Intertrochanteric femoral fractures. Mechanical failure after internal fixation

Davis, T. R. C.; Sher, J. L.; Horsman, A.; Simpson, Margaret; Porter, Bonita; Checketts, R. G.

doi:10.1302/0301-620x.72b1.2298790

Cited by 429 publications

(263 citation statements)

References 10 publications

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“…Shortening due to collapse and varisation of the femoral neck is a well-recognised complication of both internal and external fixation in unstable fractures or in the presence of severe osteoporosis [7,12]. In our study,12 of 50 patients had an average shortening of 14 mm (range, 5-20) and varus angulation of 5°(range, 4°-8°) in ten patients.…”

Section: Discussionmentioning

confidence: 58%

Management of trochanteric fractures of the femur with external fixation in high-risk patients

Karn

Singh

Kumar

et al. 2008

International Orthopaedics (SICOT)

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Section: Discussionmentioning

confidence: 58%

Management of trochanteric fractures of the femur with external fixation in high-risk patients

Karn

Singh

Kumar

et al. 2008

International Orthopaedics (SICOT)

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“…Davis et al demonstraram que nas fraturas trocanté-ricas instáveis, tipos 31A2 e 31A3, o sistema de fixação interna e seu perfeito posicionamento na extremidade proximal do fêmur influem diretamente no resultado final, pois a falta de estabilização dos fragmentos fraturários, invariavelmente, acarreta falha do implante e/ou falha da consolidação óssea (14) .…”

Section: Discussionunclassified

Avaliação do emprego da haste femoral curta na fratura trocantérica instável do fêmur

Guimarães¹,

Guimarães²,

Franco³

2008

Rev. bras. ortop.

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“…[1][2][3][4][5][6][7] The rate of implant cut-out was significantly reduced in the past by changing from mostly rigid fixation principles to dynamically acting devices such as the dynamic hip screw. The failure rates remain high, however, for comminuted fractures in osteoporotic proximal femurs.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical evaluation of a new augmentation method for enhanced screw fixation in osteoporotic proximal femoral fractures

et al. 2006

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A biomechanical investigation on eight pairs of human cadaver proximal femurs was performed to evaluate the impact of a new augmentation method on the internal fixation of osteoporotic proximal femur fractures. The study focused on enhancing implant purchase to reduce the incidence of implant cut-out in osteoporotic bone. In a left-right comparison, a conventional hip screw fixation (control) was compared to the new cement augmentation method. After bone bed preparation through high pressure irrigation to remove fat, blood, and bone debris, the bones were augmented with low viscosity polymethylmethacrylate (PMMA) cement.Step-wise fatigue testing was performed by cyclically loading the femoral heads in a physiological manner, beginning at 1,500 N and increasing 500 N every 5,000 cycles to 4,000 N, and continuously monitoring head displacement. Failure was defined as >5.0 mm head displacement. The head displacement at 2,000 N was significantly smaller (p ¼ 0.018) for the augmented group as compared to the conventionally treated bones (0.09 AE 0.01 mm vs. 0.90 AE 0.32 mm; mean AE SEM). The displacement rate at the second load step was significantly higher (p ¼ 0.018) for the conventionally treated bones as compared to the augmented ones. All of the nonaugmented specimens failed during testing, where 50% of the augmented specimens did not fail. The promising results of these experiments suggest that this new standardized irrigation/augmentation method enhances the implant anchorage and offers a potential solution to the problem of implant cut-out in osteoporotic metaphyseal bone. ß

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Intertrochanteric femoral fractures. Mechanical failure after internal fixation

Abstract: had no significant influence. We conclude that these fractures should be reduced as accurately as possible and it is imperative that the implant is placed centrally within the femoral head.

Cited by 429 publications

References 10 publications

Management of trochanteric fractures of the femur with external fixation in high-risk patients

Management of trochanteric fractures of the femur with external fixation in high-risk patients

Avaliação do emprego da haste femoral curta na fratura trocantérica instável do fêmur

Biomechanical evaluation of a new augmentation method for enhanced screw fixation in osteoporotic proximal femoral fractures

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