Augmentationstechnik am proximalen Femur

Neuerburg, Carl; Gosch, Markus; Blauth, M.; Böcker, Wolfgang; Kammerlander, Christian

doi:10.1007/s00113-015-0051-6

Cited by 9 publications

(6 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, despite the higher costs and not reaching statistical significance, this might confirm the higher stability of augmented femoral neck blades in patients with severe osteoporosis. In line with the literature [ 12 , 13 , 14 , 15 ], there was no significant difference in the cut-out rate between the groups. Due to the low overall cut-out rate of less than 1%, the study cohort needs to be even larger than the 620 evaluated patients.…”

Section: Discussionsupporting

confidence: 89%

“…One of the most commonly used implants today for treating proximal femoral fractures is the PFNA (“proximal femur nail anti-rotation”; DePuy Synthes). To increase stability in the femoral head, the perforated helical femoral neck blade can be augmented with cement [ 12 ]. Biomechanical experiments have shown higher osteosynthesis stability by cement augmentation of the femoral neck blade.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Blade Augmentation in Nailing Proximal Femur Fractures—An Advantage despite Higher Costs?

Böhringer

Cintean

Eickhoff

et al. 2023

JCM

View full text Add to dashboard Cite

Background: Proximal femoral fractures occur with increasing incidence, especially in the elderly. Commonly used implants for surgical treatment are cephalomedullary nails. To increase stability, a perforated femoral neck blade can be augmented with cement. The study investigated whether this results in a relevant clinical advantage and justifies the higher cost. Materials and methods: This is a single-center retrospective study of 620 patients with proximal femur fractures treated with cephalomedullary nailing. Between January 2016 and December 2020, 207 male and 413 female patients were surgically treated with a proximal femur nail (DePuy Synthes) using a perforated blade and cement augmentation in cases with severe osteoporosis. Primary outcome measures were the rate of cut-out, tip apex distance and the positioning of the blade in the femoral head. Secondary outcome measures were the implant costs and operating times. Results: Of the 620 femoral neck blades, 299 were augmented with cement. A total of six cut-outs were seen in the first 3 months after the operation. There were three in the cement-augmented group (CAB = cement-augmented blade) and three in the conventional group (NCAB = non-cement-augmented blade). There was a significant positive correlation between age and augmentation, with a mean difference of 11 years between the two groups (CAB 85.7 ± 7.9 vs. NCAB 75.3 ± 15.1; p < 0.05). There was no difference in the tip-apex distance (CAB 15.97 vs. 15.69; p = 0.64) or rate of optimal blade positions between the groups (CAB 81.6% vs. NCAB 83.2%; p = 0.341). Operation times were significantly longer in the cemented group (CAB 62.6 21.2 min vs. NCAB 54.1 7.7 min; p < 0.05), and the implant cost nearly doubled due to augmentation. Conclusion: When the principles of anatomic fracture reduction, optimal tip-apex distance and optimal blade position are combined with cement augmentation in cases of severe osteoporosis, a cut-out rate of less than 1% can be achieved. Nevertheless, it should be noted that augmentation remains expensive and prolongs surgery time without definite proof of mechanical superiority.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Blade Augmentation in Nailing Proximal Femur Fractures—An Advantage despite Higher Costs?

Böhringer

Cintean

Eickhoff

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…Hierzu erfolgt nach der Implantation zunächst die Applikation eines Kontrastmittels über die Klinge zum Ausschluss einer intraartikulären Leckage. Anschließend werden 3-6 ml PMMA-Zement appliziert [31]. Biomechanische Studien zeigen eine signifikant höhere Primärstabilität nach Zementaugmentation mit gesteigerter axialer Belastbarkeit bis zum Versagen der Osteosynthese [32,33].…”

Section: Zementaugmentationunclassified

“…To this end, a contrast agent is first applied over the blade after implantation to rule out intra-articular leakage. Subsequently, 3-6 ml PMMA cement is applied [31]. Biomechanical studies have shown significantly higher primary stability following cement augmentation with increased axial load-bearing capacity until osteosynthesis failure [32,33].…”

Section: Cement Augmentationmentioning

confidence: 99%

Osteosynthese bei proximalen Femurfrakturen – Wie entscheidend sind Reposition und die Wahl des Implantats?

et al. 2022

View full text Add to dashboard Cite

ZusammenfassungProximale Femurfrakturen sind häufige und gleichsam komplexe Verletzungen, die einer zeitnahen Versorgung bedürfen. Ziel der operativen Therapie ist stets die rasche Wiederherstellung einer schmerzfreien und belastungsstabilen Extremität. Betroffen sind meist ältere, multimorbide Patienten mit einer hohen postoperativen Komplikations- und Mortalitätsrate. Bei gleichzeitig steigender Inzidenz besteht eine hohe medizinische und volkswirtschaftliche Relevanz der Thematik. In dieser Arbeit soll anhand der aktuellen Literatur die Reposition und Implantatwahl bei der Osteosynthese von proximalen Femurfrakturen in Abhängigkeit von der Frakturmorphologie untersucht werden. Zur Standardversorgung gehören neben der Schraubenosteosynthese (SO) die Versorgung mit einer Dynamischen Hüftschraube (DHS) und die intramedulläre Nagelosteosynthese (IN). Des Weiteren wird der Einfluss der Implantatpositionierung, Frakturreposition und additiver Maßnahmen wie einer Zementaugmentation auf das Ergebnis bewertet und diskutiert. Vorrangig für die Vermeidung von Komplikationen sind eine sorgsame Frakturreposition und die regelhafte Implantatpositionierung.

show abstract

“…As a result, proximal femur fractures are associated with a high one-year mortality rate of up to 30% [2]. The treatment goal of proximal femur fractures must therefore ensure the preservation of function and independence in orthogeriatric patients [3]. Among proximal femur fractures, the per/subtrochanteric fracture is most common, followed by femoral neck fractures [4].…”

Section: Introductionmentioning

confidence: 99%

Micro-Structural and Biomechanical Evaluation of Bioresorbable and Conventional Bone Cements for Augmentation of the Proximal Femoral Nail

Linhart,

Kistler,

Saller

et al. 2023

JCM

View full text Add to dashboard Cite

Osteoporotic proximal femur fractures are on the rise due to demographic change. The most dominant surgical treatment option for per/subtrochanteric fractures is cephalomedullary nailing. As it has been shown to increase primary stability, cement augmentation has become increasingly popular in the treatment of osteoporotic per/subtrochanteric femur fractures. The ultimate goal is to achieve stable osteosynthesis, allowing for rapid full weight-bearing to reduce possible postoperative complications. In recent years, bioresorbable bone cements have been developed and are now mainly used to fill bone voids. The aim of this study was to evaluate the biomechanical stability as well as the micro-structural behaviour of bioresorbable bone cements compared to conventional polymethylmethacrylate (PMMA)-cements in a subtrochanteric femur fracture model. Biomechanical as well as micro-computed tomography morphology analysis revealed no significant differences in both bone cements, as they showed equal mechanical stability and tight interdigitation into the spongious bone of the femoral head. Given the positive risk/benefit ratio for bioresorbable bone cements, their utilisation should be evaluated in future clinical studies, making them a promising alternative to PMMA-bone cements.

show abstract

Augmentationstechnik am proximalen Femur

Cited by 9 publications

References 30 publications

Blade Augmentation in Nailing Proximal Femur Fractures—An Advantage despite Higher Costs?

Blade Augmentation in Nailing Proximal Femur Fractures—An Advantage despite Higher Costs?

Osteosynthese bei proximalen Femurfrakturen – Wie entscheidend sind Reposition und die Wahl des Implantats?

Micro-Structural and Biomechanical Evaluation of Bioresorbable and Conventional Bone Cements for Augmentation of the Proximal Femoral Nail

Contact Info

Product

Resources

About