Increased torsional stability by a novel femoral neck locking plate. The role of plate design and pin configuration in a synthetic bone block model

Brattgjerd, Jan Egil; Loferer, Martin; Niratisairak, Sanyalak; Steen, Harald; Strømsøe, Knut

doi:10.1016/j.clinbiomech.2018.03.024

Cited by 11 publications

(22 citation statements)

References 73 publications

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“…Stability testing of the same plate with three Hansson pins called the Hansson Pinloc ® system compared with two or three pins alone in a proximal femur fracture model has been performed to calculate torsional stiffness, torque at failure and failure energy. The new implant significantly improved all parameters [3]. Comparable results have been obtained with similar testing of the Dynaloc ® implant.…”

Section: Introductionsupporting

confidence: 62%

“…Thus, despite the biomechanical advantage in the laboratory of Hansson pins or cannulated screws locked in a plate over pins and screws alone [3] the clinical outcomes were not so advantageous.…”

Section: Discussionmentioning

confidence: 99%

“…The rationale behind the concept is that when the pins or screws are locked in a plate the risk of individual screw backout is overcome because the construct acts like one unit, which should reduce the risk of fracture collapse because it could better withstand rotational forces [3].…”

Section: Discussionmentioning

confidence: 99%

“…Sample size calculation was based on a previous long-term follow up study, which reported a 66% rate of objectively measured femoral neck shortening on radiographs following FNF treated with osteosynthesis with cancellous screws [3]. Thus, our sample size was based on pairwise comparisons of Dynaloc ® vs. cancellous screws for the primary outcome (leg shortening).…”

Section: Methodsmentioning

confidence: 99%

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Premature discontinuation of a randomized comparison between a new implant Dynaloc® and cancellous screws for femoral neck fractures: An ethical dilemma

Lc¹,

Thorninger²,

Brink³

2020

J Traumatol Clin Orthop.

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Background and purpose: To evaluate the clinical efficacy of Dynaloc ® , a new implant for fixation of femoral neck fractures, which comprises 3 cancellous screws fixed in a small side plate. Patients and methods: Patients older than 50 years with fresh femoral neck fractures were randomly allocated to osteosynthesis with Dynaloc ® or cancellous screws. The primary endpoint was leg length discrepancy due to femoral neck shortening. The secondary endpoints were WOMAC, EQ-5D, and Harris hip scores after 12 months as well as the fracture healing properties, all reoperations, and adverse events after 24 months. Results: Mean patient age was 71.9 (SD 11.8) years; 60% were women. Fracture types were mainly Garden I and II. No significant differences in the primary or secondary endpoints between the Dynaloc ® and cancellous screw groups were observed. Seventeen patients experienced at least one reoperation: in the Dynaloc group 2 patients had THA and 5 had the implant removed additionally one patient developed infection requiring operation, in the screw group 4 had an arthroplasty (1 HA and 3 THA) and the implants were removed in 5. Avascular necrosis of the femoral head was verified in three patients in the Dynaloc ® group. Conclusion: A firm conclusion cannot be drawn from this study because of small numbers, but we found no differences in terms of limb length and other outcome measures between the groups at one year, which cannot justify the use of Dynaloc ® due to the frequent complications related to the implant.

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Section: Introductionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Premature discontinuation of a randomized comparison between a new implant Dynaloc® and cancellous screws for femoral neck fractures: An ethical dilemma

Lc¹,

Thorninger²,

Brink³

2020

J Traumatol Clin Orthop.

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“…Biomechanical laboratory studies with composite bone block have shown greater stiffness, torque at failure, and absorbed total energy at failure when fixed with Pinloc compared with 2 Hansson pins (Brattgjerd et al. 2018). Torsional stability is thought to be beneficial for healing of femoral neck fractures (Ragnarsson and Kärrholm 1992) and could possibly mean less pain for the patient and thus facilitate rehabilitation.…”

mentioning

confidence: 99%

Similar outcome of femoral neck fractures treated with Pinloc or Hansson Pins: 1-year data from a multicenter randomized clinical study on 439 patients

et al. 2019

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Background and purpose — There are few reports on the efficiency of the Hansson Pinloc System (Pinloc) for fixation of femoral neck fractures. We compare Pinloc with the commonly used Hansson Pin System in a randomized clinical trial. The primary outcome measure is non-union or avascular necrosis within 2 years. We now report fracture failures and reoperations within the first year.Patients and methods — Between May 2014 and February 2017, 439 patients were included in the study. They were above 50 years of age and treated for a femoral neck fracture at 9 orthopedic departments in Sweden. They were randomized to either Pinloc or Hansson pins. The fractures were grouped as (a) non-displaced regardless of age, (b) displaced in patients < 70 years, or (c) ≥ 70 years old, but deemed unfit to undergo arthroplasty. Follow-up with radiographs and outpatient visits were at 3 and 12 months. Failure was defined as early displacement/non-union, symptomatic segmental collapse, or deep infection.Results — 1-year mortality was 11%. Of the 325 undisplaced fractures, 12% (21/169) Pinloc and 13% (20/156) Hansson pin patients had a failure during the first year. The reoperation frequencies were 10% (16/169) and 8% (13/156) respectively. For the 75 patients 50–69 years old with displaced fractures, 11/39 failures occurred in the Pinloc group and 11/36 in the Hansson group, and 8/39 versus 9/36 patients were reoperated. Among those 39 patients ≥ 70 years old, 7/21 failures occurred in the Pinloc group and 4/18 in the Hansson group. Reoperation frequencies were 4/21 for Pinloc and 3/18 for the Hansson pin patients. No statistically significant differences were found in any of the outcomes between the Pinloc and Hansson groups.Interpretation — We found no advantages with Pinloc regarding failure or reoperation frequencies in this 1-year follow-up.

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Increased stability by a novel femoral neck interlocking plate compared to conventional fixation methods. A biomechanical study in synthetic bone

Brattgjerd

Steen

Strømsøe

2020

Clinical Biomechanics

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Increased torsional stability by a novel femoral neck locking plate. The role of plate design and pin configuration in a synthetic bone block model

Abstract: The novel plate design with its pin configuration enhanced torsional stability. To reveal clinical relevance a clinical study is planned.

Cited by 11 publications

References 73 publications

Premature discontinuation of a randomized comparison between a new implant Dynaloc® and cancellous screws for femoral neck fractures: An ethical dilemma

Premature discontinuation of a randomized comparison between a new implant Dynaloc® and cancellous screws for femoral neck fractures: An ethical dilemma

Similar outcome of femoral neck fractures treated with Pinloc or Hansson Pins: 1-year data from a multicenter randomized clinical study on 439 patients

Increased stability by a novel femoral neck interlocking plate compared to conventional fixation methods. A biomechanical study in synthetic bone

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