Biomechanical Analysis of Fixation Devices for Basicervical Femoral Neck Fractures. 2019

Joseph Johnson, and Matthew Deren, and Alison Chambers, and Dale Cassidy, and Sarath Koruprolu, and Christopher Born
From the Department of Orthopaedic Surgery, Loma Linda University, Loma Linda, CA (Dr. Johnson), and the Department of Orthopedic Surgery, Brown University, Providence, RI (Dr. Deren, Dr. Chambers, Mr. Koruprolu, and Dr. Born), and Colorado Springs Orthopedic Group, Colorado Springs, CO (Dr. Cassidy).

BACKGROUND Basicervical femoral neck fractures are challenging fractures in geriatric populations. The goal of this study was to determine whether compression hip screw (CHS) constructs are superior to cephalomedullary constructs for the treatment of basicervical femoral neck fractures. METHODS Thirty cadaver femurs were osteotomized and received a CHS with derotation screw, a long cephalomedullary nail (long Gamma nail), or a short cephalomedullary nail (short Gamma nail). All constructs were loaded dynamically in compression until dynamic failure. RESULTS All failed CHS constructs demonstrated superior femoral head cutout. In the long Gamma nail and short Gamma nail groups, constructs failed by nail cutout through the medial wall of the trochanter or rotationally. Normalized fluoroscopic distance was found to increase markedly with an increasing cycle count when considering all treatment groups. CONCLUSIONS Given our results and those of previous studies, we could not determine superiority of one implant and recommend that surgeons select fixation constructs based on the individual patient's anatomy and the surgeon's comfort with the implant.

UI MeSH Term Description Entries
D001858 Bone Nails Rods of bone, metal, or other material used for fixation of the fragments or ends of fractured bones. Bone Pins,Bone Nail,Bone Pin,Nail, Bone,Nails, Bone,Pin, Bone,Pins, Bone
D001863 Bone Screws Specialized devices used in ORTHOPEDIC SURGERY to repair bone fractures. Bone Screw,Screw, Bone,Screws, Bone
D002102 Cadaver A dead body, usually a human body. Corpse,Cadavers,Corpses
D005260 Female Females
D005265 Femoral Neck Fractures Fractures of the short, constricted portion of the thigh bone between the femur head and the trochanters. It excludes intertrochanteric fractures which are HIP FRACTURES. Femur Neck Fractures,Femoral Neck Fracture,Femur Neck Fracture
D005471 Fluoroscopy Production of an image when x-rays strike a fluorescent screen. Fluoroscopies
D005548 Foreign-Body Migration Migration of a foreign body from its original location to some other location in the body. Foreign Body Migration,Foreign-Body Migrations,Migration, Foreign-Body,Migrations, Foreign-Body
D005594 Fracture Fixation, Intramedullary The use of nails that are inserted into bone cavities in order to keep fractured bones together. Intramedullary Nailing,Nailing, Intramedullary,Osteosynthesis, Fracture, Intramedullary,Fixation, Intramedullary Fracture,Fixations, Intramedullary Fracture,Fracture Fixations, Intramedullary,Intramedullary Fracture Fixation,Intramedullary Fracture Fixations,Intramedullary Nailings,Nailings, Intramedullary
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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