Comparison of fixation techniques in Vancouver type AG periprosthetic femoral fracture: a biomechanical study. 2016

Kerim Sarıyılmaz, and Murat Korkmaz, and Okan Özkunt, and Halil Can Gemalmaz, and Mustafa Sungur, and Murat Baydoğan, and İbrahim Kaya, and Fatih Dikici
Acıbadem University Atakent Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey. ksariyilmaz@gmail.com.

OBJECTIVE The purpose of this study was to biomechanically compare cable, trochanteric grip plate, and locking plate techniques in Vancouver type AG fracture model in an in vitro test environment. METHODS Fifteen pieces of fourth-generation synthetic femora were separated into 3 groups of 5 models each. A greater trochanteric fracture model was created after femoral stem implantation. Group 1 was fixated with only cable, Group 2 with trochanteric grip plate, and Group 3 with locking plate. Horizontal stiffness, axial stiffness, and failure loads were compared between the groups. RESULTS In horizontal compression tests, Group 3 had the highest values, but the only statistically significant difference was between the locking plate group and cable group. Axial distraction test results showed that mean stiffness of Group 1 was 94.6±9.44 N/mm, that of Group 2 was 174.8±28.64 N/mm, and that of Group 3 was 185.6±71.64 N/mm. While locking plate versus cable fixation and grip plate fixation versus cable fixation showed statistically significant differences (p<0.05), comparison of locking plate versus grip plate fixation showed no statistically significant difference (p>0.05). In axial failure load test, Group 3 had the highest results. The only significant difference was between the locking plate and cable groups (p<0.05). CONCLUSIONS In Vancouver type AG fractures stable fixation may be achieved with grip plate fixation and locking plates, with the former ensuring more stable osteosynthesis.

UI MeSH Term Description Entries
D001860 Bone Plates Implantable fracture fixation devices attached to bone fragments with screws to bridge the fracture gap and shield the fracture site from stress as bone heals. (UMDNS, 1999) Bone Plate,Plate, Bone,Plates, Bone
D001863 Bone Screws Specialized devices used in ORTHOPEDIC SURGERY to repair bone fractures. Bone Screw,Screw, Bone,Screws, Bone
D005264 Femoral Fractures Fractures of the femur. Femoral Fracture,Fracture, Femoral,Fractures, Femoral
D005269 Femur The longest and largest bone of the skeleton, it is situated between the hip and the knee. Trochanter,Greater Trochanter,Lesser Trochanter,Femurs,Greater Trochanters,Lesser Trochanters,Trochanter, Greater,Trochanter, Lesser,Trochanters,Trochanters, Greater,Trochanters, Lesser
D005593 Fracture Fixation, Internal The use of internal devices (metal plates, nails, rods, etc.) to hold the position of a fracture in proper alignment. Osteosynthesis, Fracture,Fixation, Internal Fracture,Fixations, Internal Fracture,Fracture Fixations, Internal,Fracture Osteosyntheses,Fracture Osteosynthesis,Internal Fracture Fixation,Internal Fracture Fixations,Osteosyntheses, Fracture
D006622 Hip Prosthesis Replacement for a hip joint. Femoral Head Prosthesis,Femoral Head Prostheses,Hip Prostheses,Prostheses, Femoral Head,Prostheses, Hip,Prosthesis, Femoral Head,Prosthesis, Hip
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001696 Biomechanical Phenomena The properties, processes, and behavior of biological systems under the action of mechanical forces. Biomechanics,Kinematics,Biomechanic Phenomena,Mechanobiological Phenomena,Biomechanic,Biomechanic Phenomenas,Phenomena, Biomechanic,Phenomena, Biomechanical,Phenomena, Mechanobiological,Phenomenas, Biomechanic
D057068 Periprosthetic Fractures Fractures around joint replacement prosthetics or implants. They can occur intraoperatively or postoperatively. Fractures, Periprosthetic,Peri-Implant Fractures,Fracture, Peri-Implant,Fracture, Periprosthetic,Fractures, Peri-Implant,Peri Implant Fractures,Peri-Implant Fracture,Periprosthetic Fracture
D019644 Arthroplasty, Replacement, Hip Replacement of the hip joint. Hip Prosthesis Implantation,Hip Replacement, Total,Total Hip Arthroplasty,Arthroplasties, Hip Replacement,Arthroplasties, Replacement, Hip,Arthroplasty, Hip Replacement,Hip Replacement Arthroplasties,Hip Replacement Arthroplasty,Replacement Arthroplasties, Hip,Replacement Arthroplasty, Hip,Replacement, Total Hip,Total Hip Replacement,Arthroplasty, Total Hip,Hip Arthroplasty, Total,Hip Prosthesis Implantations,Implantation, Hip Prosthesis,Prosthesis Implantation, Hip,Total Hip Arthroplasties,Total Hip Replacements

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