Prevention of fracture at the distal locking site of the gamma nail. A biomechanical study
To investigate the origin of fractures at the distal locking site of the Gamma nail, we loaded ten paired human cadaver femora fixed with a Gamma nail in torsion until they fractured. When an awl was hammered in to start the hole for distal locking a fissure appeared in the lateral cortex of all the femora, and the mean torsional load to create a fracture was reduced by 57.8% compared with that in a control group in which the distal locking hole had been started with a centre drill. When an additional drill hole was made, the mean failure load in torsion decreased by 35.7%. We strongly recommend that an awl should not be used at the distal locking site of the Gamma nail; we recommend the use of a centre drill. Additional drill holes should be avoided because they act as stress raisers.
|Keywords||Femoral Fractures/etiology/*prevention & control, Fracture Fixation, Intramedullary/*adverse effects/methods, Hip Fractures/*surgery, Humans, Stress, Mechanical, Surgical Instruments|
Lacroix, H., Arwert, H., Snijders, C.J., & Fontijne, W.P.. (1995). Prevention of fracture at the distal locking site of the gamma nail. A biomechanical study. Journal of Bone and Joint Surgery: British Volume. Retrieved from http://hdl.handle.net/1765/8552