Hybrid triad provides fracture plane stability in a computational model of a Pauwels Type III hip fracture

Cordeiro, Minal; Caskey, Sean; Frank, C.; Martin, Sidney; Srivastava, Amit; Atkinson, Theresa

doi:10.1080/10255842.2020.1738404

Cited by 10 publications

(4 citation statements)

References 33 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: 51%

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: 51%

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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“…Poor stability and low compression in the site of fracture have been related to a higher rate of late consolidation, non-union, and chronic pain in multiple scenarios [ 20 , 21 ]. Sufficient compression is important to achieve optimal stabilization of the fracture, and lag screws allow for maximum compression on the direct surface of the bone [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Salvaging Pull-Out Strength in a Previously Stripped Screw Site: A Comparison of Three Rescue Techniques

Addevico

Solitro

Morandi

2021

JFMK

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Screw stripping during bone fixation is a common occurrence during operations that results in decreased holding capacity and bone healing. We aimed to evaluate the rescue of the stripped screw site using screws of different dimensions. Five screw configurations were tested on cadaveric specimens for pull-out strength (POS). The configurations included a control screw tightened without stripping, a configuration voluntarily stripped and left in place, and three more configurations in which the stripped screws were replaced by a different screw with either increased overall length, diameter, or thread length. Each configuration was tested five times, with each screw tested once. The POS of the control screw, measured to be 153.6 ± 27 N, was higher than the POS measured after stripping and leaving the screw in place (57.1 ± 18 N, p = 0.001). The replacement of the stripped screw resulted in a POS of 158.4 ± 64 N for the screw of larger diameter, while the screws of the same diameter but increased length or those with extended thread length yielded POS values of 138.4 ± 42 and 185.7 ± 48 N, respectively. Screw stripping is a frequent intraoperative complication that, according to our findings, cannot be addressed by leaving the screw in place. The holding capacity of a stripped screw implanted in cancellous bone can successfully be restored with a different screw of either larger diameter, longer length, or extended thread length.

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“…For DHS+DS, we used values for titanium, which has Young's modulus ( E ) of 110,000 MPa and Poisson's ratio of 0.3 [ 23 , 24 ]. Bone resorption at the fracture site was modeled by creating a 1 mm wide gap along the fracture plane [ 25 , 26 ]. A load of 2100 N was applied above the femoral head.…”

Section: Methodsmentioning

confidence: 99%

Clinical Outcome and Biomechanical Analysis of Dynamic Hip Screw Combined with Derotation Screw in Treating Displaced Femoral Neck Fractures Based on Different Reduction Qualities in Young Patients (≤65 Years of Age)

Zhu

Zhang

et al. 2022

BioMed Research International

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Objective. To examine the clinical results and biomechanical mechanism of the dynamic hip screw (DHS) and derotation screw (DS) in the treatment of displaced femoral neck fractures (FNF) based on different reduction qualities in young patients (≤65 years of age). Methods. All patients with FNF who received closed reduction and internal fixation with DHS+DS from January 2014 to August 2019 were retrospectively analyzed. Data on demographics, surgery, clinical outcomes, and postoperative complications were collected. According to the reduction quality immediately after surgery, all patients were categorized into the positive buttress reduction group (PBRG) and the anatomical reduction group (ARG). The complications and clinical outcomes were compared between the two groups. Meanwhile, the biomechanical mechanism of different reduction qualities was further analyzed with finite element analysis (FEA). The distribution of von Mises stress, the peak stress of internal fixation, and the displacement of the proximal fragment were compared between the two groups. Results. A total of 68 patients were included in our study. Among them, 31 were divided into the PBRG while 37 were in the ARG. The surgical time and fluoroscopy time were significantly shorter in the PBRG than in the ARG ( p < 0.05 ). The degree of femoral neck shortening and the varus change of the femoral-neck shaft angle were lower in the PBRG compared to the ARG ( p < 0.05 ). The excellent-good rate of the Harris hip score was higher in the PBRG compared to the ARG (83.9% vs. 64.8%). The FEA results demonstrated that the stress of DHS+CS and the downward displacement of the proximal femoral neck fragment were greater in the ARG than in the PBRG. Conclusion. For displaced FNF with difficulty to achieve reduction, DHS+CS combined with positive buttress reduction was an effective treatment in young patients due to better mechanical support, shorter surgical time, less radiation exposure, and higher excellent-good rate of Harris hip score.

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Hybrid triad provides fracture plane stability in a computational model of a Pauwels Type III hip fracture

Cited by 10 publications

References 33 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

Salvaging Pull-Out Strength in a Previously Stripped Screw Site: A Comparison of Three Rescue Techniques

Clinical Outcome and Biomechanical Analysis of Dynamic Hip Screw Combined with Derotation Screw in Treating Displaced Femoral Neck Fractures Based on Different Reduction Qualities in Young Patients (≤65 Years of Age)

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