What is the risk of stress risers for interprosthetic fractures of the femur? A biomechanical analysis

Lehmann, Wolfgang; Rupprecht, Martin; Nuechtern, Jacob; Melzner, Daniel; Sellenschloh, Kay; Kolb, Jan Philipp; Fensky, Florian; Hoffmann, Michael; Püschel, Klaus; Morlock, Michael M.; Rueger, Johannes M.

doi:10.1007/s00264-012-1697-0

Cited by 62 publications

(24 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Numerous biomechanical studies investigated different techniques of periprosthetic fracture fixation [7][8][9][10][11][12], although as yet, not all types of these fractures or fixation methods have been comprehensively evaluated and new tools for fixation are on the way.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical comparison of two angular stable plate constructions for periprosthetic femur fracture fixation

Wähnert

Schröder

Schulze

et al. 2013

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose Fractures of the femur associated with total hip arthroplasty are a significant concern in orthopaedic and trauma surgery. However, little is known about the different biomechanical properties of internal fixation systems in combination with periprosthetic fractures. In this study two new internal fixation systems for periprosthetic fractures are investigated using a cadaver fracture model simulating a Vancouver B1 periprosthetic femur fracture. Methods Nine pairs of fresh-frozen cadaver femurs were scanned by dual X-ray absorptiometry. Cementless total hip prostheses were implanted and a periprosthetic femur fracture was simulated. Fractures were randomly fixed either with the fixed angle locking attachment plate (LAP®, Depuy Synthes®, Solothurn, Switzerland) or the variable angle noncontact bridging plate (NCB®, Zimmer GmbH, Winterthur, Switzerland). Each construct was cyclically loaded to failure in axial compression. Results Axial stiffness and cycles to failure were significantly higher in the NCB group. Both systems were able to be fixed well around the femoral stem. Conclusion The two different internal fixation systems for periprosthetic fractures differed significantly in our setup. The non-contact bridging plate system revealed significantly higher failure load and may be the preferred option where high stability and load capacity is needed right after operation.

show abstract

Section: Introductionmentioning

confidence: 99%

Biomechanical comparison of two angular stable plate constructions for periprosthetic femur fracture fixation

Wähnert

Schröder

Schulze

et al. 2013

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…Many studies report the occurrence of discomfort due to implant, which can affect activity of daily living in around 10–40% patients [12, 13, 19–25]. These kinds of discomfort can lead to implant removal.…”

Section: Discussionmentioning

confidence: 99%

“…Although implant removal in proximal femur fractures is debated and there are many reports on the disadvantages of the inserted implant in view of biomechanics, certain situations such as discomfort during activities of daily living, painful hardware, metal allergy, carcinogenicity, and metal detection demand implant removal following the union of fractures [12–14]. Surgeons should get prepared for the implant removal and anticipate implant specific complications, because bone defects caused by intra- and extramedullary fixation devices vary in locations, sizes, and numbers.…”

Section: Introductionmentioning

confidence: 99%

The Analysis of Biomechanical Properties of Proximal Femur after Implant Removal

Yang

Jung

Honnurappa

et al. 2016

Applied Bionics and Biomechanics

View full text Add to dashboard Cite

Introduction. To compare the biomechanical stability of the femur following the removal of proximal femoral nail antirotation (PFNA-II) and dynamic hip screw (DHS). Material and Methods. 56 paired cadaveric femurs were used as experimental and control groups. In the experimental group, PFNA-II and DHS were randomly inserted into femurs on both sides and then removed. Thereafter, compression load was applied until fracture occurred; biomechanical stability of the femurs and associated fracture patterns were studied. Results. The ultimate load and stiffness of the control group were 6227.8 ± 1694.1 N and 990.5 ± 99.8 N/mm, respectively. These were significantly higher than experimental group (p = 0.014, <0.001) following the removal of PFNA-II (4085.6 ± 1628.03 N and 656.3 ± 155.3 N/mm) and DHS (4001.9 ± 1588.3 N and 656.3 ± 155.3 N/mm). No statistical differences in these values were found between the 2 device groups (p = 0.84, 0.71), regardless of age groups. However, fracture patterns were different between two devices, intertrochanteric and subtrochanteric fractures. Conclusions. Mechanical stability of the proximal femurs does not differ after the removal of 2 different of fixation devices regardless of the age. However, it was significantly lower compared to an intact femur. Different fracture patterns have been shown following the removal of different fixation devices as there are variations in the site of stress risers for individual implants.

show abstract

“…In presence of an intramedullary implant, one must bridge it to avoid stress fracture on a weak spot [31] and must be bridged by the length of two diaphyseal diameters [11]. It has been proven that osteosynthesesis of a PPF on a THA when a retrograde nail is used is at great risk of fracture between the implants [31], emphasising once again the need for locking plates in patients with these indications.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive surgery with locking plate for periprosthetic femoral fractures: technical note

Ehlinger

Scheibling

Rahmé

et al. 2015

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

What is the risk of stress risers for interprosthetic fractures of the femur? A biomechanical analysis

Cited by 62 publications

References 14 publications

Biomechanical comparison of two angular stable plate constructions for periprosthetic femur fracture fixation

Biomechanical comparison of two angular stable plate constructions for periprosthetic femur fracture fixation

The Analysis of Biomechanical Properties of Proximal Femur after Implant Removal

Minimally invasive surgery with locking plate for periprosthetic femoral fractures: technical note

Contact Info

Product

Resources

About