Comparison of compressive forces generated by dynamic compression angle-stable interlocking nail versus traditional dynamic compression plate and locking compression plate

Abstract

The aim of this study was to compare the compressive forces generated by Dynamic Compression Angle-Stable Interlocking Nail (DCASIN) with those of traditional Dynamic Compression Plates (DCP) and Locking Compression Plates (LCP) using synthetic diaphyseal bone models (SDBM). Three groups were established based on the fixation method (G-DCASIN, G-DCP, and G-LCP), with implants fixed to SDBM simulating a transverse fracture, comprising 10 repetitions per group. A strain-gauge load cell was positioned in the SDBM gap to measure compressive forces in kilograms, recorded 30 s after the completion of each group-specific compression technique. For G-DCASIN, the proximal SDBM was compressed against the load cell using the external implantation guide and compression device. For G-DCP and G-LCP, the same-side double loading technique was applied to the proximal SDBM. Compressive forces among groups were compared using the Kruskal-Wallis test followed by Dunn's post-hoc analysis. The mean compressive forces recorded for G-DCASIN, G-DCP, and G-LCP were 22.56 ± 5.1 kg, 27.28 ± 1.86 kg, and 11.65 ± 1.69 kg, respectively. Both G-DCASIN and G-DCP exhibited significantly greater compressive forces compared to G-LCP (p = 0.0013 and p < 0.0001, respectively), whereas G-DCASIN and G-DCP did not differ significantly (p = 0.2228). In this mechanical trial, DCASIN demonstrated the ability to generate interfragmentary compression superior to LCP and comparable to DCP. The combination of compressive capability and angle-stable locking suggests that this model may be a viable option for the treatment of transverse fractures of long bones.