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Article
Title An in vivo evaluation of surface polishing of TAN intermedullary nails for ease of removal 
Author Hayes J S, Vos D I, Hahn J, Pearce S G, Richards R G  
Article Information Abstract
Publication European Cells and Materials  Fractures of the tibia and femoral diaphysis are commonly repaired by
intra-medullary (IM) nailing. Currently IM nails are available in
either electropolished stainless steel (SS) or in
Titanium-Aluminium-Niobium (TAN). After healing, removal of the nails
still is common but removal of TAN IM nails often has complications
whereas SS IM nails of the same design are less often associated with
problems. We believe the differences in removal are due to the ability
of TAN to promote strong bone on-growth. We have previously shown in vivo
that polishing cortical screws reduces removal torque and the percentage
of bone-implant contact. Therefore, we postulate that bony on-growth
onto IM nails can be reduced by means of surface polishing, for ease of
removal. Here we aim to compare the pull-out forces for removal of
standard TAN (TAN-S) compared to experimental paste polished TAN
(TAN-PP) IM nails from a bilateral non-fracture sheep tibia model
after 12 months implantation. Histological analysis was also
performed to assess tissue on-growth to the nails. We show that
polishing significantly reduces (p=0.05) the extraction force
required for TAN IM nail removal. This effect in part is attributable to
the distinct tissue-material reaction produced. For TAN-S nails direct
bone contact was observed while for TAN-PP nails a fibrous tissue
interface was noted. Since TAN is preferred over SS for IM nailing
due to superior biocompatibility and mechanical properties, we believe
these findings could be used to recommend changes to current surface
technologies of intramedullary nails to reduce complications
seen with nail removal especially in rapidly growing bone in children.


Reference BUPP10091 
Year 2009 
Logged 17/02/2010 
Volume 18 
Part  
Pages 15-26 
ISSN 1473-2262 
Keywords  
Comparison Drug  
Language English 

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