Is humeral segmental defect replacement device a stronger construct than locked im nailing?

Robert Heck, Ruxandra Marinescu, Haden Janda, Seth Cooper, Jason Schroeder

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Intramedullary (IM) nailing is currently the most common method for treating patients with impending pathologic humeral fractures; however, this treatment is associated with known complications primarily owing to violation of the rotator cuff during insertion. A better option is needed. To determine if a humeral segmental replacement prosthesis would provide a stronger construct compared with an IM nail in this setting, we compared the mechanical properties of these two devices in a cadaver model simulating an impending pathologic fracture. In each of nine matched pairs of fresh human humeri one was randomly selected to undergo a 50% lateral middiaphyseal defect simulating an impending pathologic fracture and subsequent fixation with an IM nail and bone cement. The contralateral humerus underwent fixation using a humeral segmental defect prosthesis. We determined T-scores using DEXA. Each specimen subsequently was tested in torsion to failure. Peak torque and peak rotation at failure were greater for the prosthesis specimens whereas torsional stiffness was greater for the IM nail specimens. We found a linear relationship between peak torque and T-score for each device with the slopes of the lines suggesting the construct with the prosthesis can withstand greater forces than the IM nail and the differences between devices were greater in weaker bones.

Original languageEnglish (US)
Pages (from-to)252-258
Number of pages7
JournalClinical Orthopaedics and Related Research
Volume468
Issue number1
DOIs
StatePublished - Jan 1 2010

Fingerprint

Nails
Spontaneous Fractures
Prostheses and Implants
Equipment and Supplies
Humerus
Torque
Humeral Fractures
Intramedullary Fracture Fixation
Bone Cements
Fracture Fixation
Rotator Cuff
Cadaver
Bone and Bones
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Is humeral segmental defect replacement device a stronger construct than locked im nailing? / Heck, Robert; Marinescu, Ruxandra; Janda, Haden; Cooper, Seth; Schroeder, Jason.

In: Clinical Orthopaedics and Related Research, Vol. 468, No. 1, 01.01.2010, p. 252-258.

Research output: Contribution to journalArticle

Heck, Robert ; Marinescu, Ruxandra ; Janda, Haden ; Cooper, Seth ; Schroeder, Jason. / Is humeral segmental defect replacement device a stronger construct than locked im nailing?. In: Clinical Orthopaedics and Related Research. 2010 ; Vol. 468, No. 1. pp. 252-258.
@article{44d3af5259b34aa0a1d37229792edd09,
title = "Is humeral segmental defect replacement device a stronger construct than locked im nailing?",
abstract = "Intramedullary (IM) nailing is currently the most common method for treating patients with impending pathologic humeral fractures; however, this treatment is associated with known complications primarily owing to violation of the rotator cuff during insertion. A better option is needed. To determine if a humeral segmental replacement prosthesis would provide a stronger construct compared with an IM nail in this setting, we compared the mechanical properties of these two devices in a cadaver model simulating an impending pathologic fracture. In each of nine matched pairs of fresh human humeri one was randomly selected to undergo a 50{\%} lateral middiaphyseal defect simulating an impending pathologic fracture and subsequent fixation with an IM nail and bone cement. The contralateral humerus underwent fixation using a humeral segmental defect prosthesis. We determined T-scores using DEXA. Each specimen subsequently was tested in torsion to failure. Peak torque and peak rotation at failure were greater for the prosthesis specimens whereas torsional stiffness was greater for the IM nail specimens. We found a linear relationship between peak torque and T-score for each device with the slopes of the lines suggesting the construct with the prosthesis can withstand greater forces than the IM nail and the differences between devices were greater in weaker bones.",
author = "Robert Heck and Ruxandra Marinescu and Haden Janda and Seth Cooper and Jason Schroeder",
year = "2010",
month = "1",
day = "1",
doi = "10.1007/s11999-009-0947-y",
language = "English (US)",
volume = "468",
pages = "252--258",
journal = "Clinical Orthopaedics and Related Research",
issn = "0009-921X",
publisher = "Springer New York",
number = "1",

}

TY - JOUR

T1 - Is humeral segmental defect replacement device a stronger construct than locked im nailing?

AU - Heck, Robert

AU - Marinescu, Ruxandra

AU - Janda, Haden

AU - Cooper, Seth

AU - Schroeder, Jason

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Intramedullary (IM) nailing is currently the most common method for treating patients with impending pathologic humeral fractures; however, this treatment is associated with known complications primarily owing to violation of the rotator cuff during insertion. A better option is needed. To determine if a humeral segmental replacement prosthesis would provide a stronger construct compared with an IM nail in this setting, we compared the mechanical properties of these two devices in a cadaver model simulating an impending pathologic fracture. In each of nine matched pairs of fresh human humeri one was randomly selected to undergo a 50% lateral middiaphyseal defect simulating an impending pathologic fracture and subsequent fixation with an IM nail and bone cement. The contralateral humerus underwent fixation using a humeral segmental defect prosthesis. We determined T-scores using DEXA. Each specimen subsequently was tested in torsion to failure. Peak torque and peak rotation at failure were greater for the prosthesis specimens whereas torsional stiffness was greater for the IM nail specimens. We found a linear relationship between peak torque and T-score for each device with the slopes of the lines suggesting the construct with the prosthesis can withstand greater forces than the IM nail and the differences between devices were greater in weaker bones.

AB - Intramedullary (IM) nailing is currently the most common method for treating patients with impending pathologic humeral fractures; however, this treatment is associated with known complications primarily owing to violation of the rotator cuff during insertion. A better option is needed. To determine if a humeral segmental replacement prosthesis would provide a stronger construct compared with an IM nail in this setting, we compared the mechanical properties of these two devices in a cadaver model simulating an impending pathologic fracture. In each of nine matched pairs of fresh human humeri one was randomly selected to undergo a 50% lateral middiaphyseal defect simulating an impending pathologic fracture and subsequent fixation with an IM nail and bone cement. The contralateral humerus underwent fixation using a humeral segmental defect prosthesis. We determined T-scores using DEXA. Each specimen subsequently was tested in torsion to failure. Peak torque and peak rotation at failure were greater for the prosthesis specimens whereas torsional stiffness was greater for the IM nail specimens. We found a linear relationship between peak torque and T-score for each device with the slopes of the lines suggesting the construct with the prosthesis can withstand greater forces than the IM nail and the differences between devices were greater in weaker bones.

UR - http://www.scopus.com/inward/record.url?scp=73449095226&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=73449095226&partnerID=8YFLogxK

U2 - 10.1007/s11999-009-0947-y

DO - 10.1007/s11999-009-0947-y

M3 - Article

VL - 468

SP - 252

EP - 258

JO - Clinical Orthopaedics and Related Research

JF - Clinical Orthopaedics and Related Research

SN - 0009-921X

IS - 1

ER -