Treatment of Unstable Intertrochanteric Fractures with Anatomic Reduction and Compression Hip Screw Fixation

Rao, Juluru P.; Banzon, Manuel T.; Weiss, Andrew B.; Rayhack, John M.

doi:10.1097/00003086-198305000-00011

Cited by 72 publications

(42 citation statements)

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“…Sliding of the lag screw had been impeded by the special locking-set screw in the MSP. Used in this way, the rate of technical failure of the MSP with one-way compression along the femoral shaft was much the same as the 2% to 20% reported in studies with the sliding hip screw (SHS) (Wolfgang, Bryant and O'Neill 1982;Rao et al 1983;Mainds and Newman 1989;Simpson, Varty and Dodd 1989;Bannister et al 1990;Larsson, Friberg and Hansson 1990;Leung et al 1992).…”

supporting

confidence: 56%

Two-Way Compression Along the Shaft and the Neck of the Femur With the Medoff Sliding Plate

Lunsjö¹,

Ceder²,

Stigsson

et al. 1996

The Journal of Bone and Joint Surgery. British volume

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The Medoff sliding plate (MSP) is a new device used to treat intertrochanteric and subtrochanteric fractures. There are three options for sliding; either along the shaft or the neck of the femur, or a combination of both.In a prospective series of 108 consecutive displaced intertrochanteric fractures we used combined dynamic compression. The patients were followed clinically and radiologically for one year. All fractures healed during the follow-up period. The only postoperative technical failure was one lag-screw penetration.Combined compression of the MSP gives increased dynamic capacity which reduces the risk of complications. The low rate of technical failure in our series compares favourably with that of the sliding hip screw or the Gamma nail but randomised trials comparing the MSP with other hip screw systems are necessary to find the true role of the MSP with its various sliding modes.

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supporting

confidence: 56%

Two-Way Compression Along the Shaft and the Neck of the Femur With the Medoff Sliding Plate

Lunsjö¹,

Ceder²,

Stigsson

et al. 1996

The Journal of Bone and Joint Surgery. British volume

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“…Clinical studies have consistently failed to find significant differences between implant designs with regard to lag screw cut-out [3,13,35,36]. The clinical incidence of implant-related cut-out is masked by the high variability in bone quality, frgcture pattern, quality of reduction, and implant placement.…”

Section: Introductionmentioning

confidence: 99%

Lag screws for hip fracture fixation: Evaluation of migration resistance under simulated walking

Ehmke

Fitzpatrick²,

Krieg

et al. 2005

J. Orthop. Res.

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Previous mechanical studies concerning cut-out of lag screws for pertrochanteric hip fractures have relied on static or dynamic uniaxial loading regimens to induce construct failure by varus collapse and superior cut-out. However, the hip is loaded in a multiplanar, dynamic manner during normal gait. We designed a hip implant performance simulator (HIPS) system to evaluate lag screw cut-out under multiplanar loading representative of normal gait. Five surrogate pertrochanteric fracture specimens with lag screw fixation were loaded up to 20,000 cycles using a biaxial rocking motion (BRM) gait simulation protocol. Anothpr five specimens were loaded using a standard uniaxial loading protocol. The BRM loading group exhibited combined varus collapse (5.4 ? 2.9") and backward rotation (7.2 2.8"). The uniaxial loading group exhibited four times less varus collapse (1.4 f 1.1 ") as compared to the BRM group, and only negligible rotation. For correlation of lag screw migration in surrogate specimens to that in native bone, six human cadaveric specimens were subjected to BRM loading. The degree of varus collapse (8.5 ? 7.7") and rotation (7.2 & 6.4") in cadaveric specimens were comparable to that in surrogate specimens, with the surrogate specimens showing significantly less variability. The results demonstrate that accounting for clinically realistic multiplanar loading vectors significantly affects implant migration, and therefore should be considered when evaluating the fixation strength of hip screw implants.

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“…Owing to vascular anatomy, prognostically, the two groups are very different. The intracapsular group often requires replacement of the femoral head especially when displaced [16,24], whereas the extracapsular group usually can be treated by internal fixation and the femoral head can be preserved [4,22].…”

Section: Introductionmentioning

confidence: 99%

Influence of Acetabular and Femoral Version on Fractures of the Femoral Neck

Frost

Pavlou

Richards

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Fractures through the proximal femur are broadly grouped into intertrochanteric fractures and intracapsular fractures. It is not clear why a patient may sustain an intertrochanteric fracture as compared with an intracapsular fracture. There is an established relationship between relative hip retroversion and the development of osteoarthritis. We postulate retroversion also may be a risk factor for having intracapsular fractures develop. Questions/purposes We looked specifically at the geometry of the hip to analyze the possibility of a relationship between acetabular version, femoral version, and Mckibbin's instability index and fracture type. Patients and Methods We recruited 40 patients with fractures of the femoral neck for the study. There were 15 men and 25 women with a mean age of 80 years (range, 57-92 years). There were 14 intertrochanteric fractures and 26 intracapsular fractures. After treating their fracture, the contralateral hip was scanned in a CT scanner and assessed by two independent observers to establish the acetabular and femoral version. Results We found no correlation between proximal femoral fracture type and the contralateral femoral version, femoral neck length, acetabular version, or Mckibbin's instability index or between fracture type and age or gender. Conclusions There appears to be no correlation between proximal femoral fracture type and acetabular or femoral version.

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Treatment of Unstable Intertrochanteric Fractures with Anatomic Reduction and Compression Hip Screw Fixation

Cited by 72 publications

References 0 publications

Two-Way Compression Along the Shaft and the Neck of the Femur With the Medoff Sliding Plate

Two-Way Compression Along the Shaft and the Neck of the Femur With the Medoff Sliding Plate

Lag screws for hip fracture fixation: Evaluation of migration resistance under simulated walking

Influence of Acetabular and Femoral Version on Fractures of the Femoral Neck

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