000064410 001__ 64410
000064410 005__ 20190709135624.0
000064410 0247_ $$2doi$$a10.1016/S0020-1383(17)30794-5
000064410 0248_ $$2sideral$$a103583
000064410 037__ $$aART-2017-103583
000064410 041__ $$aeng
000064410 100__ $$0(orcid)0000-0002-2934-1525$$aGabarre, S.
000064410 245__ $$aInfluence of screw combination and nail materials in the stability of anterograde reamed intramedullary nail in distal femoral fractures
000064410 260__ $$c2017
000064410 5060_ $$aAccess copy available to the general public$$fUnrestricted
000064410 5203_ $$aIntramedullary nailing (IM) is a technique universally accepted to treat femoral diaphyseal fractures. The treatment of fractures located in the distal third remains a controversial issue though. A finite element model of the femur has been developed, analyzing distal fractures with several gap sizes combined with different interlocking combinations of distal screws with one oblique screw proximally to stabilize the intramedullary nail. The mechanical strength of the nail against bending and compression efforts was also studied. Beside the FE simulations, a clinical follow-up of 15 patients, 6 males and 9 females, with mean age of 53.2 years was carried out. Localizations of fractures were 10 in the right femur and 5 in the left femur, respectively. A fairly good correspondence agreement between clinical results and the simulated fractures in terms of gap size was found. Non-comminuted fractures had a mean consolidation time of 20.5 weeks (4.8 months), a tendency corresponding well to the mobility obtained in the FE simulations; Comminuted fractures on the other hand exhibited a higher mean consolidation period of 22.2 weeks (5.2 months) secondary to the excessive mobility at fracture site obtained by means of FE simulations. The best stability at fracture site was found for the system with three distal screws and the system with two distal screws placed medial lateral. The highest leverage of distal screws was obtained maximizing the distance between them and choosing the coronal plane for their orientation. The results obtained with both nail materials (stainless steel and titanium alloy) show a higher mobility when using titanium nails. Steel nails provide stiffer osteosyntheses than the titanium nails. In conclusion, the best screw combination in terms of stability to produce fracture healing and the least difficulties during treatment is the one which had one oblique proximal screw with two distal lateral screw implanted in the coronal plane.
000064410 536__ $$9info:eu-repo/grantAgreement/ES/MINECO/DPI2016-77745-R
000064410 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000064410 590__ $$a2.199$$b2017
000064410 591__ $$aEMERGENCY MEDICINE$$b8 / 26 = 0.308$$c2017$$dQ2$$eT1
000064410 591__ $$aORTHOPEDICS$$b31 / 77 = 0.403$$c2017$$dQ2$$eT2
000064410 591__ $$aSURGERY$$b76 / 200 = 0.38$$c2017$$dQ2$$eT2
000064410 591__ $$aCRITICAL CARE MEDICINE$$b21 / 33 = 0.636$$c2017$$dQ3$$eT2
000064410 592__ $$a0.99$$b2017
000064410 593__ $$aEmergency Medicine$$c2017$$dQ1
000064410 593__ $$aSurgery$$c2017$$dQ1
000064410 593__ $$aOrthopedics and Sports Medicine$$c2017$$dQ1
000064410 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000064410 700__ $$0(orcid)0000-0003-4489-3130$$aAlbareda, J.$$uUniversidad de Zaragoza
000064410 700__ $$0(orcid)0000-0001-7944-9625$$aGracia, L.$$uUniversidad de Zaragoza
000064410 700__ $$0(orcid)0000-0002-3613-4209$$aPuértolas, S.$$uUniversidad de Zaragoza
000064410 700__ $$0(orcid)0000-0003-0785-4132$$aIbarz, E.$$uUniversidad de Zaragoza
000064410 700__ $$0(orcid)0000-0002-8643-7558$$aHerrera, A.$$uUniversidad de Zaragoza
000064410 7102_ $$11004$$2830$$aUniversidad de Zaragoza$$bDpto. Cirugía,Ginecol.Obstetr.$$cÁrea Traumatología y Ortopedia
000064410 7102_ $$15004$$2605$$aUniversidad de Zaragoza$$bDpto. Ingeniería Mecánica$$cÁrea Mec.Med.Cont. y Teor.Est.
000064410 773__ $$g48, Suppl. 6 (2017), S47-S53$$pInjury$$tINJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED$$x0020-1383
000064410 8564_ $$s389485$$uhttps://zaguan.unizar.es/record/64410/files/texto_completo.pdf$$yPostprint
000064410 8564_ $$s40493$$uhttps://zaguan.unizar.es/record/64410/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000064410 909CO $$ooai:zaguan.unizar.es:64410$$particulos$$pdriver
000064410 951__ $$a2019-07-09-12:29:57
000064410 980__ $$aARTICLE