Krettek C, Mannss J, Könemann B, Miclau T, Schandelmaier P, Tscherne H
Trauma Department, Hannover Medical School, Germany.
J Biomech. 1997 Apr;30(4):391-4. doi: 10.1016/s0021-9290(96)00160-1.
'Radiation-independent' aiming systems for the placement of interlocking screws in intramedullary tibial nails have failed because of insertional related nail deformation. Prior to the development of these distal aiming systems, the variable position of the nails' interlocking holes after insertion must be known. In this study, the amount and direction of implant deformation of solid stainless-steel tibial nails (diameters of 8 and 9 mm, n = 20) were analyzed. Measurement of implant deflection (three translations, three angles) in the center of distal transverse locking hole was performed with a three-dimensional-magnetic motion tracker system after nail insertion in paired human cadaver tibiae. The results showed combined mean lateral translation of the 8 and 9 mm nails (n = 20) of -4.5 +/- 3.5 mm (range: 14.3 mm) and dorsal translation -7.8 +/- 5.8 mm (range: 19.2 mm). The combined mean rotational deformation about the longitudinal axis of the nail was 0.3 +/- 0.7 degree (range: 2.4 degrees). The authors conclude that a simple aiming arm, mounted on the proximal nail end alone, is not sufficient to provide accurate distal aiming.
用于在胫骨髓内钉中置入交锁螺钉的“非放射性”瞄准系统因插入相关的钉变形而失败。在这些远端瞄准系统开发之前，必须了解插入后钉的交锁孔的可变位置。在本研究中，分析了实心不锈钢胫骨髓内钉（直径8和9毫米，n = 20）的植入物变形量和方向。在成对的人体尸体胫骨中插入髓内钉后，使用三维磁运动跟踪系统测量远端横向锁定孔中心的植入物偏斜（三个平移、三个角度）。结果显示，8毫米和9毫米髓内钉（n = 20）的平均侧向平移组合为-4.5 +/- 3.5毫米（范围：14.3毫米），背侧平移为-7.8 +/- 5.8毫米（范围：19.2毫米）。围绕钉纵轴的平均旋转变形组合为0.3 +/- 0.7度（范围：2.4度）。作者得出结论，仅安装在近端钉端的简单瞄准臂不足以提供准确的远端瞄准。
