Proximal femoral fractures: a biomechanical study to compare intramedullary and extramedullary fixation

Curtis, Mark J.; Jinnah, Riyaz H.; Wilson, Valerie D.; Cunningham, Brian

doi:10.1016/0020-1383(94)90111-2

Cited by 178 publications

(96 citation statements)

References 26 publications

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“…The mean number of radiation exposures was 12 (range, [8][9][10][11][12][13][14][15][16]. The mean time to full weight bearing was 11 (range, [8][9][10][11][12][13][14][15][16][17][18][19] weeks. The mean follow-up period was 25 (range, 18-30) months.…”

Section: Resultsmentioning

confidence: 99%

“…8 Intramedullary fixation is biomechanically superior to extramedullary fixation. 3,10 Functional evaluation showed no significant difference in pain, range of movement, or walking ability, but recovery was significantly earlier in patients with the Gamma nail than the DCS. 26 Good results have been reported in elderly patients after intramedullary fixation.…”

Section: Discussionmentioning

confidence: 96%

“…7 Intramedullary devices require less surgical exposure, enable early weight bearing, achieve better proximal fixation, and exert less biomechanical stresses (as the lever arm is moved medially). [9][10][11] However, they are not suitable for subtrochanteric fractures with intertrochanteric extension and are associated with technical difficulties in up to 63% of cases. 12,13 Reconstruction nailing is technically demanding; plate and screw fixation is probably the best option.…”

Section: Introductionmentioning

confidence: 99%

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Mini-Incision Dynamic Condylar Screw Fixation for Comminuted Subtrochanteric Hip Fractures

Rohilla

Singh

Magu

et al. 2008

J Orthop Surg (Hong Kong)

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Purpose. To review the results of indirect reduction and mini-incision dynamic condylar screw (DCS) fixation for comminuted subtrochanteric femoral fractures. Methods. 29 men and 14 women aged 25 to 65 (mean, 44) years with comminuted subtrochanteric femoral fractures underwent indirect reduction and mini-incision DCS fixation. Fractures were classified according to the AO classification (10 type 32B and 33 type 32C) and Seinsheimer classification (6 type III, 15 type IV, and 22 type V). Functional outcomes were assessed using the Harris hip score and Merle d'Aubigne score. Results. The mean time to full weight bearing was 11 (range, 8-19) weeks. The mean time to union was 16 (range, 13-22) weeks. There were no cases of non-union or implant failure after a mean follow-up period of 25 (range, 18-30) months. Seven patients had a mean limb length discrepancy of 1.5 (range, 1-2) cm. Two patients had coxa vara and persistent limp. Conclusion.Results of indirect reduction and miniincision DCS fixation for comminuted subtrochanteric femoral fractures are favourable. Proper planning and execution of the technique is required to achieve good functional outcomes and avoid complications. Preservation of vascularity of the medial fragments leads to rapid callus formation and early union and hence avoids implant failure and secondary bone grafting.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Mini-Incision Dynamic Condylar Screw Fixation for Comminuted Subtrochanteric Hip Fractures

Rohilla

Singh

Magu

et al. 2008

J Orthop Surg (Hong Kong)

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“…curvature and on the nail tip in contact with the lateral cortex, thus exposing the femur to intra operative and post operative fractures, even under physiologic loads [18]. Moreover, the high implant stiffness also results in a stress rising effect at the nail tip [19].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Functional and Clinical Outcome of Intramedullary Osteosynthesis with Gamma Nail in Treatment of Unstable Peritrochanteric Fractures

Alshareef¹

2017

Clin Med Rev Case Rep

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Background: Peritrochanteric fractures of the femur rank among the most severe fractures in elderly people. The Gamma Nail is one of the latest advance in the treatment of trochanteric fractures based on intramedullary nailing principles during closed procedures. This paper is made to assess the efficacy of closed intramedullary osteosynthesis with a gamma nail in the treatment of peritrochanteric fractures depending on the type of fracture and patient age.

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“…Today, the principle used is one of relative stability through intra and extramedullary implants, represented by sliding pin plates and intramedullary nails (7)(8)(9)(10)(11) . Among sliding screw systems, the biggest representative is the implant known as the dynamic hip screw (DHS)®, which is considered to be the gold standard (4,5,9) for treatment of these fractures.…”

Section: Introductionmentioning

confidence: 99%

Sistema MINUS® - técnica minimamente invasiva para o tratamento das fraturas transtrocanterianas do fêmur

Sawaia¹,

Belangero²

2012

Rev. bras. ortop.

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The authors declare that there was no conflict of interest in conducting this work ABSTRACTThe MINUS system was developed as a minimally invasive procedure that uses a diaphyseal cephalic extramedullary implant for the treatment of transtrochanteral fractures of the femur in elderly patients. The implant consists of a sliding screw coupled to a plate adapted to the minimally invasive technique. The surgical access is approximately three centimeters in length located on the lateral surface of the hip, below the projection of the small trochanter. A perfectly adapted instrument was used for the procedure, which also requires the use of an image intensifier, reducing surgery time and rate of bleeding. The objective of this study is to present a new instrument and implant, developed specifically for treatment with the minimally invasive technique, reducing the length of the conventional surgical access from 10 to three centimetres. This new implant was given the commercial name of MI-NUS System.

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Proximal femoral fractures: a biomechanical study to compare intramedullary and extramedullary fixation

Cited by 178 publications

References 26 publications

Mini-Incision Dynamic Condylar Screw Fixation for Comminuted Subtrochanteric Hip Fractures

Mini-Incision Dynamic Condylar Screw Fixation for Comminuted Subtrochanteric Hip Fractures

Evaluation of the Functional and Clinical Outcome of Intramedullary Osteosynthesis with Gamma Nail in Treatment of Unstable Peritrochanteric Fractures

Sistema MINUS® - técnica minimamente invasiva para o tratamento das fraturas transtrocanterianas do fêmur

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