Biomechanical comparison of 3 possible fixation strategies to resist femoral neck shortening after fracture.
Orthopedics
; 33(4)2010 Apr.
Article
em En
| MEDLINE
| ID: mdl-20415297
ABSTRACT
In light of recent reports that patients with femoral neck shortening following fracture fixation are dissatisfied with their outcomes, the objective of this study was to compare the compressive strength, or resistance to shortening, of 3 possible strategies for stabilization of the femoral neck that should resist shortening. The proximal portion of 21 synthetic composite femurs were prepared to isolate the femoral neck for study. A 4-mm segment of the femoral neck was removed to simulate a transcervical comminuted fracture that would be expected to shorten under standard treatment conditions. These simulated fractures were fixed by 1 of 3 methods:
a 3-screw configuration using parallel partially threaded screws augmented with an injectable hydroxyapatite bone substitute in the fracture site; a 3-screw configuration using parallel fully threaded screws; or a nonparallel 3-screw configuration using partially threaded screws. The specimens were tested in compression along the axis of the femoral neck, and the mean stiffness and load to failure values were calculated.The hydroxyapatite bone substitute-augmented partially threaded screw fixation construct resulted in the highest stiffness (1928+/-135 N/mm) and load to failure (6529+/-674 N), followed by the fully threaded screw construct (1210+/-166 N/mm and 3987+/-419 N, respectively), and finally the nonparallel construct (518+/-176 N/mm and 592+/-295 N, respectively) (P<.001 for all groups). This study supports further evaluation of hydroxyapatite bone substitute augmentation at the fracture site to prevent femoral neck shortening in femoral neck fractures receiving internal fixation.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cimentos Ósseos
/
Alongamento Ósseo
/
Parafusos Ósseos
/
Suporte de Carga
/
Fraturas do Colo Femoral
/
Fixação Interna de Fraturas
Tipo de estudo:
Evaluation_studies
Limite:
Humans
Idioma:
En
Revista:
Orthopedics
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Estados Unidos