Authors:	Greenfield, Julia Appelmann, Philipp Wunderlich, Felix Mehler, Dorothea Rommens, Pol Maria Kuhn, Sebastian
Title:	Retrograde tibial nailing of far distal tibia fractures : a biomechanical evaluation of double- versus triple-distal interlocking
Online publication date:	26-Oct-2022
Year of first publication:	2022
Language:	english
Abstract:	Objectives Retrograde tibial nailing using the Distal Tibia Nail (DTN) is a novel surgical option in the treatment of distal tibial fracture. Its unique retrograde insertion increases the range of surgical options in far distal fractures of the tibia beyond the use of plating. The aim of this study was to assess the feasibility of the DTN for far distal tibia fractures where only double rather than triple-distal locking is possible due to fracture localisation and morphology. Methods Six Sawbones® were instrumented with a DTN and an AO/OTA 43-A3 fracture simulated. Samples were tested in two configurations: first with distal triple locking, second with double locking by removing one distal screw. Samples were subjected to compressive (350 N, 600 N) and torsional (± 8 Nm) loads. Stiffness construct and interfragmentary movement were quantified and compared between double and triple-locking configurations. Results The removal of one distal screw resulted in a 60–70% preservation of compressive stiffness, and 90% preservation of torsional stiffness for double locking compared to triple locking. Interfragmentary movement remained minimal for both compressive and torsional loading. Conclusions The DTN with a distal double locking can, therefore, be considered for far distal tibia fractures where nailing would be preferred over plating.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-7632
Version:	Published version
Publication type:	Zeitschriftenaufsatz
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	European journal of trauma and emergency surgery 48
Pages or article number:	3693 3700
Publisher:	Springer Medizin
Publisher place:	Heidelberg
Issue date:	2022
ISSN:	1863-9941
Publisher DOI:	10.1007/s00068-021-01843-5
Appears in collections:	JGU-Publikationen