Intramedullary nailing biomechanics: Evolution and challenges

• Type: Article in International Scientific Journal
• Date: 2019

Authors

Natacha Rosa (Author) Other; Miguel Marta (Author) Other; Mário Vaz (Author) FEUP; Sérgio M. O. Tavares (Author) Other; Ricardo Simões (Author) Other; Fernão D. Magalhães (Author) FEUP; António Torres Marques (Author) FEUP

Journal

Title: Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine

Vol. 233 No. 3

Pages: 308-295

ISSN: 0954-4119

Publisher: SAGE

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 7 Citations

INSPEC

Other information

Authenticus ID: P-00Q-CPG

DOI: 10.1177/0954411919827044

Abstract (EN): This article aims to review the biomechanical evolution of intramedullary nailing and describe the breakthrough concepts which allowed for nail improvement and its current success. The understanding of this field establishes an adequate background for forthcoming research and allows to infer on the path for future developments on intramedullary nailing. It was not until the 1940s, with the revolutionary Kuntscher intramedullary nailing design, that this method was recognized as a widespread medical procedure. Such achievement was established based on the foundations created from intuition-based experiments and the first biomechanical ideologies. The nail evolved from allowing alignment and stability through press-fit fixation with nail-cortical wall friction to the nowadays nail stability achieved through interlocking screws mechanical linkage between nail and bone. Important landmarks during nail evolution comprise the introduction of flexible reaming, the progress from slotted to non-slotted nails design, the introduction of nail 'dynamization' and the use of titanium alloys as a new nail material. Current biomechanical improvement efforts aim to enhance the bone-intramedullary nail system stability. We suggested that benefit would be attained from a better understanding of the ideal mechano-biological environment at the fracture site, and future improvements will emerge from combining mechanics and biological tools.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 14