The Journal of Bone and Joint Surgery, Vol 58, Issue 2 185-190, Copyright © 1976 by Journal of Bone and Joint Surgery, Inc
Experimental stabilization of segmental defects in the human femur. A torsional study
JS Mensch, KL Markolf, SB Roberts and GM Finerman
One of each of thirty-five pairs of fresh intact femora were tested to
failure in torsion, recording the dynamic torque, the absorbed energy, and
the angle of rotation. These results were compared with the results
obtained with the contralateral femur, reconstituted after removal of a
segment. Intramedullary nails with polymethylmethacrylate cement, strips of
titanium mesh with cement, bone plates with and without cement, and
multiple Steinmann pins with cement were the reconstituting configurations.
Bone plates were the strongest configuration; the failure torques in all
cases were limited by the stress concentration effects of the holes in the
bone used for screw fixation. The use of cement as an adjunct to
single-plate fixation provided some additional strength. The torsional
strength of femora fixed with Kuntscher and Schneider nails was limited by
failure of the cement and bone. The use of titanium mesh with
polymethylmethacrylate was less effective, because this composite has a low
torsional rigidity. The use of multiple Steinmann pins packed with
polymethylmethacrylate in the medullary cavity should be discouraged
because severe twisting and fragmentation of the surrounding acrylic will
occur at low levels of torque.
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