Increased stability by a novel femoral neck interlocking plate compared to conventional fixation methods. A biomechanical study in synthetic bone.
Biomechanics
Composite bone
Femoral neck fracture
Internal fixation
Locking plate
Journal
Clinical biomechanics (Bristol, Avon)
ISSN: 1879-1271
Titre abrégé: Clin Biomech (Bristol, Avon)
Pays: England
ID NLM: 8611877
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
07
11
2019
revised:
12
02
2020
accepted:
15
03
2020
pubmed:
18
5
2020
medline:
20
2
2021
entrez:
17
5
2020
Statut:
ppublish
Résumé
Stable fixation promotes union in the common femoral neck fractures, but high non-union rates due to fixation failure remain with traditional fixations. To enhance stability, a plate interlocking pins, but without further fixation to femur has been developed. To our knowledge, no comparison to other conventional fixation methods has been performed. We tested the hypothesis that the novel implant biomechanically leads to a more stable femoral neck fixation. Fifty synthetic femurs with a cervical wedge osteotomy were allocated to intervention with three hook-pins interlocked in a plate (Hansson Pinloc® System) or standard fixations with a two-hole Dynamic Hip Screw® plate with an anti-rotational screw, three cannulated screws (ASNIS® III) or two screws (Olmed® or Cannulated Hip Screws®). Quasi-static non-destructive torsion around the neck, anteroposterior bending and vertical compression were tested to detect stiffness. The specimen's deformation was evaluated after cyclic compression simulating weight-bearing. Local deformation of implant channels was measured. Fixation failure was defined by fissure formation. Compared to the conventional implants all together, the interlocked pins enhanced mean stiffness 130% in torsion and 33% in bending (P < 0.001), while compressive stability was increased by a reduced deformation of 62% in average of the global test specimen and 95% decreased local implant channel deformation after cycling (P < 0.001). In comparisons with each of the standard fixations the interlocking pins revealed no signs of adverse effects. The novel femoral neck interlocking plate allowed dynamic compression and improved multi-directional stability compared to the traditional fixations.
Sections du résumé
BACKGROUND
Stable fixation promotes union in the common femoral neck fractures, but high non-union rates due to fixation failure remain with traditional fixations. To enhance stability, a plate interlocking pins, but without further fixation to femur has been developed. To our knowledge, no comparison to other conventional fixation methods has been performed. We tested the hypothesis that the novel implant biomechanically leads to a more stable femoral neck fixation.
METHODS
Fifty synthetic femurs with a cervical wedge osteotomy were allocated to intervention with three hook-pins interlocked in a plate (Hansson Pinloc® System) or standard fixations with a two-hole Dynamic Hip Screw® plate with an anti-rotational screw, three cannulated screws (ASNIS® III) or two screws (Olmed® or Cannulated Hip Screws®). Quasi-static non-destructive torsion around the neck, anteroposterior bending and vertical compression were tested to detect stiffness. The specimen's deformation was evaluated after cyclic compression simulating weight-bearing. Local deformation of implant channels was measured. Fixation failure was defined by fissure formation.
FINDINGS
Compared to the conventional implants all together, the interlocked pins enhanced mean stiffness 130% in torsion and 33% in bending (P < 0.001), while compressive stability was increased by a reduced deformation of 62% in average of the global test specimen and 95% decreased local implant channel deformation after cycling (P < 0.001). In comparisons with each of the standard fixations the interlocking pins revealed no signs of adverse effects.
INTERPRETATION
The novel femoral neck interlocking plate allowed dynamic compression and improved multi-directional stability compared to the traditional fixations.
Identifiants
pubmed: 32416403
pii: S0268-0033(20)30104-2
doi: 10.1016/j.clinbiomech.2020.104995
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
104995Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest All authors declare no conflict of interest.