Helical blade versus sliding hip screw for treatment of unstable intertrochanteric hip fractures: A biomechanical evaluation

Strauss, Eric J.; Frank, Joshua B.; Lee, Jason; Kummer, Frederick J.; Tejwani, Nirmal C.

doi:10.1016/j.injury.2006.06.008

Cited by 194 publications

(132 citation statements)

References 11 publications

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“…Positioning of the intramedullary device close to the weightbearing axis of the femur reduces forces on the implant. The primary innovation of the proximal femoral nail antirotation (PFNA, AO/ASIF) design is the helical neck blade that reduces the risk of bone loss and offers improved purchase in the femoral head as a result of compaction of cancellous bone around the blade during insertion [35,36,41]. Rotation of the head-blade combination as a whole is prevented by an intrinsic locking mechanism [3,38].…”

Section: Introductionmentioning

confidence: 99%

Does PFNA II Avoid Lateral Cortex Impingement for Unstable Peritrochanteric Fractures?

Macheras

Koutsostathis

Galanakos

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Section: Introductionmentioning

confidence: 99%

Does PFNA II Avoid Lateral Cortex Impingement for Unstable Peritrochanteric Fractures?

Macheras

Koutsostathis

Galanakos

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Next, each specimen was cyclically loaded, with 750 N vertical loads applied at a rate of 3 Hz for 10, 100, 1000, and 10,000 cycles. Each specimen was allowed to reach equilibrium (120 s) after each cyclic interval, and displacement measurements both loaded and unloaded were taken 23. Finally, each specimen was axially loaded to failure recorded in load displacement curve.…”

Section: Methodsmentioning

confidence: 99%

A biomechanical evaluation of proximal femoral nail antirotation with respect to helical blade position in femoral head: A cadaveric study

Hwang

Garg²,

et al. 2012

IJOO

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Objective:Despite new developments in the management of osteoporotic fractures, complications like screw cutout are still found in the fixation of proximal femur fractures even with biomechanically proven better implants like proximal femoral nail antirotation (PFNA). The purpose of this cadaveric study was to investigate the biomechanical stability of this device in relation to two common positions (center-center and inferior-center) of the helical blade in the femoral head in unstable trochanteric fractures.Materials and Methods:Eight pairs of human cadaveric femurs were used; in one group [center-center (C-C) group], the helical blade of PFNA was fixed randomly in central position both in anteroposterior and lateral view, whereas in the other group it was fixed in inferior one-third position in anteroposterior and in central position in lateral view [inferior-center (I-C) group]. Unstable intertrochanteric fracture was created and each specimen was loaded cyclically till load to failureResults:Angular and rotational displacements were significantly higher within the C-C group compared to the I-C group in both unloaded and loaded condition. Loading to failure was higher in the I-C group compared to the C-C group. No statistical significance was found for this parameter. Correlations between tip apex distance, cyclic loading which lead to femoral head displacement, and ultimate load to failure showed a significant positive relationship.Conclusion:The I-C group was superior to the C-C group and provided better biomechanical stability for angular and rotational displacement. This study would be a stimulus for further experimental studies with larger number specimens and complex loading protocols at multicentres.

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“…Only 04% patient had poor range of movements. Strauss et al showed that in 49 patients treated with PFN, the walking ability and squatting ability was completely restored in almost all the cases at 6 months follow up post operatively [24] . No limp was present in 92% of patients in our series at final follow up & were able to use the stairs without any problem.…”

Section: Complicationsmentioning

confidence: 99%

Proximal femoral nail: A boon for peritrochanteric fractures

Arora¹,

Singh²,

Chaudhary³

et al. 2017

Int. J. Orthop. Sci.

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Expected age of human race has increased, leading to increase in the number of geriatric people with osteoporotic bones and falls associated with them. In 1949, Boyd and Griffin classified fractures in the trochanteric region of femur into four types. Biomechanical studies have shown that intramedullary device with sliding screw is better. Its location & rotational stability provides better load transfer and hence provides biological fixation. This was a prospective study of 25 cases of peritrochanteric fractures of femur evaluated as per Harris Hip score. In our study, 60% of the patients had excellent to good functional score with 40% of patients had fair to poor functional score due to presence of comorbidity or affected by one of the complications mentioned further. In our study, the average Harris Hip Score was 82.12 with the range of 66.5-92.5.

show abstract

Helical blade versus sliding hip screw for treatment of unstable intertrochanteric hip fractures: A biomechanical evaluation

Cited by 194 publications

References 11 publications

Does PFNA II Avoid Lateral Cortex Impingement for Unstable Peritrochanteric Fractures?

Does PFNA II Avoid Lateral Cortex Impingement for Unstable Peritrochanteric Fractures?

A biomechanical evaluation of proximal femoral nail antirotation with respect to helical blade position in femoral head: A cadaveric study

Proximal femoral nail: A boon for peritrochanteric fractures

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