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Biomechanical validation of a new nail-plate for the repair of stable proximal femoral fractures

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Abstract

The mechanical performance and the stress shielding effects of the Howmedica Spherolock MKII implant were evaluated. Three types of stable proximal femoral fractures were created in composite femurs and fixed with the nail-plate. The femurs were loaded to failure, and the yield strength, stiffness, and failure modes were noted. Additional intact composite femurs were fitted proximally with strain gauges, and the strain was examined under load. The femurs then underwent intertrochanteric fracture, plating, and re-testing. Comparative analysis showed that while the Spherolock system is less strong and stiff than other commonly used implants, it provides excellent and uniform load transfer across the fracture site. Varus rotation of the femoral head under load tended to open the fracture gap and localize the resultant load medially. Stress shielding of the calcar was less than 25% of the applied load even in the worst case. This very low stress shielding behavior was attributed mainly to the implant's low stiffness.

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References

  1. American Society for Testing and Materials (1992) Annual book of standards, Part 384, Designation F. ASTM, Philadelphia, pp 110–111

    Google Scholar 

  2. Apel DM, Patwardhan A, Pinzur MS, Dobozi WR (1989) Axial loading studies of unstable intertrochanteric fractures of the femur. Clin Orthop 246:156–164

    Google Scholar 

  3. Chang WS, Zuckerman JD, Kummer FJ, Frankel VH (1987) Biomechanical evaluation of anatomic reduction versus medial displacement osteotomy in unstable intertrochanteric fractures. Clin Orthop 225:141–146

    Google Scholar 

  4. Clark DI, Crofts CE, Saleh M (1990) Femoral neck fracture fixation: comparison of a sliding screw with lag screws. J Bone Joint Surg [Br] 72:797–800

    Google Scholar 

  5. Den Hartog BD, Bartal E, Cooke F (1991) Treatment of the unstable intertrochanteric fracture. Effect of the placement of the screw, its angle of insertion, and osteotomy. J Bone Joint Surg [Am] 73:726–733

    Google Scholar 

  6. Goodman SB, Davidson JA, Locke L, Novotny S, Jones H, Csongradi JJ (1992) A biomechanical study of two methods of internal fixation of unstable fractures of the femoral neck. A preliminary study. J Orthop Trauma 6:66–72

    Google Scholar 

  7. Jacobs RR, McClain O, Armstrong H (1980) Internal fixation of intertrochanteric hip fractures: a clinical and biomechanical study. Clin Orthop 146:62–70

    Google Scholar 

  8. Larsson S, Elloy M, Hansson LI (1988) Fixation of unstable trochanteric hip fractures. A cadaver study comparing three different devices. Acta Orthop Scand 59:658–663

    Google Scholar 

  9. Larsson S, Elloy M, Hansson LI (1988) Stability of osteosynthesis in trochanteric fractures. Comparison of three fixation devices in cadavers. Acta Orthop Scand 59:386–390

    Google Scholar 

  10. Mahomed N, Harrington I, Kellam J, Maistrelli G, Hearn T, Vroemen J (1994) Biomechanical analysis of the gamma nail and sliding hip screw. Clin Orthop 304:280–288

    Google Scholar 

  11. Meislin RJ, Zuckerman JD, Kummer FJ, Frankel VH (1990) A biomechanical analysis of the sliding hip screw: the question of plate angle. J Orthop Trauma 4:130–136

    Google Scholar 

  12. Müller ME, Allgöwer M, Schneider R, Willenegger H (1993) Manuale dell'osteosintesi. tecniche raccomandate dal gruppo AO. Springer, Berlin Heidelberg New York, pp 522–529

    Google Scholar 

  13. Pipino F, Calderale PM, Molfetta L (1993) Spherholock: a new osteosynthesis advice in the treatment of femoral trochanteric region fractures. (Abstract) 1st European Congress of Orthopedics, Paris, April 1993

  14. Ramser JR Jr, Mihalko WM, Carr JB, Beaudoin AJ, Krause WR (1993) A comparison of femoral neck fixation with the reconstruction nail versus cancellous screws in anatomic specimens. Clin Orthop 290:189–196

    Google Scholar 

  15. Rosenblum SF, Zuckerman JD, Kummer FJ, Tam BS (1992) A biomechanical evaluation of the Gamma nail. J Bone Joint Surg [Br] 74:352–357

    Google Scholar 

  16. Springer ER, Lachiewicz PF, Gilbert JA (1991) Internal fixation of femoral neck fractures. A comparative biomechanical study of Knowles pins and 6.5-mm cancellous screws. Clin Orthop 267:85–92

    Google Scholar 

  17. Swiontkowski MF, Harrington RM, Keller TS, Van Patten PK (1987) Torsion and bending analysis of internal fixation techniques for femoral neck fractures: the role of implant design and bone density. J Orthop Res 5:433–444

    Google Scholar 

  18. Szivek JA, Gealer RL (1991) Technical note: comparison of the deformation response of synthetic cadaveric femora during simulated one-legged stance. J Appl Mat 2:277–280

    Google Scholar 

  19. Tencer AF, Johnson KD, Johnston WC, Gill K (1984) A biomechanical comparison of various methods of stabilization of subtrochanteric fractures of the femur. J Orthop Res 2:297–305

    Google Scholar 

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Ramer, M., Viceconti, M., Toni, A. et al. Biomechanical validation of a new nail-plate for the repair of stable proximal femoral fractures. Arch Orthop Trauma Surg 116, 137–142 (1997). https://doi.org/10.1007/BF00426062

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  • DOI: https://doi.org/10.1007/BF00426062

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