Reattachment of the greater trochanter using the Dall-Miles cable grip system in revision hip arthroplasty

Koyama, Koichi; Higuchi, Fujio; Kubo, Manabu; Okawa, Takahiro; Inoue, Akio

doi:10.1007/s007760170020

Cited by 36 publications

(23 citation statements)

References 26 publications

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“…Moreover, since the lesser trochanter is an attachment site for the psoas and flexor muscles, and gait disturbances resulted from abnormal hip flexion and dislocation caused by a decrease of soft tissue tension around the hip may occur if the lesser trochanteric fragment is not reduced. Several studies have addressed a variety of surgical techniques and instruments by paying attention to the importance of fixation of the greater and lesser trochanters272829). However, these instruments have led to unsatisfactory outcomes, and a study reported that complication rates were 30% for nonunion and 25.8% for irritation symptoms after using a grip plate28).…”

Section: Discussionmentioning

confidence: 99%

Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note

et al. 2017

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PurposeFemoral intertrochanteric fractures are common in the elderly. Appropriate surgical fixation of trochanteric fracture fragments can restore normal anatomical structure and ambulation, and can aid in the recovery of biomechanical function of the hip. We evaluated clinical outcomes of bipolar hemiarthroplasty using a wiring technique for trochanteric fracture fragment fixation.Materials and MethodsFrom September 2006 to February 2015, a total of 260 cases underwent simultaneous bipolar hemiarthroplasty and wire fixation. A total of 65 patients (69 hips) with an average age of 78 years and more than one year of follow-up was included in the study. Using pre-, postoperative and follow-up radiograms, we evaluated wire fixation failure and also assessed changes in walking ability.ResultsLoosening or osteolysis around the stem was not observed; however, we did observe bone growth around the stem (54 cases), cortical hypertrophy (6 cases), a wide range of sclerotic lines but no stem subsidence (1 case), wire breakage (9 cases), and fracture fragment migration with no significant functional deficiency (2 cases).ConclusionOur study showed that additional wiring for trochanteric fracture fragment fixation following bipolar hemiarthroplasty can help restore normal anatomy. The added stability results in faster rehabilitation, and good clinical and radiographic outcomes. We recommend this procedure in this type of fracture.

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Section: Discussionmentioning

confidence: 99%

Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note

et al. 2017

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“…Fixation of a greater trochanteric fracture can be achieved using a standard wire or cable grip system. In the literature, the rate of nonunion for greater trochanteric fractures was reported to be 37.5% when using a standard wire or cable grip system [4]. The nonunion rate in the study described here was 18.7%.…”

Section: Discussionmentioning

confidence: 66%

“…Impaired function or dysfunction of the abductor lever arm may result in pain, tenderness, an increased risk of hip dislocation, a Trendelenburg gait pattern, and reduced quality of life [4–7]. …”

Section: Introductionmentioning

confidence: 99%

Greater Trochanteric Fixation Using a Cable System for Partial Hip Arthroplasty: A Clinical and Finite Element Analysis

Ozan

Koyuncu

Pekedis

et al. 2014

BioMed Research International

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The aim of the study was to investigate the efficacy of greater trochanteric fixation using a multifilament cable to ensure abductor lever arm continuity in patients with a proximal femoral fracture undergoing partial hip arthroplasty. Mean age of the patients (12 men, 20 women) was 84.12 years. Mean follow-up was 13.06 months. Fixation of the dislocated greater trochanter with or without a cable following load application was assessed by finite element analysis (FEA). Radiological evaluation was based on the distance between the fracture and the union site. Harris hip score was used to evaluate final results: outcomes were excellent in 7 patients (21.8%), good in 17 patients (53.1%), average in 5 patients (15.6%), and poor in 1 patient (9.3%). Mean abduction angle was 20.21°. Union was achieved in 14 patients (43.7%), fibrous union in 12 (37.5%), and no union in 6 (18.7%). FEA showed that the maximum total displacement of the greater trochanter decreased when the fractured bone was fixed with a cable. As the force applied to the cable increased, the displacement of the fractured trochanter decreased. This technique ensures continuity of the abductor lever arm in patients with a proximal femoral fracture who are undergoing partial hip arthroplasty surgery.

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“…[22] 62 revizyon kalça artroplasti vakalarında yapmış olduğu trokanter major osteotomi sonrası kablo fiksasyonun medial kortekse dayandırılan grupta kaynamama oranının, medial kortekse drilleme yapılıp kablo uygulanan gruba göre yüksek olduğunu tespit ettiler. Bu nedenle kablo fiksasyonunda longitudinal mobilite önlemek için kablonun drill deliğinden geçilmesi gerekliliğini vurgulamışlardır.…”

Section: Discussionunclassified

Çok düzlemli kablo fiksasyon sisteminin biyomekanik dayanıklılığının araştırılması

Kılınç¹,

Bulut²,

Tezeren³

et al. 2013

CMJ

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Amaç. Çok düzlemli kablo fiksasyon sisteminin biyomekanik dayanıklılığının araştırılması. Yöntem. Çalışmada 12 adet dana femur kemiğine subtrokanterik oblik osteotomi yapılarak standart kablo fiksasyon sistemi ve çok düzlemli kablo fiksasyon sistemi ile tespit edildikten sonra aksiyel kompresyon testleri uygulandı. Bulgular. Yöntemlere ait kompresyon kuvvet değerlerinin aritmetik ortalaması standart kablo fiksasyon sistemi için 787,33 N, çok düzlemli kablo fiksasyon sistemi için 1631,66 N olarak ölçüldü. Gruplara ait tespit yetersizliği ölçümleri karşılaştırıldığında gruplar arası farklılık anlamlı bulundu (p<0.05). Sonuç. Kırık yada osteotomi hattının çok düzlemli uzanımlarının önceden öngörülememesi, standart kablo fiksasyon sisteminin tek bir düzlemde fiksasyona izin vermesi ve metafizer metafizo-diafizer bölgede gevşemesi nedeni ile çok düzlemli kablo fiksasyon sistemi bu sorunların giderilmesinde mutlak bir üstünlük sağlamaktadır.Anahtar sözcükler: Kablo fiksasyon, periprostetik kırık, tespit yetersizliği, osteotomi fiksasyon Abstract Aim. Research of bio-mechanical stability of multi-plane cable fixation system. Method. In this study, axial compression tests were applied, after 12 calf femur bone was fixed with standard cable fixation system and multi-plane cable fixation system by subtrochanteric osteotomy. Results. Arithmetic mean of compression force values of technics were measured for standard cable fixation system as 787,33 N, for multi-plane cable fixation system as 1631,66 N. When fixation inadequacy measurements was compared, difference of between groups shows correlation. (p<0.05). Conclusion. Due to multi plane elongations of line of fracture or osteotomy can not be foreseen, standard cable fixation system allows fixation on a single plane and relaxed on metaphyseal metaphyso-diaphsial region, Multi-plane cable fixation system provides significant advantage in solving this problem. GirişÇevresel tel tespiti ortopedi ve travmatolojide kırık tespitinde ana veya yardımcı materyal olarak geçmişten beri sıkça kullanılan bir yöntemdir. Ancak geçmişte kullanılan tel sisteminin zayıflığı, daha güçlü fiksasyon cihazı ihtiyacına ve kablo tutucu sistem gelişmesine sebep olmuştur.Kablo fiksasyon sistemi günümüzde uzun kemik metafizer, metafizo-diafizeal uzun oblik yada spiral kırıklarda, osteotomilerde, revizyon protez cerrahisinde, periprostetik kırıklarda ve bir çok alanda kullanılmakla birlikte tespit stabilitesi ve devamlılığı bazı

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Reattachment of the greater trochanter using the Dall-Miles cable grip system in revision hip arthroplasty

Cited by 36 publications

References 26 publications

Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note

Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note

Greater Trochanteric Fixation Using a Cable System for Partial Hip Arthroplasty: A Clinical and Finite Element Analysis

Çok düzlemli kablo fiksasyon sisteminin biyomekanik dayanıklılığının araştırılması

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