Biomechanical Performance of Locked Intramedullary Nail Systems in Comminuted Femoral Shaft Fractures

The biomechanical properties of commercially available locked nail systems designed for use in comminuted femoral shaft fractures were compared and evaluated. Ender nails as well as three forms of interlocking nails, Brooker-Wills (B-W), Klenm-Schellman (K-S), and Grosse-Kempf (G-K), were implanted in cadaver femora. The femora were tested in torsion, bending, and axial loading to failure. Two fracture models were tested--a 3 cm subtrochanteric defect and an 8 cm midshaft defect. Results of the testing revealed the three interlocking nails to be comparable to each other and superior to Ender nails in bending and torsion. However, the distally bolted locked nails (K-S, G-K) resisted significantly higher loads than either the distally bladed locked nail (B-W) or Ender nails when tested to failure by axial loading.