiologic conditions in axial and torsional loading to determine the stability of the constructs. Three-dimensional displacement across the fracture site was recorded. Finally, all femurs were loaded to fracture under axial loading. The modes of failure were determined by assessing final radiographs.

The Locking Condylar Plate provided statistically significant greater rigidity both in axial (p = 0.048) and torsional loading (p = 0.031) compared to the retrograde nail. The axial mode of failure occurred proximally for the plate and mainly at the distal fixation for the nail.

This laboratory study enhances the biomechanical advantages of the Locking Condylar Plate when fixation stiffness is essential. Devices with head locking screws provide angular rigidity and maximize fixation stability in osteopenic bone.

Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada