Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA.
Division of Orthopaedic Surgery, City of Hope National Medical Center, Duarte, CA, USA.
Clin Biomech (Bristol). 2021 Dec;90:105508. doi: 10.1016/j.clinbiomech.2021.105508. Epub 2021 Oct 7.
The purpose of this study is to compare compression generated by a Precice magnetic lengthening intramedullary nail and a 5.0 mm limited contact dynamic compression plate.
Transverse osteotomy sites were created in the femoral shaft of ten Sawbones fourth generation composite femurs. Antegrade 10-degree trochanteric Precice nails and 8-hole, 5.0 mm plates were used for fixation. The plates were compressed by placing a neutral screw and three eccentrically drilled compression screws on alternating sides of the osteotomy. Average compression and distribution of compression were compared, and P-values <0.05 were considered statistically significant.
The Precice nail generated an average of 2.38 megapascal across the osteotomy sites. The plate generated an average of 0.70 megapascal (P < 0.001) with the initial compression screw, 0.93 megapascal (P < 0.001) after the second screw, and 1.04 megapascal (p < 0.001) after the final screw. The distribution of compression was assessed utilizing a polar transformation to compare pressure values. We found that the distribution of compression was more circumferentially uniform in the Precice nail group (P = 0.046).
This study demonstrates that an electromagnetic intramedullary device is capable of generating significantly higher compression, in a more uniform distribution, than a 5.0 mm limited contact dynamic compression plate in a Sawbones model. The results indicate that electromagnetic intramedullary nail systems may be an ideal alternative to compression plating for treatment of at-risk fractures, nonunions, delayed unions, and intercalary allograft reconstruction.
本研究旨在比较 Precice 磁性延长髓内钉和 5.0mm 有限接触动力加压板产生的压缩力。
在十个 Sawbones 第四代复合材料股骨的股骨干上创建横向骨折部位。采用顺行 10 度转子 Precice 钉和 8 孔 5.0mm 钢板进行固定。通过在骨折部位的对侧交替放置中立螺钉和三个偏心钻孔的压缩螺钉来压缩钢板。比较平均压缩力和压缩分布，P 值<0.05 认为具有统计学意义。
Precice 钉在骨折部位产生的平均压缩力为 2.38 兆帕斯卡。钢板初始压缩螺钉产生的平均压缩力为 0.70 兆帕斯卡（P<0.001），第二个螺钉为 0.93 兆帕斯卡（P<0.001），最后一个螺钉为 1.04 兆帕斯卡（p<0.001）。利用极坐标变换评估压缩分布，我们发现 Precice 钉组的压缩分布更具圆周均匀性（P=0.046）。
本研究表明，电磁髓内装置能够在 Sawbones 模型中产生比 5.0mm 有限接触动力加压板更高的压缩力，且分布更均匀。结果表明，电磁髓内钉系统可能是治疗高危骨折、骨不连、延迟愈合和节段性同种异体骨重建的理想选择。
