Osteossíntese da fratura do colo femoral: dois ou três parafusos?

Basile, Ricardo; Pepicelli, Gustavo Roberto; Takata, Edmilson Takehiro

doi:10.1590/s0102-36162012000200004

Cited by 6 publications

(3 citation statements)

References 6 publications

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“…However, some studies have shown that parallelism of the screws is not a foreseeable risk factor for complications, and these also do not mention the ability to stabilize the fracture with this synthesis methodology. 10 - 12…”

Section: Discussionmentioning

confidence: 99%

Analysis of mechanical strength to fixing the femoral neck fracture in synthetic bone type Asnis

Freitas¹,

Lula²,

Oliveira³

et al. 2014

Acta ortop. bras.

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OBJECTIVE: To analyze the results of biomechanical assays of fixation of Pauwels type III femoral neck fracture in synthetic bone, using 7.5mm cannulated screws in inverted triangle formation, in relation to the control group. METHODS: Ten synthetic bones were used, from a domestic brand, divided into two groups: test and control. In the test group, a 70° tilt osteotomy of the femoral neck was fixated using three cannulated screws in inverted triangle formation. The resistance of this fixation and its rotational deviation were analyzed at 5mm displacement (phase 1) and 10mm displacement (phase 2). The control group was tested in its integrity until the fracture of the femoral neck occurred. The Mann-Whitney test was used for group analysis and comparison. RESULTS: The values in the test group in phase 1, in samples 1-5, showed a mean of 579N and SD =77N. Rotational deviations showed a mean of 3.33°, SD = 2.63°. In phase 2, the mean was 696N and SD =106N. The values of the maximum load in the control group had a mean of 1329N and SD=177N. CONCLUSION: The analysis of mechanical strength between the groups determined a statistically significant lower value in the test group. Level of Evidence III, Control Case.

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Section: Discussionmentioning

confidence: 99%

Analysis of mechanical strength to fixing the femoral neck fracture in synthetic bone type Asnis

Freitas¹,

Lula²,

Oliveira³

et al. 2014

Acta ortop. bras.

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show abstract

“…Esse contexto possui grandes chances de mudar quando pacientes acima de 65 anos de idade são inseridos, apontados na Classificação de Garden como III ou IV. Devemos considerar que a classificação I refere-se a uma fratura incompleta; II é uma fratura completa sem desvio; III é fratura completa com desvio parcial; e na IV há um desvio completo da fratura 3 .…”

Section: Revisão Da Literaturaunclassified

“…A utilização de três desses itens na forma de um triângulo invertido se mostrou mais estável, apesar de que o uso de apenas dois parafusos também apresentou ser suficiente para o tratamento proposto. Não fosse o custo elevado, seu uso seria maior 3 .…”

Section: Abordagens E Localização Das Lesõesunclassified

Análise de abordagens cirúrgicas em pacientes submetidos à cirurgia de fêmur

Souza¹,

Lima²,

Oliveira³

et al. 2022

HRJ

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Objetivo: analisar as principais abordagens cirúrgicas em pacientes submetidos à cirurgia do fêmur, descrevendo seu perfil epidemiológico. Método: pesquisa integrativa exploratória descritiva com abordagem quantitativa, realizada em um hospital de médio porte do Distrito Federal, analisando prontuários dos pacientes que realizaram cirurgia de fêmur no ano de 2019. Resultados: os tratamentos para fraturas de fêmur e quadril variam de acordo com o local lesionado e a idade do paciente. A região corporal mais atingida foi a transtrocanteriana do fêmur. O material mais usado foi a placa de DHS. Conclusão: o tratamento está diretamente associado à idade do paciente e região da lesão.

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Risk of bony violation with standard triple screw configurations for fixation of femoral neck fractures: A preliminary computed tomography based analysis

Trikha

Kumar

Mittal

et al. 2020

Journal of Clinical Orthopaedics and Trauma

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The reduction and fixation of femoral neck fractures is mainly an indirect one with intraoperative fluoroscopy being trusted for the safe containment of screws within the bony limits of the femoral neck. Radiologically undetected bony perforations may have an impact on the fracture stability and radiological outcomes that have not been studied previously. The purpose of this computed tomography (CT) based study is to analyze the safety of containment of triple screw configurations using standard 6.5 mm diameter screws for fixation of femoral neck fractures in the Indian population using a software-based analysis. Methods: Data from consecutive CT scans with intact proximal femur performed over a six month period were retrospectively analyzed using iPlan® BrainLab AG, Feldkirchen, Germany. The safe containment of virtual screw trajectories placed in inverted triangular and non-inverted triangular configurations for a 6.5 mm diameter screw was analyzed in intact femoral necks. Results: A total of 72 cases were considered for the final assessment. For 6.5 mm screws, the proportion for safe containment (without bony violation) of triple screw inverted triangular configuration was 75% with additional safety corridor to 1 mm around the screw trajectories and 31.94% for non-inverted triangular configuration. All male cases and 28% of female cases allowed safe placement of three 6.5 mm screw trajectories in an inverted triangular pattern with a safety margin of 1 mm around the screw. Replacement of one of the two superior 6.5 mm diameter screw trajectories with a 4.5 mm diameter trajectory resulted in 100% safe containment in female cases. Conclusion: Inverted triangular configuration is a relatively safer configuration compared to the noninverted triangular configuration. Standard triple 6.5 mm screws for fixation of femoral neck fractures carry a risk of bony violation, especially in females. A preoperative radiographic assessment to screen the cases with narrow vertical and anteroposterior extents of the femoral neck can help in reducing the risk of fluoroscopically undetected violation of the bony margins. Replacement of one of the two superior screws with a 4.5 mm diameter screw can be helpful in such cases.

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Osteossíntese da fratura do colo femoral: dois ou três parafusos?

Cited by 6 publications

References 6 publications

Analysis of mechanical strength to fixing the femoral neck fracture in synthetic bone type Asnis

Analysis of mechanical strength to fixing the femoral neck fracture in synthetic bone type Asnis

Análise de abordagens cirúrgicas em pacientes submetidos à cirurgia de fêmur

Risk of bony violation with standard triple screw configurations for fixation of femoral neck fractures: A preliminary computed tomography based analysis

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