THE USE OF ONE COMPARED WITH 2 DISTAL SCREWS IN THE TREATMENT OF FEMORAL-SHAFT FRACTURES WITH INTERLOCKING INTRAMEDULLARY NAILING - A CLINICAL AND BIOMECHANICAL ANALYSIS
Pd. Hajek et al., THE USE OF ONE COMPARED WITH 2 DISTAL SCREWS IN THE TREATMENT OF FEMORAL-SHAFT FRACTURES WITH INTERLOCKING INTRAMEDULLARY NAILING - A CLINICAL AND BIOMECHANICAL ANALYSIS, Journal of bone and joint surgery. American volume, 75A(4), 1993, pp. 519-525
The torsional and compressive biomechanical characteristics of a syste
m for intramedullary fixation with a slotted locking nail and either o
ne or two distal locking screws were evaluated in sixteen femora obtai
ned from eight cadavera. No significant difference was found in the to
rsional rigidity or axial load to failure when one as opposed to two d
istal screws had been used. We also managed twenty-seven patients who
had a fracture of the femoral shaft with interlocking fixation, using
only a single distal screw for distal fixation. The average duration o
f follow-up was nine months (range, three to twenty-five months). The
average time to radiographic healing was three months (range, two to s
ix and one-half months). There were no non-unions or failures of the i
mplant. Clinically unimportant migration of the distal screw occurred
in rive patients. We concluded that one distal screw provides adequate
distal fixation of fractures of the femoral shaft treated with interl
ocking intramedullary nailing.