Journal article
A biomechanical study on proximal plate fixation techniques in periprosthetic femur fractures.
- Lenz M AO Research Institute Davos, Clavadelerstrasse 8, CH-7270 Davos-Platz, Switzerland; Department of Trauma, Hand and Reconstructive Surgery, Friedrich-Schiller-University Jena, Erlanger Allee 101, D-07747 Jena, Germany. Electronic address: mark.lenz@med.uni-jena.de.
- Perren SM AO Research Institute Davos, Clavadelerstrasse 8, CH-7270 Davos-Platz, Switzerland. Electronic address: stephan.perren@aofoundation.org.
- Gueorguiev B AO Research Institute Davos, Clavadelerstrasse 8, CH-7270 Davos-Platz, Switzerland. Electronic address: boyko.gueorguiev@aofoundation.org.
- Richards RG AO Research Institute Davos, Clavadelerstrasse 8, CH-7270 Davos-Platz, Switzerland. Electronic address: geoff.richards@aofoundation.org.
- Hofmann GO Department of Trauma, Hand and Reconstructive Surgery, Friedrich-Schiller-University Jena, Erlanger Allee 101, D-07747 Jena, Germany. Electronic address: gunther.hofmann@med.uni-jena.de.
- Fernandez dell'Oca A Department of Traumatology, British Hospital, Av. Italia 2420, Montevideo, Uruguay. Electronic address: AaFernan@netgate.com.uy.
- Höntzsch D Department of Medical Technology Development, BG Trauma Hospital Tübingen, Schnarrenbergstrasse 95, D-72076 Tübingen, Germany. Electronic address: DHoentzsch@bgu-tuebingen.de.
- Windolf M AO Research Institute Davos, Clavadelerstrasse 8, CH-7270 Davos-Platz, Switzerland. Electronic address: markus.windolf@aofoundation.org.
- 2013-11-21
Published in:
- Injury. - 2014
Cerclage
Hip arthroplasty
Locking attachment plate
Periprosthetic fracture
Biomechanical Phenomena
Bone Plates
Bone Screws
Cadaver
Female
Femoral Fractures
Fracture Fixation, Internal
Humans
Male
Materials Testing
Osteotomy
Periprosthetic Fractures
Weight-Bearing
English
INTRODUCTION
Proximal plate fixation is a crucial factor in osteosynthesis of periprosthetic femur fractures. Stability and strength of different fixation concepts for proximal plate fixation were compared.
MATERIALS AND METHODS
Twelve fresh frozen, bone mineral density matched human femora, instrumented with cemented hip endoprosthesis were osteotomized simulating a Vancouver B1 fracture. Specimens were instrumented with locking compression plates, fixed proximally with either locking attachment plate (LAP), monocortical screws, cerclage plus monocortical screws (1cerclage) or cerclages only (4cerclages). Cyclic testing was performed with monotonically increasing load until failure. Relative movements at the proximal plate-femur interface were registered by motion tracking.
RESULTS
The LAP construct exhibited a significantly longer cumulative survival (failure criterion 1mm separation at the proximal plate fixation) compared to the monocortical (p=0.048) and 4cerclages constructs (p=0.012) but not to 1cerclage constructs.
CONCLUSION
Bicortical screw anchorage improves proximal plate fixation in periprosthetic fractures. The cerclage-screw combination is a valuable alternative especially in osteoporotic bone.
Proximal plate fixation is a crucial factor in osteosynthesis of periprosthetic femur fractures. Stability and strength of different fixation concepts for proximal plate fixation were compared.
MATERIALS AND METHODS
Twelve fresh frozen, bone mineral density matched human femora, instrumented with cemented hip endoprosthesis were osteotomized simulating a Vancouver B1 fracture. Specimens were instrumented with locking compression plates, fixed proximally with either locking attachment plate (LAP), monocortical screws, cerclage plus monocortical screws (1cerclage) or cerclages only (4cerclages). Cyclic testing was performed with monotonically increasing load until failure. Relative movements at the proximal plate-femur interface were registered by motion tracking.
RESULTS
The LAP construct exhibited a significantly longer cumulative survival (failure criterion 1mm separation at the proximal plate fixation) compared to the monocortical (p=0.048) and 4cerclages constructs (p=0.012) but not to 1cerclage constructs.
CONCLUSION
Bicortical screw anchorage improves proximal plate fixation in periprosthetic fractures. The cerclage-screw combination is a valuable alternative especially in osteoporotic bone.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.injury.2013.10.027
- PMID 24252576
- Persistent URL
- https://folia.unifr.ch/global/documents/23025
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