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Abstract
Comminuted fractures of the long bones present problems of mechanical instability.
We therefore used a plate and six screws as the main osteosynthesis combined with
supplementary lag screws or cerclage wire. These two supplementary methods were compared.
As a model, we used 60 plastic tibias with standard midshaft butterfly fractures.
These models, depending on the osteosynthesis applied for the fixation of the butterfly
onto the main fracture, were split into three groups of 20 bones. Group A1 with two
lag screws, group A2 with two lag screws and two double cerclages, and group A3 with
two double cerclages with no lag screws. The models were tested in torque and axial
load. The results were:
- 1.1. In torque, group A1 was the most unstable with significant statistical difference from group A2 (P < 0.01) and from A3 (P < 0.05). There was no significant statistical difference between groups A2 and A3.
- 2.2. In axial load, group A3 was stable with significant statistical difference from A2 (P < 0.05). There was no difference between A1 and A3.
The experiment showed that if the cerclage is used double, anchored at the end of
the screws and tensioned, it acts like a spring and is mechanically more stable than
lag screws in torque. In axial load, no mechanical difference exists between lag screws
and double cerclage.
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References
- The Feyman Lectures on Physics. Vol II. Addison-Wesley Publishing, New York, London1989: 38
- Manual of Internal Fixation. Springer-Verlag, Berlin, Heidelberg, New York1979
- A new device for the treatment of fractures.New Orleans Med. Surg. J. 1913; 21: 451
- Fractures of the shaft of the femur.Acta Orthop. Hellenica. 1973; 24: 142
- Practical Surgery for the General Practitioner. W. B. Saunders, Philadelphia1901: 531
- Intramedullary nailing combined with cerclage wiring in the treatment of fractures of femoral shaft.Clin. Orthop. 1986; 212: 62
Article info
Publication history
Accepted:
October 3,
1990
Identification
Copyright
© 1991 Published by Elsevier Inc.
