Biomechanical comparison of screw vs. cerclage refixation in orthogeriatric lesser trochanteric fractures: a cadaveric study.
Biomechanic stability
Cerclage
DHS
Refixation lesser trochanter
Screw
Journal
European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
15
02
2022
accepted:
19
09
2022
pubmed:
29
9
2022
medline:
16
2
2023
entrez:
28
9
2022
Statut:
ppublish
Résumé
Osteoporosis-related proximal femur fractures continue to increase significantly due to demographic change. This study was designed to evaluate the biomechanical stability of two different fixation methods (cerclage vs. screw) for refixation of a trochanter minor fragment in the pertrochanteric fractures in cadaveric bones. Artificial bones (n = 14) and human bones (n = 16) were treated with a DHS and the trochanter minor fragment was reduced by cerclage wiring or direct screw fixation. After preloading the simulated iliopsoas with 10 N, a tensile test was performed, ending with either a 70% loss of strength or avulsion of the fragment. The mean values of the avulsion force and the surface strain were recorded. All tensile tests showed no significant differences between refixation using a direct screw or wire cerclage, for both artificial bones and human specimens. Absolute values showed higher avulsion forces after direct screw fixation than refixation with a wire cerclage. The surface tension of specimens treated with direct screw fixation was lower than that of specimens treated with wire cerclage. An opposite effect was seen in artificial bones. Both effects were not statistically significant. Based on the equal stability after lag screw placement compared to cerclage wiring, we promote the placement of a lag screw into the lesser trochanter fragment in pertrochanteric femur fractures when using a dynamic hip screw. Level III.
Identifiants
pubmed: 36167986
doi: 10.1007/s00068-022-02116-5
pii: 10.1007/s00068-022-02116-5
pmc: PMC9925468
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
181-188Subventions
Organisme : FöFoLe-Grant, LMU Munich
ID : no. 1043
Informations de copyright
© 2022. The Author(s).
Références
BMC Musculoskelet Disord. 2015 Mar 05;16:47
pubmed: 25879412
Arch Orthop Trauma Surg. 2015 Jun;135(6):811-8
pubmed: 25840887
Orthop Traumatol Surg Res. 2013 Jun;99(4):377-83
pubmed: 23707739
Injury. 2020 Aug;51(8):1763-1768
pubmed: 32580889
Int J Surg. 2017 Jul;43:67-74
pubmed: 28549994
Clin Orthop Relat Res. 1989 Sep;(246):156-64
pubmed: 2766604
Clin Biomech (Bristol, Avon). 2017 Feb;42:31-37
pubmed: 28073094
Osteoporos Int. 2012 Sep;23(9):2239-56
pubmed: 22419370
Biomed Res Int. 2020 Aug 18;2020:1896935
pubmed: 32923477
Eur J Trauma Emerg Surg. 2015 Oct;41(5):523-9
pubmed: 26038002
Osteoporos Int. 2008 Aug;19(8):1139-45
pubmed: 18087659
J Bone Joint Surg Am. 2009 Mar 1;91(3):712-9
pubmed: 19255235
Injury. 2018 Dec;49(12):2209-2215
pubmed: 30366830
Injury. 2017 Feb;48(2):406-413
pubmed: 27887702
Chirurg. 2008 Jun;79(6):595-611; quiz 612
pubmed: 18523744
Unfallchirurg. 2005 May;108(5):387-399; quiz 400
pubmed: 15864509
Clin Geriatr Med. 2014 May;30(2):175-81
pubmed: 24721358
Orthopedics. 2014 Mar;37(3):151-7
pubmed: 24762143
Bone. 2018 Sep;114:116-124
pubmed: 29885926
J Orthop Surg Res. 2017 Dec 28;12(1):197
pubmed: 29282138
Clin Biomech (Bristol, Avon). 2012 Dec;27(10):1006-10
pubmed: 22884619
Unfallchirurg. 2011 Jun;114(6):485-90
pubmed: 21584705
Chirurg. 2005 Jan;76(1):10-8
pubmed: 15551009
J Orthop Sci. 2013 Nov;18(6):977-86
pubmed: 24085380
Eur J Orthop Surg Traumatol. 2013 May;23(4):371-7
pubmed: 23412289
Arch Orthop Trauma Surg. 2019 Apr;139(4):537-545
pubmed: 30535582
Acta Orthop Scand. 2003 Aug;74(4):500-1
pubmed: 14521306
World J Orthop. 2019 Mar 18;10(3):166-175
pubmed: 30918799