A sliding hip screw augmented with 2 screws is biomechanically similar to an inverted triad of cannulated screws in repair of a Pauwels type-III fracture

Kemker, Bernard P.; Magone, Kevin M.; Owen, J.; Atkinson, Patrick; Martin, Sidney; Atkinson, Theresa

doi:10.1016/j.injury.2017.05.013

Cited by 35 publications

(21 citation statements)

References 40 publications

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“…When these data are interpreted clinically, it is obvious that increasing the angle of fracture results in increased instability. In the Pauwels classification, fracture angles of more than 50 o are classified as Type 3 and these angles are associated with high instability and complication rates [3,8,20,21]. However, our study results show that notable differences occur across fracture angles ranging from 30 o to 50 o , whereas biomechanical differences occur less at angles of more than 50 o .…”

Section: Discussioncontrasting

confidence: 50%

Fixation of femoral neck fractures with three cannulated screws: biomechanical changes at critical fracture angles

Öner¹,

Paksoy²,

Özer³

2020

Journal of Surgery and Medicine

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Section: Discussioncontrasting

confidence: 50%

Fixation of femoral neck fractures with three cannulated screws: biomechanical changes at critical fracture angles

Öner¹,

Paksoy²,

Özer³

2020

Journal of Surgery and Medicine

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“…25 For comminuted fractures affecting load transfer, a sliding hip screw combined with cancellous screw fixation is the best treatment. 26 Compared with three parallel cancellous screws, PCS significantly improved the mechanical properties of vertical femoral neck fractures, and the improvements seemed to be consistent with the performance of dynamic hip screws. 12 The models developed in this study fully support the improved biomechanical stability of the new plate fixation technique.…”

Section: Discussionmentioning

confidence: 62%

Finite element analysis of a new plate for Pauwels type III femoral neck fractures

Wang

Tang²,

et al. 2020

J Int Med Res

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Background: A new plate for the treatment of Pauwels type III femoral neck fractures was developed, and its biomechanical stability was analyzed by the finite element method. Method: Using 3-matic and UG-NX software, we constructed models of Pauwels type III femoral neck fractures with angles of 50 , 60 , and 70 . Moreover, a new femoral neck plate (NFNP) fixation model and a Pauwels screw fixation model were developed. Under axial loads of 1400 N and 2100 N, von Mises stress (VMS) distribution on the screws, peak VMS, displacement between fracture fragments, and model principal strains in cancellous bone were recorded. Result: The peak VMS of internal fixation in the two models was mostly located near the fracture line, and the screw closest to the femoral calcar experienced maximum stress. With a Pauwels angle of 50 , 60 , and 70 , the peak VMS values of the new plates were lower than in the Pauwels screw. The displacement of fracture fragments in the NFNP was smaller than in the Pauwels screw, and peak VMS values of cancellous bone in the NFNP were lower than in the Pauwels screw. Conclusion: The newly developed plate provided excellent biomechanical stability for Pauwels type III femoral neck fractures.

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“…A fracture table was not used in order to avoid traction force into the fracture site. We used partially threaded 6.5 mm cannulated screws in an inverted triangle configuration11). The placement of the portal for the inferior screw was made just superior to the lowest level of the lesser trochanter in order to prevent additional stress on the subtrochanteric area.…”

Section: Methodsmentioning

confidence: 99%

Surgical Outcomes of Internal Fixation Using Multiple Screws in Femoral Neck Fractures with Valgus Impaction: When Should We Consider Hip Arthroplasty? A Retrospective, Multicenter Study

et al. 2019

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Purpose We analyzed the surgical outcomes at two institutions after internal fixation using multiple screws in femoral neck fractures with valgus impaction to determine independent predictors and their cut-off values for nonunion and reoperation. Materials and Methods Between January 2006 and December 2016, 104 femoral neck fractures with valgus impaction that underwent internal fixation using multiple screws from two institutions were enrolled. The multiple logistic regression model and receiver operating characteristics analysis were used to determine the independent predictors and cut-off values for nonunion and reoperation. Results There were 20 reoperations (19.2%) due to 11 nonunions (10.6%) and nine cases of femoral head osteonecrosis (8.7%). Multiple logistic regression analysis revealed that independent predictors of nonunion and reoperation were age and posterior tilt angle ( P <0.05). The cut-off value for age and the posterior tilt angle for reoperation were 72.5 years and 12.2°, respectively. The patients with a posterior tilt angle of greater than 13° had poorer radiological and clinical outcomes compared with those with a posterior tilt angle of less than 13°, even though they did achieve bone union. Conclusion Primary hip arthroplasty should be considered in patients older than 73 years of age with a posterior tilt angle greater than 13°.

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A sliding hip screw augmented with 2 screws is biomechanically similar to an inverted triad of cannulated screws in repair of a Pauwels type-III fracture

Cited by 35 publications

References 40 publications

Fixation of femoral neck fractures with three cannulated screws: biomechanical changes at critical fracture angles

Fixation of femoral neck fractures with three cannulated screws: biomechanical changes at critical fracture angles

Finite element analysis of a new plate for Pauwels type III femoral neck fractures

Surgical Outcomes of Internal Fixation Using Multiple Screws in Femoral Neck Fractures with Valgus Impaction: When Should We Consider Hip Arthroplasty? A Retrospective, Multicenter Study

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