Evaluating the design modifications of an intramedullary forearm nail system: a cadaver study

Authors

Keywords:

radius and ulna intramedullary nail, locked forearm nail, forearm fractures

Abstract

Background: Current orthopaedic practice requires a forearm nail that is length and rotationally stable an which can restore functional anatomy. A forearm nailing system was designed based on clinical need. This nailing system features unique designs and locking holes that offer a larger approach and escape angle for ease of interlocking. The aim of the present study was to test the prototype and evaluate the design changes in cadaver bones.

Methods: A cross-sectional cadaveric study, including ten cadavers with normal forearm anatomy (n = 20 forearms) was conducted. Both forearms of the cadavers were used to evaluate the locking times and exposure time during i) insertion; ii) locking; and iii) removal of the nails, resulting in the evaluation of a total of 40 procedures. All nails were assessed for insertions of interlocking screws.

Results: The nail was successfully inserted into 38 bones. Inserted nails were available for locking (n = 38), and all locking attempts at both driving ends (n = 38, 100%), as well as the non-driving ends (n = 76, 100%), were successful. Freehand locking at the non-driving end of the nail (38 cases, 76 locking holes) took a median of 44.5 seconds (interquartile range [IQR] 33.0–59.0), while the number of exposures ranged from 2 to 12 with a median of 5.5 exposures (IQR 4.0–8.0). The freehand locking procedure’s exposure time was 0.09 minutes (IQR 0.07–0.23).

Conclusion: The proposed forearm intramedullary nail design modifications allowed for successful implantation, interlocking and removal of nails in both radius and ulna cadaver bones, with acceptable radiation exposure.

Level of evidence: Level 5

Author Biographies

Henry S Pretorius, Stellenbosch University

Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

Marilise C Burger, Stellenbosch University

Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

Nando Ferreira, Stellenbosch University

Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

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Published

2022-03-16

Issue

Section

Trauma

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