Biomechanical characteristics of interlocking femoral nails in the treatment of complex femoral fractures

Interlocking intramedullary (IM) nails allow more comminuted and proximal or distal femoral fractures to be successfully treated than previously possible with routine IM nailing. Autopsy specimens were prepared to evaluate the effectiveness of different locking mechanisms on fracture site stability. Grosse-Kempf (GK) and Brooker-Wills (BW) IM nails were inserted in anatomic specimen femurs with transverse fractures and 1-, 2-, and 3-cm defects. The femurs were loaded in four-point bending, and bending stiffness was calculated. The femurs were also loaded in torsion, and the amount of slippage between the nail and bone (at 10 Nm of applied torque) was measured. The GK nail, fully interlocked, had the lowest amount of rotational slip, followed by the BW and the GK noninterlocked nail. Bending stiffness was not significantly different for these IM nails.