Biomechanical evaluation of peri- and interprosthetic fractures of the femur.
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Biomechanical evaluation of peri- and interprosthetic fractures of the femur. / Lehmann, Wolfgang; Rupprecht, Martin; Hellmers, Nils; Sellenschloh, Kai; Briem, Daniel; Püschel, Klaus; Amling, Michael; Morlock, Michael; Rueger, Johannes Maria.
in: J TRAUMA, Jahrgang 68, Nr. 6, 6, 2010, S. 1459-1463.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Biomechanical evaluation of peri- and interprosthetic fractures of the femur.
AU - Lehmann, Wolfgang
AU - Rupprecht, Martin
AU - Hellmers, Nils
AU - Sellenschloh, Kai
AU - Briem, Daniel
AU - Püschel, Klaus
AU - Amling, Michael
AU - Morlock, Michael
AU - Rueger, Johannes Maria
PY - 2010
Y1 - 2010
N2 - BACKGROUND:: Because of an increasing life expectancy of patients and the rising number of joint replacements, peri- and interprosthetic femoral fractures are a common occurrence in most trauma centers. This study was designed to answer two primary questions. First, whether the fracture risk increases with two intramedullary implants in one femur; and second, whether a compression plate osteosynthesis is sufficient for stabilizing an interprosthetic fracture. METHODS:: Twenty-four human cadaveric femurs were harvested and four groups were matched based on the basis of bone density using a peripher quantitative computer tomography (pQCT). All groups-(I) hip prosthesis with a cemented femoral stem; (II) hip prosthesis and retrograde femoral nail; (III) hip prosthesis, retrograde femoral nail, and lateral compression plate; (IV) all three implants with an additional simulated interprosthetic fracture-were biomechanically tested in a four-point bending in lateral-medial direction. RESULTS:: The second group with two intramedullary implants exhibited 20% lower fracture strength in comparison with group 1 with proximal femoral stem only. The stabilization of an interprosthetic fracture with a lateral compression plate (group IV) resulted in a fracture strength similar to femur with prosthesis only. CONCLUSION:: Two intramedullary implants reduce the fracture strength significantly. If an interprosthetic fracture occurs, sufficient stability can be achieved by a lateral compression plate. Because two intramedullary implants in the femur may decrease the fracture strength, the treatment of supracondylar femoral fractures with a retrograde nail in cases with preexisting ipsilateral hip prosthesis should be reconsidered.
AB - BACKGROUND:: Because of an increasing life expectancy of patients and the rising number of joint replacements, peri- and interprosthetic femoral fractures are a common occurrence in most trauma centers. This study was designed to answer two primary questions. First, whether the fracture risk increases with two intramedullary implants in one femur; and second, whether a compression plate osteosynthesis is sufficient for stabilizing an interprosthetic fracture. METHODS:: Twenty-four human cadaveric femurs were harvested and four groups were matched based on the basis of bone density using a peripher quantitative computer tomography (pQCT). All groups-(I) hip prosthesis with a cemented femoral stem; (II) hip prosthesis and retrograde femoral nail; (III) hip prosthesis, retrograde femoral nail, and lateral compression plate; (IV) all three implants with an additional simulated interprosthetic fracture-were biomechanically tested in a four-point bending in lateral-medial direction. RESULTS:: The second group with two intramedullary implants exhibited 20% lower fracture strength in comparison with group 1 with proximal femoral stem only. The stabilization of an interprosthetic fracture with a lateral compression plate (group IV) resulted in a fracture strength similar to femur with prosthesis only. CONCLUSION:: Two intramedullary implants reduce the fracture strength significantly. If an interprosthetic fracture occurs, sufficient stability can be achieved by a lateral compression plate. Because two intramedullary implants in the femur may decrease the fracture strength, the treatment of supracondylar femoral fractures with a retrograde nail in cases with preexisting ipsilateral hip prosthesis should be reconsidered.
M3 - SCORING: Zeitschriftenaufsatz
VL - 68
SP - 1459
EP - 1463
IS - 6
M1 - 6
ER -