Çok düzlemli kablo fiksasyon sisteminin biyomekanik dayanıklılığının araştırılması

Year 2013, Volume: 35 Issue: 4, 555 - 562, 24.05.2013

Seyran Kılınç Okay Bulut Gündüz Tezeren Hayati Öztürk Zekeriya Öztemur

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.

Keywords

Cable fixation, periprosthetic fracture, fixation insufficiency, osteotomy fixation

Çok düzlemli kablo fiksasyon sisteminin biyomekanik dayanıklılığının araştırılması

Abstract

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.

Keywords

Kablo fiksasyon, periprostetik kırık, tespit yetersizliği, osteotomi fiksasyon

References

• Gruen TA, McNeice GM, Amstutz HC. "Modes of failure" of cemented stemtype femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 1979; 141:17-27.
• Parrish TF, Jones JR. Fracture of the femur following prosthetic arthroplasty of the hip. report of nine cases. J Bone Joint Surg Am 1964; 46: 241-8.
• Campbell P, McWilliams TG. Periprosthetic femoral fractures. Current Orthopaedics 2002; 16: 126-32.
• Berry DJ. Epidemiology: hip and knee. Orthop Clin North Am 1999; 30:183-90. Fink B, Fuerst M, Singer J. Periprosthetic fractures of the femur associated with hip arthroplasty. Arch Orthop Trauma Surg 2005; 125: 433-42.
• Brady OH, Garbuz DS, Masri BA, Duncan CP. The treatment of periprosthetic fractures of the femur using cortical onlay allograft struts. Orthop Clin North Am 1999; 30: 249-57.
• Greidanus NV, Mitchell PA, Masri BA, Garbuz DS, Duncan CP. Principles of management and results of treating the fractured femur during and after total hip arthroplasty. Instr Course Lect 2003; 52: 309-22.
• Mallory TH, Kraus TJ, Vaughn BK. Intraoperative femoral fractures associated with cementless total hip arthroplasty. Orthopedics 1989; 12: 231-9.
• Johansson JE, McBroom R, Barrington TW, Hunter GA. Fracture of the ipsilateral femur in patients wih total hip replacement. J Bone Joint Surg Am 1981; 63: 1435-42.
• John J, Callaghan MD, Aaron G, Rosenberg MD, Harry E, Rubash MD. The Adult Hip, Çeviri Editörü: Erişkin Kalça, Mustafa ÖZKAN-Meriç ÜNAL, Doğan Tıp Kitabevi, II. Baskı, II. Cilt, Bölüm 2007; 83: 1252.
• Kaab MJ, Stöckle U, Schütz M, Stefansky J, Perka C, Haas NP.Stabilisation of periprosthetic fractures with angular stable internal fixation: a report of 13 cases. Arch Orthop Trauma Surg 2006; 126: 105-10.
• Haddad FS, Marston RA, Muirhead-Allwood SK. The Dall-Miles cable and plate system for periprosthetic femoral fractures. Injury 1997; 28: 445-7.
• Tsiridis E, Haddad FS, Gie GA. Dall-Miles plates for periprosthetic femoral fractures. A critical review of 16 cases. Injury 2003; 34: 107-10.
• Haddad FS, Duncan CP, Berry DJ, Lewallen DG, Gross AE, Chandler HP. Periprosthetic femoral fractures around well-fixed implants: use of cortical onlay allografts with or without a plate. J Bone Joint Surg Am 2002; 84: 945-50.
• Wang JW, Wang CJ. Periprosthetic fracture of the femur after hip arthroplasty: The clinical outcome using cortical strut allografts. J Orthop Surg (Hong Kong) 2000; 8: 27-31.
• Eckardt A, Aberman HM, Cantwell HD, Heine J. Biological fixation of hydroxyapatite-coated versus grit-blasted titanium hip stems: a canine study. Arch Orthop Trauma Surg 2003; 123: 28-35.
• Ko PS, Lam JJ, Tio MK, Lee OB, Ip FK. Distal fixation with Wagner revision stem in treating Vancouver type B2 periprosthetic femur fractures in geriatric patients. J Arthroplasty 2003; 18: 446-52.
• Berend KR, Lombardi AV Jr, Mallory TH, Chonko DJ, Dodds KL, Adams JB. Cerclage wires or cables for the management of intraoperative fracture associated with a cementless, tapered femoral prosthesis: results at 2 to 16 years. J Arthroplasty 2004; 19: 17-21.
• Tsiridis E, Haddad FS, Gie GA. The management of periprosthetic femoral fractures around hip replacements. Injury 2003; 34: 95-105.
• Fitzgerald RH Jr, Brindley GW, Kavanagh BF. The uncemented total hip arthroplasty. Intraoperative femoral fractures. Clin Orthop Relat Res 1988; 235: 61Shaw JA, Daubert HB. Compression capability of cerclage fixation systems. A biomechanical study. Orthopedics 1988; 11: 1169-74.
• Koyama K, Higuchi F, Kubo M, Okawa T, Inoue A. Reattachment of the greater trochanter using the dall-miles cable grip system in revision hip arthroplasty. J Orthopaedic science 2001; 6: 22-7.
• Sandhu R, Avramidis K, Johnson-Nurse C. Dall-Miles cable and plate fixation system in the treatment of periprosthetic femoral fractures: a review of 20 cases. J orthopaedic Surgery 2005; 13: 259-66.