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Vet Comp Orthop Traumatol
DOI: 10.1055/s-0044-1788316
Review Article

Biomechanical Principles of Intramedullary Nails in Veterinary and Human Medicine

Morgan R. Sisk
1   Department of Orthopaedic Surgery, University of Alabama in Birmingham Heersink School of Medicine, Birmingham, Alabama, United States
,
Lydia C. Yang
1   Department of Orthopaedic Surgery, University of Alabama in Birmingham Heersink School of Medicine, Birmingham, Alabama, United States
,
Kyle D. Paul
1   Department of Orthopaedic Surgery, University of Alabama in Birmingham Heersink School of Medicine, Birmingham, Alabama, United States
,
Joseph W. Elphingstone
2   Department of Orthopaedic Surgery, University of Alabama in Birmingham, Birmingham, Alabama, United States
,
Eugene W. Brabston
2   Department of Orthopaedic Surgery, University of Alabama in Birmingham, Birmingham, Alabama, United States
,
Brent A. Ponce
3   Hughston Foundation, Hughston Clinic, Columbus, Georgia, United States
,
Elliott C. Martin
4   VCA Liberty Animal Hospital, Birmingham, Alabama, United States
,
Kayla M. Corriveau 
5   Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, United States
› Author Affiliations Funding This research did not receive any direct funding. K.M.C. receives funding support from Morris Animal Foundation, Presidential Awards for Interdisciplinary Research from Auburn University, Veterinary Orthopaedic Implants, and Animal Nutritional Products. B.A.P. receives funding support from Stryker, ODI North America, and Smith & Nephew.
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Abstract

Intramedullary nails are specialized metal rods inserted into the medullary cavity of a fractured bone and secured to reduce load on the fracture site, provide stability, and permit healing. The purpose of this review is to highlight the biomechanics of orthopaedic intramedullary nailing, as well as discuss the biomechanical considerations that have shaped implant design and fixation technique in veterinary and human medicine. Relevant studies were included from the PubMed database and Google Scholar for discussion on the basic science and nail design of intramedullary nails. Implant design and implementation continues to progress, with new innovative designs currently under investigation. A lack of consensus remains on the superior implant material. Recent studies, particularly in human populations, have supported the use of reaming based on reoperation rates, nonunion rates, and dynamization. Design modifications, such as the expandable intramedullary nails and angle-stable interlocking designs, have been investigated as methods of improving cortical contact and resisting torsional stress. Intramedullary nailing is a valuable stabilization technique for long bone fractures across a variety of species. The technology continues to undergo design improvements in both veterinary and human medicine.

Keywords

biomechanics - fracture - fixation techniques - stabilization - orthopedic

Authors' Contribution

All authors made meaningful contributions to this work. M.R.S., L.C.Y., K.D.P., E.W.B., B.A.P., E.C.M., and K.M.C. contributed to the study conception and design. M.R.S., L.C.Y., and K.D.P. contributed to acquisition of data. M.R.S., L.C.Y., and J.W.E. contributed to data interpretation and integration. M.R.S. and L.C.Y. generated the figures and drafted the manuscript. All authors contributed to revision and development of the manuscript.


aAssuming a solid cylinder configuration,


k T = torsional stiffness of shaft (Nm/rad)


k B = bending stiffness of shaft (1/m)


G = shear modulus of elasticity (N/m2)[13]


L = length of rod (m)


D = diameter (m).


bUnder a cantilever beam, uniform load distribution,


E = elastic modulus of elasticity (N/m2)[13]


I = Moment of Inertia, for a solid beam and for a hollow beam (m4)


L = length of rod (m)


Q = load (N/m).




Publication History

Received: 24 July 2023

Accepted: 25 June 2024

Article published online:
09 July 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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