Graham, SM, Mak, JH, Moazen, M et al. (4 more authors) (2015) Periprosthetic femoral fracture fixation: A biomechanical comparison between proximal locking screws and cables. Journal of Orthopaedic Science, 20 (5). pp. 875-880. ISSN 0949-2658
Abstract
Background: The incidence of periprosthetic femoral fractures (PFF) around a stable stem is increasing. The aim of this biomechanical study was to examine how three different methods of fixation, for Vancouver type B1 PFF, alter the stiffness and strain of a construct under various configurations, in order to gain a better insight into the optimal fixation method. Methods: Three different combinations of proximal screws and Dall-Miles cables were used: (A) proximal unicortical locking screws alone; (B) proximal cables and unicortical locking screws; (C) proximal cable alone, each in combination with distal bicortical locking screws, to fix a stainless steel locking compression plate to five synthetic femora with simulated Vancouver type B1 PFFs. In one synthetic femora, there was a 10-mm fracture gap, in order to simulate a comminuted injury. The other four femora had no fracture gap, to simulate a stable injury. An axial load was applied to the constructs at varying degrees of adduction, and the overall construct stiffness and surface strain were measured. Results: With regards to stiffness, in both the gap and no gap models, method of fixation A was the stiffest form of fixation. The inclusion of the fracture gap reduced the stiffness of the construct quite considerably for all methods of fixation. The strain across both the femur and the plate was considerably less for method of fixation C, compared to A and B, at the locations considered in this study. Conclusion: This study highlights that the inclusion of cables appears to damage the screw fixations and does not aid in construct stability. Furthermore, the degree of fracture reduction affects the whole construct stability and the bending behaviour of the fixation.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | (c) 2015 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved. This is an author produced version of a paper published in Journal of Orthopaedic Science. Uploaded in accordance with the publisher's self-archiving policy |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Engineering & Physical Sciences (Leeds) > School of Mechanical Engineering (Leeds) > Institute of Medical and Biological Engineering (iMBE) (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 15 Aug 2016 09:19 |
Last Modified: | 10 Nov 2016 08:09 |
Published Version: | http://dx.doi.org/10.1007/s00776-015-0735-3 |
Status: | Published |
Publisher: | Springer Verlag (Germany) |
Identification Number: | 10.1007/s00776-015-0735-3 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:99557 |