BibTex RIS Kaynak Göster

Biomechanical outcome of proximal femoral nail antirotation is superior to proximal femoral locking compression plate for reverse oblique intertrochanteric fractures: a biomechanical study of intertrochanteric fractures

Yıl 2015, Cilt: 49 Sayı: 4, 426 - 432, 19.08.2015

Öz

Objective: Reverse obliquity intertrochanteric fractures are a challenge for orthopedic surgeons. The optimal internal fixation for repairing this type of unstable intertrochanteric fractures remains controversial. This study aimed to compare the biomechanical properties in axial load and cyclical axial load of proximal femoral nail antirotation (PFNA) and proximal femoral locking compression plate (PFLCP) for fixation of reverse obliquity intertrochanteric fractures.
Methods: Sixteen embalmed cadaver femurs were sawed to simulate reverse obliquity intertrochanteric fracture and instrumented with PFNA or PFLCP. Axial loads and axial cyclic loads were applied to the femoral head by an Instron tester. If the implant-femur constructs did not fail, axial failure load was added to the remaining implant-femur constructs.
Results: Mean axial stiffness for PFNA was 21.10% greater than that of PFLCP. Cyclic axial loading caused significantly less (p=0.022) mean irreversible deformation in PFNA (3.43 mm) than in PFLCP (4.34 mm). Significantly less (p=0.002) mean total deformation was detected in PFNA (6.16 mm) than in PFLCP (8.67 mm).
Conclusion: For fixing reverse obliquity intertrochanteric fractures, PFNA is superior to PFLCP under axial load.

 

DOI: 10.3944/AOTT.2015.14.0306



Kaynakça

  • Haidukewych GJ, Israel TA, Berry DJ. Reverse obliquity fractures of the intertrochanteric region of the femur. J Bone Joint Surg Am 2001;83-A:643–50.
  • Min WK, Kim SY, Kim TK, Lee KB, Cho MR, Ha YC, et al. Proximal femoral nail for the treatment of reverse obliq- uity intertrochanteric fractures compared with gamma nail. J Trauma 2007;63:1054–60.
  • Park SY, Yang KH, Yoo JH, Yoon HK, Park HW. The treatment of reverse obliquity intertrochanteric fractures with the intramedullary hip nail. J Trauma 2008;65:852–7.
  • Honkonen SE, Vihtonen K, Järvinen MJ. Second-gener- ation cephalomedullary nails in the treatment of reverse obliquity intertrochanteric fractures of the proximal femur. Injury 2004;35:179–83.
  • Mereddy P, Kamath S, Ramakrishnan M, Malik H, Don- nachie N. The AO/ASIF proximal femoral nail antirota- tion (PFNA): a new design for the treatment of unstable proximal femoral fractures. Injury 2009;40:428–32.
  • Simmermacher RK, Ljungqvist J, Bail H, Hockertz T, Vochteloo AJ, Ochs U, et al. The new proximal femoral nail antirotation (PFNA) in daily practice: results of a multi- centre clinical study. Injury 2008;39:932–9.
  • Sahin S, Ertürer E, Oztürk I, Toker S, Seçkin F, Akman S. Radiographic and functional results of osteosynthesis us- ing the proximal femoral nail antirotation (PFNA) in the treatment of unstable intertrochanteric femoral fractures. Acta Orthop Traumatol Turc 2010;44:127–34.
  • Soucanye de Landevoisin E, Bertani A, Candoni P, Charpail C, Demortiere E. Proximal femoral nail antiro- tation (PFN-ATM) fixation of extra-capsular proximal femoral fractures in the elderly: retrospective study in 102 patients. Orthop Traumatol Surg Res 2012;98:288–95.
  • Kim JW, Oh CW, Byun YS, Oh JK, Kim HJ, Min WK, et al. A biomechanical analysis of locking plate fixation with minimally invasive plate osteosynthesis in a subtrochan- teric fracture model. J Trauma 2011;70:19–23.
  • Crist BD, Khalafi A, Hazelwood SJ, Lee MA. A biome- chanical comparison of locked plate fixation with percu- taneous insertion capability versus the angled blade plate in a subtrochanteric fracture gap model. J Orthop Trauma 2009;23:622–7.
  • Floyd JC, O’Toole RV, Stall A, Forward DP, Nabili M, Shillingburg D, et al. Biomechanical comparison of prox- imal locking plates and blade plates for the treatment of comminuted subtrochanteric femoral fractures. J Orthop Trauma 2009;23:628–33.
  • Zha GC, Chen ZL, Qi XB, Sun JY. Treatment of pertro- chanteric fractures with a proximal femur locking compres- sion plate. Injury 2011;42:1294–9.
  • Haidukewych GJ. Intertrochanteric fractures: ten tips to improve results. J Bone Joint Surg Am 2009;91:712–9.
  • Kuzyk PR, Lobo J, Whelan D, Zdero R, McKee MD, Schemitsch EH. Biomechanical evaluation of extramedul- lary versus intramedullary fixation for reverse obliquity in- tertrochanteric fractures. J Orthop Trauma 2009;23:31–8.
  • Bong MR, Patel V, Iesaka K, Egol KA, Kummer FJ, Koval KJ. Comparison of a sliding hip screw with a trochanteric lateral support plate to an intramedullary hip screw for fix- ation of unstable intertrochanteric hip fractures: a cadaver study. J Trauma 2004;56:791–4.
  • Du CL, Ma XL, Ma JX, Zhang T, Fu X. Influence of ante- version angles on stress distributions of the proximal femur after femoral neck fracture fixation: A finite element analy- sis. Journal of Medical Biomechanics 2012;27:603–35.
  • NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis preven- tion, diagnosis, and therapy. JAMA 2001;285:785–95.
  • Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, et al. Predictive value of BMD for hip and other fractures. J Bone Miner Res 2005;20:1185–94.
  • Pohler OE. Unalloyed titanium for implants in bone sur- gery. Injury 2000;31 Suppl 4:7–13.
  • Beingessner D, Moon E, Barei D, Morshed S. Biomechani- cal analysis of the less invasive stabilization system for me- chanically unstable fractures of the distal femur: compari- son of titanium versus stainless steel and bicortical versus unicortical fixation. J Trauma 2011;71:620–4.
  • Domingo LJ, Cecilia D, Herrera A, Resines C. Trochan- teric fractures treated with a proximal femoral nail. Int Or- thop 2001;25:298–301.
  • Windolf J, Hollander DA, Hakimi M, Linhart W. Pitfalls and complications in the use of the proximal femoral nail. Langenbecks Arch Surg 2005;390:59–65.
  • Gardenbroek TJ, Segers MJ, Simmermacher RK, Ham- macher ER. The proximal femur nail antirotation: an iden- tifiable improvement in the treatment of unstable pertro- chanteric fractures? J Trauma 2011;71:169–74.
  • Takigami I, Matsumoto K, Ohara A, Yamanaka K, Naga- nawa T, Ohashi M, et al. Treatment of trochanteric frac- tures with the PFNA (proximal femoral nail antirotation) nail system - report of early results. Bull NYU Hosp Jt Dis 2008;66:276–9.
  • Wirtz C, Abbassi F, Evangelopoulos DS, Kohl S, Sieben- rock KA, Krüger A. High failure rate of trochanteric frac- ture osteosynthesis with proximal femoral locking com- pression plate. Injury 2013;44:751–6.
  • Streubel PN, Moustoukas MJ, Obremskey WT. Mechani- cal failure after locking plate fixation of unstable intertro- chanteric femur fractures. J Orthop Trauma 2013;27:22–8.
  • Forward DP, Doro CJ, O’Toole RV, Kim H, Floyd JC, Sciadini MF, et al. A biomechanical comparison of a lock- ing plate, a nail, and a 95° angled blade plate for fixation of subtrochanteric femoral fractures. J Orthop Trauma 2012;26:334–40.
  • Han GH, Wei W, Gu J. Comparison of proximal femoral locking plate and Gamma nail in the treatment of the fem- oral intertrochanteric fractures in the elder. [Article in Chi- nese] Zhongguo Gu Shang 2012;25:796–9. [Abstract]
  • Wieser K, Babst R. Fixation failure of the LCP proximal femoral plate 4.5/5.0 in patients with missing posterome- dial support in unstable per-, inter-, and subtrochanteric fractures of the proximal femur. Arch Orthop Trauma Surg 2010;130:1281–7.
  • Sadowski C, Lübbeke A, Saudan M, Riand N, Stern R, Hoffmeyer P. Treatment of reverse oblique and transverse intertrochanteric fractures with use of an intramedullary nail or a 95 degrees screw-plate: a prospective, randomized study. J Bone Joint Surg Am 2002;84-A:372–81.
  • Wagner R, Blattert TR, Weckbach A. Solution to the problem of extra-articular, femoral hip fracture by the “sliding screw-nail principle”. Results of 2 different systems (classical nail and gamma nail). [Article in German] Un- fallchirurg 1998;101:894–900. [Abstract]
  • Glassner PJ, Tejwani NC. Failure of proximal femoral locking compression plate: a case series. J Orthop Trauma 2011;25:76–83.
  • Sommers MB, Roth C, Hall H, Kam BC, Ehmke LW, Krieg JC, et al. A laboratory model to evaluate cutout re- sistance of implants for pertrochanteric fracture fixation. J Orthop Trauma 2004;18:361–8.
Yıl 2015, Cilt: 49 Sayı: 4, 426 - 432, 19.08.2015

Öz

Kaynakça

  • Haidukewych GJ, Israel TA, Berry DJ. Reverse obliquity fractures of the intertrochanteric region of the femur. J Bone Joint Surg Am 2001;83-A:643–50.
  • Min WK, Kim SY, Kim TK, Lee KB, Cho MR, Ha YC, et al. Proximal femoral nail for the treatment of reverse obliq- uity intertrochanteric fractures compared with gamma nail. J Trauma 2007;63:1054–60.
  • Park SY, Yang KH, Yoo JH, Yoon HK, Park HW. The treatment of reverse obliquity intertrochanteric fractures with the intramedullary hip nail. J Trauma 2008;65:852–7.
  • Honkonen SE, Vihtonen K, Järvinen MJ. Second-gener- ation cephalomedullary nails in the treatment of reverse obliquity intertrochanteric fractures of the proximal femur. Injury 2004;35:179–83.
  • Mereddy P, Kamath S, Ramakrishnan M, Malik H, Don- nachie N. The AO/ASIF proximal femoral nail antirota- tion (PFNA): a new design for the treatment of unstable proximal femoral fractures. Injury 2009;40:428–32.
  • Simmermacher RK, Ljungqvist J, Bail H, Hockertz T, Vochteloo AJ, Ochs U, et al. The new proximal femoral nail antirotation (PFNA) in daily practice: results of a multi- centre clinical study. Injury 2008;39:932–9.
  • Sahin S, Ertürer E, Oztürk I, Toker S, Seçkin F, Akman S. Radiographic and functional results of osteosynthesis us- ing the proximal femoral nail antirotation (PFNA) in the treatment of unstable intertrochanteric femoral fractures. Acta Orthop Traumatol Turc 2010;44:127–34.
  • Soucanye de Landevoisin E, Bertani A, Candoni P, Charpail C, Demortiere E. Proximal femoral nail antiro- tation (PFN-ATM) fixation of extra-capsular proximal femoral fractures in the elderly: retrospective study in 102 patients. Orthop Traumatol Surg Res 2012;98:288–95.
  • Kim JW, Oh CW, Byun YS, Oh JK, Kim HJ, Min WK, et al. A biomechanical analysis of locking plate fixation with minimally invasive plate osteosynthesis in a subtrochan- teric fracture model. J Trauma 2011;70:19–23.
  • Crist BD, Khalafi A, Hazelwood SJ, Lee MA. A biome- chanical comparison of locked plate fixation with percu- taneous insertion capability versus the angled blade plate in a subtrochanteric fracture gap model. J Orthop Trauma 2009;23:622–7.
  • Floyd JC, O’Toole RV, Stall A, Forward DP, Nabili M, Shillingburg D, et al. Biomechanical comparison of prox- imal locking plates and blade plates for the treatment of comminuted subtrochanteric femoral fractures. J Orthop Trauma 2009;23:628–33.
  • Zha GC, Chen ZL, Qi XB, Sun JY. Treatment of pertro- chanteric fractures with a proximal femur locking compres- sion plate. Injury 2011;42:1294–9.
  • Haidukewych GJ. Intertrochanteric fractures: ten tips to improve results. J Bone Joint Surg Am 2009;91:712–9.
  • Kuzyk PR, Lobo J, Whelan D, Zdero R, McKee MD, Schemitsch EH. Biomechanical evaluation of extramedul- lary versus intramedullary fixation for reverse obliquity in- tertrochanteric fractures. J Orthop Trauma 2009;23:31–8.
  • Bong MR, Patel V, Iesaka K, Egol KA, Kummer FJ, Koval KJ. Comparison of a sliding hip screw with a trochanteric lateral support plate to an intramedullary hip screw for fix- ation of unstable intertrochanteric hip fractures: a cadaver study. J Trauma 2004;56:791–4.
  • Du CL, Ma XL, Ma JX, Zhang T, Fu X. Influence of ante- version angles on stress distributions of the proximal femur after femoral neck fracture fixation: A finite element analy- sis. Journal of Medical Biomechanics 2012;27:603–35.
  • NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis preven- tion, diagnosis, and therapy. JAMA 2001;285:785–95.
  • Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, et al. Predictive value of BMD for hip and other fractures. J Bone Miner Res 2005;20:1185–94.
  • Pohler OE. Unalloyed titanium for implants in bone sur- gery. Injury 2000;31 Suppl 4:7–13.
  • Beingessner D, Moon E, Barei D, Morshed S. Biomechani- cal analysis of the less invasive stabilization system for me- chanically unstable fractures of the distal femur: compari- son of titanium versus stainless steel and bicortical versus unicortical fixation. J Trauma 2011;71:620–4.
  • Domingo LJ, Cecilia D, Herrera A, Resines C. Trochan- teric fractures treated with a proximal femoral nail. Int Or- thop 2001;25:298–301.
  • Windolf J, Hollander DA, Hakimi M, Linhart W. Pitfalls and complications in the use of the proximal femoral nail. Langenbecks Arch Surg 2005;390:59–65.
  • Gardenbroek TJ, Segers MJ, Simmermacher RK, Ham- macher ER. The proximal femur nail antirotation: an iden- tifiable improvement in the treatment of unstable pertro- chanteric fractures? J Trauma 2011;71:169–74.
  • Takigami I, Matsumoto K, Ohara A, Yamanaka K, Naga- nawa T, Ohashi M, et al. Treatment of trochanteric frac- tures with the PFNA (proximal femoral nail antirotation) nail system - report of early results. Bull NYU Hosp Jt Dis 2008;66:276–9.
  • Wirtz C, Abbassi F, Evangelopoulos DS, Kohl S, Sieben- rock KA, Krüger A. High failure rate of trochanteric frac- ture osteosynthesis with proximal femoral locking com- pression plate. Injury 2013;44:751–6.
  • Streubel PN, Moustoukas MJ, Obremskey WT. Mechani- cal failure after locking plate fixation of unstable intertro- chanteric femur fractures. J Orthop Trauma 2013;27:22–8.
  • Forward DP, Doro CJ, O’Toole RV, Kim H, Floyd JC, Sciadini MF, et al. A biomechanical comparison of a lock- ing plate, a nail, and a 95° angled blade plate for fixation of subtrochanteric femoral fractures. J Orthop Trauma 2012;26:334–40.
  • Han GH, Wei W, Gu J. Comparison of proximal femoral locking plate and Gamma nail in the treatment of the fem- oral intertrochanteric fractures in the elder. [Article in Chi- nese] Zhongguo Gu Shang 2012;25:796–9. [Abstract]
  • Wieser K, Babst R. Fixation failure of the LCP proximal femoral plate 4.5/5.0 in patients with missing posterome- dial support in unstable per-, inter-, and subtrochanteric fractures of the proximal femur. Arch Orthop Trauma Surg 2010;130:1281–7.
  • Sadowski C, Lübbeke A, Saudan M, Riand N, Stern R, Hoffmeyer P. Treatment of reverse oblique and transverse intertrochanteric fractures with use of an intramedullary nail or a 95 degrees screw-plate: a prospective, randomized study. J Bone Joint Surg Am 2002;84-A:372–81.
  • Wagner R, Blattert TR, Weckbach A. Solution to the problem of extra-articular, femoral hip fracture by the “sliding screw-nail principle”. Results of 2 different systems (classical nail and gamma nail). [Article in German] Un- fallchirurg 1998;101:894–900. [Abstract]
  • Glassner PJ, Tejwani NC. Failure of proximal femoral locking compression plate: a case series. J Orthop Trauma 2011;25:76–83.
  • Sommers MB, Roth C, Hall H, Kam BC, Ehmke LW, Krieg JC, et al. A laboratory model to evaluate cutout re- sistance of implants for pertrochanteric fracture fixation. J Orthop Trauma 2004;18:361–8.
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Deneysel Çalışma
Yazarlar

Jianxiong Ma Bu kişi benim

Jie Wang Bu kişi benim

Weiguo Xu Bu kişi benim

Jingtao Yu Bu kişi benim

Yang Yang Bu kişi benim

Xinlong Ma

Yayımlanma Tarihi 19 Ağustos 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 49 Sayı: 4

Kaynak Göster

APA Ma, J., Wang, J., Xu, W., Yu, J., vd. (2015). Biomechanical outcome of proximal femoral nail antirotation is superior to proximal femoral locking compression plate for reverse oblique intertrochanteric fractures: a biomechanical study of intertrochanteric fractures. Acta Orthopaedica Et Traumatologica Turcica, 49(4), 426-432. https://doi.org/10.3944/AOTT.2015.14.0306
AMA Ma J, Wang J, Xu W, Yu J, Yang Y, Ma X. Biomechanical outcome of proximal femoral nail antirotation is superior to proximal femoral locking compression plate for reverse oblique intertrochanteric fractures: a biomechanical study of intertrochanteric fractures. Acta Orthopaedica et Traumatologica Turcica. Ağustos 2015;49(4):426-432. doi:10.3944/AOTT.2015.14.0306
Chicago Ma, Jianxiong, Jie Wang, Weiguo Xu, Jingtao Yu, Yang Yang, ve Xinlong Ma. “Biomechanical Outcome of Proximal Femoral Nail Antirotation Is Superior to Proximal Femoral Locking Compression Plate for Reverse Oblique Intertrochanteric Fractures: A Biomechanical Study of Intertrochanteric Fractures”. Acta Orthopaedica Et Traumatologica Turcica 49, sy. 4 (Ağustos 2015): 426-32. https://doi.org/10.3944/AOTT.2015.14.0306.
EndNote Ma J, Wang J, Xu W, Yu J, Yang Y, Ma X (01 Ağustos 2015) Biomechanical outcome of proximal femoral nail antirotation is superior to proximal femoral locking compression plate for reverse oblique intertrochanteric fractures: a biomechanical study of intertrochanteric fractures. Acta Orthopaedica et Traumatologica Turcica 49 4 426–432.
IEEE J. Ma, J. Wang, W. Xu, J. Yu, Y. Yang, ve X. Ma, “Biomechanical outcome of proximal femoral nail antirotation is superior to proximal femoral locking compression plate for reverse oblique intertrochanteric fractures: a biomechanical study of intertrochanteric fractures”, Acta Orthopaedica et Traumatologica Turcica, c. 49, sy. 4, ss. 426–432, 2015, doi: 10.3944/AOTT.2015.14.0306.
ISNAD Ma, Jianxiong vd. “Biomechanical Outcome of Proximal Femoral Nail Antirotation Is Superior to Proximal Femoral Locking Compression Plate for Reverse Oblique Intertrochanteric Fractures: A Biomechanical Study of Intertrochanteric Fractures”. Acta Orthopaedica et Traumatologica Turcica 49/4 (Ağustos 2015), 426-432. https://doi.org/10.3944/AOTT.2015.14.0306.
JAMA Ma J, Wang J, Xu W, Yu J, Yang Y, Ma X. Biomechanical outcome of proximal femoral nail antirotation is superior to proximal femoral locking compression plate for reverse oblique intertrochanteric fractures: a biomechanical study of intertrochanteric fractures. Acta Orthopaedica et Traumatologica Turcica. 2015;49:426–432.
MLA Ma, Jianxiong vd. “Biomechanical Outcome of Proximal Femoral Nail Antirotation Is Superior to Proximal Femoral Locking Compression Plate for Reverse Oblique Intertrochanteric Fractures: A Biomechanical Study of Intertrochanteric Fractures”. Acta Orthopaedica Et Traumatologica Turcica, c. 49, sy. 4, 2015, ss. 426-32, doi:10.3944/AOTT.2015.14.0306.
Vancouver Ma J, Wang J, Xu W, Yu J, Yang Y, Ma X. Biomechanical outcome of proximal femoral nail antirotation is superior to proximal femoral locking compression plate for reverse oblique intertrochanteric fractures: a biomechanical study of intertrochanteric fractures. Acta Orthopaedica et Traumatologica Turcica. 2015;49(4):426-32.