Biomechanical analysis of the sliding hip screw, cannulated screws and Targon® FN in intracapsular hip fractures in cadaver femora

被引:40
作者
Brandt, Erwin [1 ]
Verdonschot, Nico [2 ,5 ]
van Vugt, Arie [3 ]
van Kampen, Albert [4 ]
机构
[1] Hosp Bernhoven, Dept Orthoped & Trauma Surg, NL-5340 BE Oss, Netherlands
[2] Univ Med Ctr Nijmegen, Orthoped Res Lab, Nijmegen, Netherlands
[3] Med Spectrum Twente, Dept Trauma Surg, Enschede, Netherlands
[4] Univ Med Ctr Nijmegen, Dept Orthoped Surg, Nijmegen, Netherlands
[5] Univ Twente, Lab Biomech Engn, Enschede, Netherlands
来源
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2011年 / 42卷 / 02期
关键词
Hip; Fracture; Biomechanics; Internal fixation; Intracapsular; NECK FRACTURES; INTERNAL-FIXATION; FAILURE; PLATE; PINS;
D O I
10.1016/j.injury.2010.08.021
中图分类号
R4 [临床医学];
学科分类号
100218 [急诊医学];
摘要
Background: Internal fixation is one of the main options for treating displaced intracapsular hip fractures. However, controversy remains over which osteosynthesis is the best choice. Using a simulated displaced intracapsular hip fracture model, we compared the mechanical stability of three types of osteosynthesis: the sliding hip screw (SHS), three cannulated screws and the Targon (R) FN. We also assessed whether bone mineral density (BMD) influenced the stability of the fixation. Methods: Unstable/displaced intracapsular hip fractures were induced in a total of 12 pairs of fresh-frozen cadaver femora. Each fracture was fixed at random on the left or right side with an SHS or three cannulated screws (six bone pairs; study 1), or with an SHS or the Targon (R) FN implant (six bone pairs; study 2). All femoral heads were exposed to cyclic combined axial and torque loads until failure. The failure mechanism, the maximal load-to-failure and the dual-energy X-ray absorptiometry (DEXA) values of the femoral heads were determined and their relationships were analysed. Results: There was no significant difference in the maximal load-to-failure between the SHS and the three cannulated screws. The load-to-failure was significantly higher for the Targon (R) FN than for the SHS. There was a high correlation between the bone mineral densities (BMDs) of the femoral heads and maximal load-to-failure in the Targon (R) FN group only. Interpretation: Basing the implant choice on preimplantation BMD measurements does not ensure the best biomechanical outcome. We found that the combination of a fixed-angle device and multiple sliding neck screws (Targon (R) FN) enhances the mechanical strength of reconstructions in unstable/displaced intracapsular hip fractures. (C) 2010 Elsevier Ltd. All rights reserved.
引用
收藏
页码:183 / 187
页数:5
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