INVESTIGATION OF THE EFFECTIVENESS AND SAFETY OF MODULAR PROSTHETIC NAIL COMBINATION IN THE PREVENTION OF FRACTURE RISK IN SCREW HOLE DEFECTS FOLLOWING PROXIMAL FEMORAL NAIL REMOVAL: A COMPARATIVE EXPERIMENTAL STUDY

Öz

OBJECTIVE: Proximal femoral nail (PFN) is a treatment of hip fractures. In case of non-union or hip arthrosis, the implant is removed, and prosthetic surgery is performed. This study aims to evaluate the stress distributions on the distal locking screw holes of the prosthesis applied after PFN removal and subtrochanteric fracture risk in a newly developed nail-prosthesis combination and revision hip prosthesis.
MATERIAL AND METHODS: 6 (Synbone 2162) artificial femur models were used. The modular PFN-prosthesis model was placed in these femur models. Neck screws were removed from all. Femoral neck was cut. PFN was removed from 3 models and revision stem was replaced. In 3 models, the modular PFN-prosthesis was attached. The stress on the distal screw hole was examined with the axial compression test.
RESULTS: In this study, we performed on 6 artificial femurs, a fracture in the femur at 200N and above forces was detected in the control group. When 300N and above force was applied in the experimental group, a fracture in the femur was detected.
CONCLUSIONS: Stress distribution and fracture risk in residual holes were evaluated after PFN removal in artificial femurs. The newly designed modular nail prosthesis combination (MNP) was found to have a lower risk of fracture than revision prosthesis due to the presence of screws in the distal holes.

Anahtar Kelimeler

• Modular nail prosthesis
• Screw hole,
• Periprosthetic fracture

Proje Numarası

17

PROKSİMAL FEMORAL ÇİVİ ÇIKARIMI SONRASINDA OLUŞAN VİDA DELİĞİ DEFEKTLERİNDE KIRIK RİSKİNİN ÖNLENMESİNDE MODÜLER PROTEZ ÇİVİ KOMBİNASYONUNUN ETKİNLİĞİ VE GÜVENLİĞİNİN İNCELENMESİ: KARŞILAŞTIRMALI DENEYSEL ÇALIŞMA

Öz

seçeneğidir. Kırıkta kaynamama veya kalçada artroz durumunda implant çıkarılır ve protez ameliyatı gerçekleştirilir. Bu çalışmanın amacı PFN çıkarımı sonrasında uygulanan protezlerin distal kilit vidası delikleri üzerinde oluşturduğu stres dağılımlarını ve subtrokanterik kırık riskini, yeni geliştirilen çivi protez kombinasyonu ve revizyon kalça protezlerinde karşılaştırmalı olarak değerlendirmektir.
GEREÇ VE YÖNTEM: Altı adet yapay femur modelleri (Synbone 2162) kullanıldı. Bu femur modellerine modüler PFN-protez modeli yerleştirildi. Hepsinden boyun vidaları çıkarıldı. Femur boyun kesisi yapıldı, 3 modelden PFN çıkarıldı. Revizyon stem yerleştirildi. 3 modelde modüler PFN-protezin, protez bağlantısı yapıldı. Eksenel basma testi ile distal vida deliğindeki strese bakıldı.
BULGULAR: Altı adet yapay femur üzerinde yapılan çalışmada kontrol grubunda 200N ve üzerinde kuvvetlerde femurda kırık saptandı. Deney grubunda 300N ve üzerinde kuvvet uygulandığında femurda kırık saptandı.
SONUÇ: Yapay femurlarda PFN çıkarımı sonrasında residüel deliklerde oluşan stres dağılımı ve kırık riski değerlendirilmiştir. Yeni tasarlanan modüler çivi protez kombinasyonunun (MNP) distal deliklerinde vida bulunmasından dolayı kırık riskinin revizyon protezi uygulananlara göre daha az olduğu görülmüştür.

Anahtar Kelimeler

• Modüler çivi protez
• Vida deliği
• Periprostetik kırık

Destekleyen Kurum

Afyon Kocatepe Üniversitesi Bilimsel Araştırma Proje Birimi

Proje Numarası

17

Kaynakça

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