2019
DOI: 10.1007/s11914-019-00535-9
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Biomechanics of Osteoporotic Fracture Fixation

Abstract: Purpose of Review Fractures of osteoporotic bone in elderly individuals need special attention. This manuscript reviews the current strategies to provide sufficient fracture fixation stability with a particular focus on fractures that frequently occur in elderly individuals with osteoporosis and require full load-bearing capacity, i.e., pelvis, hip, ankle, and peri-implant fractures. Recent Findings Elderly individuals benefit immensely from immediate mobilization after fracture and thus require stable fractur… Show more

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Cited by 62 publications
(39 citation statements)
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References 111 publications
(128 reference statements)
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“…Cephalomedullary nails are considered to be the best treatment option in unstable subtrochanteric fractures, when compared to other fixation techniques [ 2 ]. This is due to the central position of the cephalomedullary nail combined with impaction of the fracture [ 3 ].…”
Section: Discussionmentioning
confidence: 93%
“…Cephalomedullary nails are considered to be the best treatment option in unstable subtrochanteric fractures, when compared to other fixation techniques [ 2 ]. This is due to the central position of the cephalomedullary nail combined with impaction of the fracture [ 3 ].…”
Section: Discussionmentioning
confidence: 93%
“…Fracture reduction in elder patients is complicated especially in terms of poor bone quality, comorbidities, and unfavourable fracture configurations [ 22 ]. Due to the lack of clear evidence regarding the optimal surgical treatment, implant choice is often based on biomechanical performance: Concerning unstable fractures, modern nail designs including interlocking lag screws provide improved biomechanical performance with controlled impaction of the fracture and a close-to-central weight-bearing axis in the femoral shaft [ 27 ]. An optional supplemental cable cerclage is able to minimize the opening of the fracture gap medially and to neutralize relevant varus bending forces in trochanteric and subtrochanteric fractures and thereby maintains the biomechanically important medial pillar providing increased intrinsic primary stability [ 1 , 26 ].…”
Section: Discussionmentioning
confidence: 99%
“…An optional supplemental cable cerclage is able to minimize the opening of the fracture gap medially and to neutralize relevant varus bending forces in trochanteric and subtrochanteric fractures and thereby maintains the biomechanically important medial pillar providing increased intrinsic primary stability [ 1 , 26 ]. This supportive effect is located at the heart of any stable osteosynthesis [ 27 ]. The medial pillar is under enormous loading pressure when the proximal femur is subjected to axial loads.…”
Section: Discussionmentioning
confidence: 99%
“…Bone cutting processes are very common in knee arthroplasties, dental implants and spine surgeries; however, a bone cutting process exposes the risk of bone cracks. Such cracks cause an instable screw insertion [1] or instable cutting process in orthopedic robotic surgeries [2]. To predict a crack initiation and propagation, it is critical to investigate bone cutting behavior in a bone cutting process.…”
Section: Introductionmentioning
confidence: 99%