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Intramedullary nailing in opening wedge high tibial osteotomy-in vitro test for validation of a method of fixation.
Burchard, Rene; Katerla, Denise; Hammer, Marina; Pahlkötter, Anke; Soost, Christian; Dietrich, Gerhard; Ohrndorf, Arne; Richter, Wolfgang; Lengsfeld, Markus; Christ, Hans-Jürgen; Graw, Jan Adriaan; Fritzen, Claus-Peter.
Afiliación
  • Burchard R; Department of Trauma and Orthopaedic Surgery, Kreisklinikum Siegen, Weidenauer Str. 76, 57076, Siegen, Germany. rene.burchard@uni-wh.de.
  • Katerla D; Department of Health, University of Witten/Herdecke, Witten, Germany. rene.burchard@uni-wh.de.
  • Hammer M; School of Science and Technology, University of Siegen, Siegen, Germany. rene.burchard@uni-wh.de.
  • Pahlkötter A; Department of Trauma and Orthopaedic Surgery, Kreisklinikum Siegen, Weidenauer Str. 76, 57076, Siegen, Germany.
  • Soost C; Department of Trauma Surgery, Landeskrankenhaus Bregenz, Carl-Pedenz-Strasse 2, 6900, Bregenz, Austria.
  • Dietrich G; Department of Mechanical Engineering, University of Siegen, Paul-Bonatz-Str. 9-11, 57076, Siegen, Germany.
  • Ohrndorf A; Department of Trauma and Orthopaedic Surgery, Kreisklinikum Siegen, Weidenauer Str. 76, 57076, Siegen, Germany.
  • Richter W; Department of Statistics and Econometrics, University of Siegen, Kohlbettstr. 15, 57072, Siegen, Germany.
  • Lengsfeld M; Department of Mechanical Engineering, University of Siegen, Paul-Bonatz-Str. 9-11, 57076, Siegen, Germany.
  • Christ HJ; Department of Mechanical Engineering, University of Siegen, Paul-Bonatz-Str. 9-11, 57076, Siegen, Germany.
  • Graw JA; Department of Mechanical Engineering, University of Siegen, Paul-Bonatz-Str. 9-11, 57076, Siegen, Germany.
  • Fritzen CP; Orthopädie Rhein-Nahe Partnergesellschaft, Eibinger Str. 9, 65385, Rüdesheim, Germany.
Int Orthop ; 42(8): 1835-1843, 2018 08.
Article en En | MEDLINE | ID: mdl-29392383
ABSTRACT

PURPOSE:

Opening wedge high tibial osteotomy (HTO) as a treatment in unicompartimental osteoarthritis of the knee can significantly relieve pain and prevent or at least delay an early joint replacement. The fixation of the osteotomy has undergone development and refinements during the last years. The angle-stable plate fixator is currently one of the most commonly used plates in HTOs. The angular stable fixation between screws and the plate offers a high primary stability to retain the correction with early weight-bearing protocols. This surgical technique is performed as a standard of care and generally well tolerated by the patients. Nevertheless, some studies observed that many patients complained about discomfort related to the implant.

METHODS:

Therefore, the stability of two different intramedullary nails, a short implant used in humeral fractures and a long device used in tibial fractures for stabilization in valgus HTOs, was investigated as an alternative fixation technique. The plate fixator was defined as reference standard. Nine synthetic tibia models were standardly osteotomized and stabilized by one of the fixation devices. Axial compression was realized using a special testing machine and two protocols were performed a multi-step fatigue test and a load-to-failure test.

RESULTS:

Overall motion, medial, and lateral displacements were documented. Fractures always occurred at the lateral cortex. Axial cyclic loading up to 800 N was tolerated by all implants without failure. The tibia nail provided highest fatigue strength under the load-to-failure conditions.

CONCLUSIONS:

The results suggest that intramedullary nailing might be used as an alternative concept in HTO.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Osteotomía / Diseño de Prótesis / Fracturas de la Tibia / Clavos Ortopédicos / Fijación Intramedular de Fracturas Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: Int Orthop Año: 2018 Tipo del documento: Article País de afiliación: Alemania

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Osteotomía / Diseño de Prótesis / Fracturas de la Tibia / Clavos Ortopédicos / Fijación Intramedular de Fracturas Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: Int Orthop Año: 2018 Tipo del documento: Article País de afiliación: Alemania