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Related Experiment Videos

Fatigue failure in small diameter tibial nails

A P Whittle1, W Wester, T A Russell

  • 1University of Tennessee-Campbell Clinic, Department of Orthopaedic Surgery, Memphis, USA.

Clinical Orthopaedics and Related Research
|June 1, 1995
PubMed
Summary

Implant failure in small diameter tibial nails is common, especially in unstable fractures. Proper management, including exchange nailing or bone grafting, is crucial for successful fracture union.

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Area of Science:

  • Orthopedic surgery
  • Biomaterials science

Background:

  • Small diameter tibial nails are used for fracture fixation.
  • The failure rate of these implants is not well-documented.

Purpose of the Study:

  • To characterize the prevalence and causes of implant failure in small diameter tibial nails.
  • To identify risk factors associated with implant failure.

Main Methods:

  • Retrospective analysis of 130 tibial fractures treated with 8-mm and 9-mm nails.
  • Evaluation of implant failure modes (nail breakage, screw failure).
  • Correlation of failure with fracture characteristics and treatment methods.

Main Results:

  • Implant failure occurred in 13.8% of cases (4 nail breakages, 16 screw failures).

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  • Nail failures were associated with open, unstable fractures with delayed union, and dynamic locking.
  • Overall fracture union rate was high (98.5%).

    • Conclusions:

    • Delayed union, fracture comminution, metaphyseal location, and dynamic locking of unstable fractures increase hardware failure risk.
    • Dynamization is suitable for delayed union in stable diaphyseal fractures.
    • Exchange nailing for comminuted/metaphyseal fractures and bone grafting for significant bone loss are recommended to prevent hardware failure.