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Review Question - QID 7133

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QID 7133 (Type "7133" in App Search)
A surgeon plans to stabilize a fracture in the distal third of a femur shaft using an intramedullary nail. Two types of nails are available that have identical dimensions (diameter, wall thickness, curvature, etc.), one made of stainless steel and the other of titanium alloy. The elastic modulus of stainless steel is about double that of titanium alloy. Which of the following is a potential advantage of the titanium alloy nail in this situation?

It has a higher fatigue strength.

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It can bend more easily, to accommodate the curvature of the femur.

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During healing, the fracture will experience smaller interfragmentary motion with the titanium nail.

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Titanium alloy is more resistant to fretting wear.

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Corrosion is less likely with the titanium alloy nail.

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Because its elastic modulus is 50% lower, the more flexible titanium alloy nail will require about 50% less bending force to conform to the curvature of the canal. This means that it will require substantially less axial force (hammering) to drive the nail down the canal, reducing the likelihood of iatrogenic comminution. For an equal amount of weight bearing, the lower stiffness of the titanium alloy nail will result in larger interfragmentary motions at the fracture. Stainless steel has a higher fatigue resistance than titanium alloy. As long as the metals are not mixed (for example, stainless steel screws used with a titanium alloy nail), corrosion should not be a problem with either alloy.

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