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Femur boyun kırıklarında üç kanüle vida ve minimal invazif antirotator kompresyon vidasının biyomekanik karşılaştırması

Yıl 2014, , 196 - 201, 21.04.2014
https://doi.org/10.3944/AOTT.2014.3159

Öz

Amaç: Bu çalışmanın amacı, Pauwels tip 3 femur boyun kırık modelinde, minimal invaziv kayıcı antirotator kompresyonlu kalça vidası (MIS–A–CHS) ile 3 kanüle vidanın (KV) tespit gücünü biyomekanik açıdan karşılaştırmaktı.

Çalışma planı: On iki adet üçüncü nesil proksimal femur kemik modelinde Pauwels tip 3 vertikal femur boyun kırığı oluşturuldu ve modeller iki gruba ayrıldı. Birinci gruba üç paralel KV, ikinci gruba MIS–A–CHS ile tespit uygulandı. İki grubun aksiyel ve torsiyonel yüklenmelere karşı dayanıklılıkları ve maksimal kompresyon güçleri hesaplandı ve birbirleri ile karşılaştırıldı.

Bulgular: MIS–A–CHS grubundaki maksimal aksiyel yüklenme sınırı (912.5 N), maksimal torsiyonel yüklenme sınırı (540 N) ve maksimal kompresyon gücü (10.2 N/m); KV grubundaki değerlerden (sırasıyla 627.5 N; 380 N ve 3.9 N/m) anlamlı olarak yüksek bulundu (p<0.05).

Çıkarımlar: MIS–A–CHS, Pauwels tip 3 femur boyun kırıklarında KV’e göre aksiyel ve torsiyonel kuvvetlere daha dayanıklı olan ve daha fazla kompresyon sağlayan bir tespit yöntemidir.

Kaynakça

  • Chiu FY, Lo WH, Yu CT, Chen TH, Chen CM, Huang CK. Percutaneous pinning in undisplaced subcapital fem- oral neck fractures. Injury 1996;27:53-5. CrossRef
  • Springer ER, Lachiewicz PF, Gilbert JA. Internal fixation of femoral neck fractures. A comparative biomechanical study of Knowles pins and 6.5-mm cancellous screws. Clin Orthop Relat Res 1991;267:85-92.
  • Kannus P, Parkkari J, Sievänen H, Heinonen A, Vuo- ri I, Järvinen M. Epidemiology of hip fractures. Bone 1996;18(1 Suppl):57-63. CrossRef
  • Wallace WA. The increasing incidence of fractures of the proximal femur: an orthopaedic epidemic. Lancet 1983;1:1413-4. CrossRef
  • Liporace F, Gaines R, Collinge C, Haidukewych GJ. Re- sults of internal fixation of Pauwels type-3 vertical femoral neck fractures. J Bone Joint Surg Am 2008;90:1654-9. CrossRef
  • Bartonícek J. Pauwels’ classification of femoral neck frac- tures: correct interpretation of the original. J Orthop Trauma 2001;15:358-60. CrossRef
  • Deneka DA, Simonian PT, Stankewich CJ, Eckert D, Chapman JR, Tencer AF. Biomechanical comparison of internal fixation techniques for the treatment of unstable basicervical femoral neck fractures. J Orthop Trauma 1997;11:337-43. CrossRef
  • Sheng WC, Li JZ, Chen SH, Zhong SZ. A new technique for lag screw placement in the dynamic hip screw fixation of intertrochanteric fractures: decreasing radiation time dramatically. Int Orthop 2009;33:537-42. CrossRef
  • Lee YS, Chen SH, Tsuang YH, Huang HL, Lo TY, Huang CR. Internal fixation of undisplaced femoral neck fractures in the elderly: a retrospective comparison of fixa- tion methods. J Trauma 2008;64:155-62. CrossRef
  • Dujardin FH, Benez C, Polle G, Alain J, Biga N, Thomine JM. Prospective randomized comparison between a dy- namic hip screw and a mini-invasive static nail in fractures of the trochanteric area: preliminary results. J Orthop Trauma 2001;15:401-6. CrossRef
  • Thorngren KG, Hommel A, Norrman PO, Thorngren J, Wingstrand H. Epidemiology of femoral neck fractures. Injury 2002;33 Suppl 3:C1-7. CrossRef
  • McClung MR. The relationship between bone min- eral density and fracture risk. Curr Osteoporos Rep 2005;3:57-63. CrossRef
  • Zhang Y, Tian L, Yan Y, Sang H, Ma Z, Jie Q, et al. Biome- chanical evaluation of the expansive cannulated screw for fixation of femoral neck fractures. Injury 2011;42:1372-6.
  • Zlowodzki M, Jönsson A, Paulke R, Kregor PJ, Bhandari M. Shortening after femoral neck fracture fixation: is there a solution? Clin Orthop Relat Res 2007;461:213-8.
  • Bonnaire FA, Weber AT. Analysis of fracture gap changes, dynamic and static stability of different osteosynthetic procedures in the femoral neck. Injury 2002;33 Suppl 3:C24-32. CrossRef
  • Aminian A, Gao F, Fedoriw WW, Zhang LQ, Kalainov DM, Merk BR. Vertically oriented femoral neck fractures: mechanical analysis of four fixation techniques. J Orthop Trauma 2007;21:544-8. CrossRef
  • Baitner AC, Maurer SG, Hickey DG, Jazrawi LM, Kum- mer FJ, Jamal J, et al. Vertical shear fractures of the femo- ral neck. A biomechanical study. Clin Orthop Relat Res 1999;367:300-5. CrossRef
  • Blair B, Koval KJ, Kummer F, Zuckerman JD. Basicervi- cal fractures of the proximal femur. A biomechanical study of 3 internal fixation techniques. Clin Orthop Relat Res 1994;306:256-63.
  • Walker E, Mukherjee DP, Ogden AL, Sadasivan KK, Albright JA. A biomechanical study of simulated femo- ral neck fracture fixation by cannulated screws: effects of placement angle and number of screws. Am J Orthop (Belle Mead NJ) 2007;36:680-4.
  • Rupprecht M, Grossterlinden L, Ruecker AH, de Oliveira AN, Sellenschloh K, Nüchtern J, et al. A comparative bio- mechanical analysis of fixation devices for unstable femo- ral neck fractures: the Intertan versus cannulated screws or a dynamic hip screw. J Trauma 2011;71:625-34. CrossRef
  • Nowotarski PJ, Ervin B, Weatherby B, Pettit J, Goulet R, Norris B. Biomechanical analysis of a novel femoral neck locking plate for treatment of vertical shear Pauwel’s type C femoral neck fractures. Injury 2012;43:802-6. CrossRef
  • Lagerby M, Asplund S, Ringqvist I. Cannulated screws for fixation of femoral neck fractures. No difference be- tween Uppsala screws and Richards screws in a random- ized prospective study of 268 cases. Acta Orthop Scand 1998;69:387-91. CrossRef
  • Rau FD, Manoli A 2nd, Morawa LG. Treatment of femo- ral neck fractures with the sliding compression screw. Clin Orthop Relat Res 1982;163:137-40.
  • Saka G, Kurtulmuş T, Sağlam N, Yeniocak S, Akpınar F. Early clinical outcomes of a new and different designed detection method: applying minimal invasiveness, allow- ing sliding compression and effective antirotator in adult collum femoris fractures. In: Osteosynthese International 2012 Annula Meeting; 19-22 September 2012 Rostock, Germany.

Biomechanical comparison of antirotator compression hip screw and cannulated screw fixations in the femoral neck fractures

Yıl 2014, , 196 - 201, 21.04.2014
https://doi.org/10.3944/AOTT.2014.3159

Öz

Objective: The aim of this study was to compare the biomechanical properties of minimal invasive sliding antirotator compressive hip screw (MIS–A–CHS), and multiple cannulated screws (CS) on a Pauwels type 3 femoral neck fracture model.

Methods: A Pauwels type 3 vertical femoral neck fractures was created on 12 third-generation proximal femur models which were divided into two equal groups. The fracture was fixed with three CS in the first group, and MIS–A–CHS in the second group. The axial and rotational stiffness and maximum compression effect were compared between the groups.

Results: The axial and rotational stiffness and maximum compression were significantly higher in MIS–A–CHS group (912.5 N, 540 N and 10.2 N/m, respectively) than the CS group (627.5N, 380 N, and 3.9 N/m, respectively).

Conclusion: MIS–A–CHS appears to be a more secure fixation method in Pauwels type 3 femoral neck fractures than the CS.

Kaynakça

  • Chiu FY, Lo WH, Yu CT, Chen TH, Chen CM, Huang CK. Percutaneous pinning in undisplaced subcapital fem- oral neck fractures. Injury 1996;27:53-5. CrossRef
  • Springer ER, Lachiewicz PF, Gilbert JA. Internal fixation of femoral neck fractures. A comparative biomechanical study of Knowles pins and 6.5-mm cancellous screws. Clin Orthop Relat Res 1991;267:85-92.
  • Kannus P, Parkkari J, Sievänen H, Heinonen A, Vuo- ri I, Järvinen M. Epidemiology of hip fractures. Bone 1996;18(1 Suppl):57-63. CrossRef
  • Wallace WA. The increasing incidence of fractures of the proximal femur: an orthopaedic epidemic. Lancet 1983;1:1413-4. CrossRef
  • Liporace F, Gaines R, Collinge C, Haidukewych GJ. Re- sults of internal fixation of Pauwels type-3 vertical femoral neck fractures. J Bone Joint Surg Am 2008;90:1654-9. CrossRef
  • Bartonícek J. Pauwels’ classification of femoral neck frac- tures: correct interpretation of the original. J Orthop Trauma 2001;15:358-60. CrossRef
  • Deneka DA, Simonian PT, Stankewich CJ, Eckert D, Chapman JR, Tencer AF. Biomechanical comparison of internal fixation techniques for the treatment of unstable basicervical femoral neck fractures. J Orthop Trauma 1997;11:337-43. CrossRef
  • Sheng WC, Li JZ, Chen SH, Zhong SZ. A new technique for lag screw placement in the dynamic hip screw fixation of intertrochanteric fractures: decreasing radiation time dramatically. Int Orthop 2009;33:537-42. CrossRef
  • Lee YS, Chen SH, Tsuang YH, Huang HL, Lo TY, Huang CR. Internal fixation of undisplaced femoral neck fractures in the elderly: a retrospective comparison of fixa- tion methods. J Trauma 2008;64:155-62. CrossRef
  • Dujardin FH, Benez C, Polle G, Alain J, Biga N, Thomine JM. Prospective randomized comparison between a dy- namic hip screw and a mini-invasive static nail in fractures of the trochanteric area: preliminary results. J Orthop Trauma 2001;15:401-6. CrossRef
  • Thorngren KG, Hommel A, Norrman PO, Thorngren J, Wingstrand H. Epidemiology of femoral neck fractures. Injury 2002;33 Suppl 3:C1-7. CrossRef
  • McClung MR. The relationship between bone min- eral density and fracture risk. Curr Osteoporos Rep 2005;3:57-63. CrossRef
  • Zhang Y, Tian L, Yan Y, Sang H, Ma Z, Jie Q, et al. Biome- chanical evaluation of the expansive cannulated screw for fixation of femoral neck fractures. Injury 2011;42:1372-6.
  • Zlowodzki M, Jönsson A, Paulke R, Kregor PJ, Bhandari M. Shortening after femoral neck fracture fixation: is there a solution? Clin Orthop Relat Res 2007;461:213-8.
  • Bonnaire FA, Weber AT. Analysis of fracture gap changes, dynamic and static stability of different osteosynthetic procedures in the femoral neck. Injury 2002;33 Suppl 3:C24-32. CrossRef
  • Aminian A, Gao F, Fedoriw WW, Zhang LQ, Kalainov DM, Merk BR. Vertically oriented femoral neck fractures: mechanical analysis of four fixation techniques. J Orthop Trauma 2007;21:544-8. CrossRef
  • Baitner AC, Maurer SG, Hickey DG, Jazrawi LM, Kum- mer FJ, Jamal J, et al. Vertical shear fractures of the femo- ral neck. A biomechanical study. Clin Orthop Relat Res 1999;367:300-5. CrossRef
  • Blair B, Koval KJ, Kummer F, Zuckerman JD. Basicervi- cal fractures of the proximal femur. A biomechanical study of 3 internal fixation techniques. Clin Orthop Relat Res 1994;306:256-63.
  • Walker E, Mukherjee DP, Ogden AL, Sadasivan KK, Albright JA. A biomechanical study of simulated femo- ral neck fracture fixation by cannulated screws: effects of placement angle and number of screws. Am J Orthop (Belle Mead NJ) 2007;36:680-4.
  • Rupprecht M, Grossterlinden L, Ruecker AH, de Oliveira AN, Sellenschloh K, Nüchtern J, et al. A comparative bio- mechanical analysis of fixation devices for unstable femo- ral neck fractures: the Intertan versus cannulated screws or a dynamic hip screw. J Trauma 2011;71:625-34. CrossRef
  • Nowotarski PJ, Ervin B, Weatherby B, Pettit J, Goulet R, Norris B. Biomechanical analysis of a novel femoral neck locking plate for treatment of vertical shear Pauwel’s type C femoral neck fractures. Injury 2012;43:802-6. CrossRef
  • Lagerby M, Asplund S, Ringqvist I. Cannulated screws for fixation of femoral neck fractures. No difference be- tween Uppsala screws and Richards screws in a random- ized prospective study of 268 cases. Acta Orthop Scand 1998;69:387-91. CrossRef
  • Rau FD, Manoli A 2nd, Morawa LG. Treatment of femo- ral neck fractures with the sliding compression screw. Clin Orthop Relat Res 1982;163:137-40.
  • Saka G, Kurtulmuş T, Sağlam N, Yeniocak S, Akpınar F. Early clinical outcomes of a new and different designed detection method: applying minimal invasiveness, allow- ing sliding compression and effective antirotator in adult collum femoris fractures. In: Osteosynthese International 2012 Annula Meeting; 19-22 September 2012 Rostock, Germany.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Deneysel Çalışma
Yazarlar

Necdet Saglam Bu kişi benim

Fatih Kucukdurmaz Bu kişi benim

Hakan Kivilcim Bu kişi benim

Tuhan Kurtulmus Bu kişi benim

Cengiz Sen Bu kişi benim

Fuat Akpinar Bu kişi benim

Yayımlanma Tarihi 21 Nisan 2014
Yayımlandığı Sayı Yıl 2014

Kaynak Göster

APA Saglam, N., Kucukdurmaz, F., Kivilcim, H., Kurtulmus, T., vd. (2014). Biomechanical comparison of antirotator compression hip screw and cannulated screw fixations in the femoral neck fractures. Acta Orthopaedica Et Traumatologica Turcica, 48(2), 196-201. https://doi.org/10.3944/AOTT.2014.3159
AMA Saglam N, Kucukdurmaz F, Kivilcim H, Kurtulmus T, Sen C, Akpinar F. Biomechanical comparison of antirotator compression hip screw and cannulated screw fixations in the femoral neck fractures. Acta Orthopaedica et Traumatologica Turcica. Nisan 2014;48(2):196-201. doi:10.3944/AOTT.2014.3159
Chicago Saglam, Necdet, Fatih Kucukdurmaz, Hakan Kivilcim, Tuhan Kurtulmus, Cengiz Sen, ve Fuat Akpinar. “Biomechanical Comparison of Antirotator Compression Hip Screw and Cannulated Screw Fixations in the Femoral Neck Fractures”. Acta Orthopaedica Et Traumatologica Turcica 48, sy. 2 (Nisan 2014): 196-201. https://doi.org/10.3944/AOTT.2014.3159.
EndNote Saglam N, Kucukdurmaz F, Kivilcim H, Kurtulmus T, Sen C, Akpinar F (01 Nisan 2014) Biomechanical comparison of antirotator compression hip screw and cannulated screw fixations in the femoral neck fractures. Acta Orthopaedica et Traumatologica Turcica 48 2 196–201.
IEEE N. Saglam, F. Kucukdurmaz, H. Kivilcim, T. Kurtulmus, C. Sen, ve F. Akpinar, “Biomechanical comparison of antirotator compression hip screw and cannulated screw fixations in the femoral neck fractures”, Acta Orthopaedica et Traumatologica Turcica, c. 48, sy. 2, ss. 196–201, 2014, doi: 10.3944/AOTT.2014.3159.
ISNAD Saglam, Necdet vd. “Biomechanical Comparison of Antirotator Compression Hip Screw and Cannulated Screw Fixations in the Femoral Neck Fractures”. Acta Orthopaedica et Traumatologica Turcica 48/2 (Nisan 2014), 196-201. https://doi.org/10.3944/AOTT.2014.3159.
JAMA Saglam N, Kucukdurmaz F, Kivilcim H, Kurtulmus T, Sen C, Akpinar F. Biomechanical comparison of antirotator compression hip screw and cannulated screw fixations in the femoral neck fractures. Acta Orthopaedica et Traumatologica Turcica. 2014;48:196–201.
MLA Saglam, Necdet vd. “Biomechanical Comparison of Antirotator Compression Hip Screw and Cannulated Screw Fixations in the Femoral Neck Fractures”. Acta Orthopaedica Et Traumatologica Turcica, c. 48, sy. 2, 2014, ss. 196-01, doi:10.3944/AOTT.2014.3159.
Vancouver Saglam N, Kucukdurmaz F, Kivilcim H, Kurtulmus T, Sen C, Akpinar F. Biomechanical comparison of antirotator compression hip screw and cannulated screw fixations in the femoral neck fractures. Acta Orthopaedica et Traumatologica Turcica. 2014;48(2):196-201.