Clinical and Biomechanical Effects of Femoral Neck Buttress Plate Used for Vertical Femoral Neck Fractures

Injury ◽  
2021 ◽  
Author(s):  
Andrew Steffensmeier ◽  
Nihar Shah ◽  
Michael Archdeacon ◽  
David Watson ◽  
Roy W Sanders ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fractures ◽  
Buttress Plate

scholarly journals The Role of Medial Buttress Plate Augmentation of Cannulated Screws in Unstable Femoral Neck Fractures: A Pilot Study

2021 ◽  
Author(s):  
Sayyed Hadi Sayyed Hoseinian ◽  
Ali Birjandi Nejad ◽  
Farshid Bagheri ◽  
Mohammad Taghi Peivandi ◽  
Ehsan Vahedi ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Reoperation Rate ◽  
Deep Infection ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Cannulated Screws ◽  
Vein Thrombosis ◽  
Buttress Plate

Background: About 20% of femoral neck fracture surgeries require re-operation. The use of medial buttress plate may reduce the reoperation rate. The purpose of this study is to examine the results of using the method of augmentation of the cannulated screws with medial buttress plate for treatment of unstable femoral neck fractures. Methods: This study included patients with femoral neck fractures of Pauwels type 2 and 3 in which closed reduction was not successful. The patients underwent open anatomical reduction and implantation of three screws, and then the medial placement of the buttress plate was performed. Patients were followed up after 2 weeks, 6 weeks, 3 months, and 6 months. Union and fracture healing and operative complications were assessed using plain radiography. Results: This study included 8 patients with Pauwels type 2 and 3 femoral neck fractures. All patients were men with the mean age of 38.0 ± 11.3 years. Re-hospitalization 30 days after surgery, surgical site infection, deep vein thrombosis (DVT), and deep infection were not observed in any of the patients. The angle between the neck and the femur shaft dramatically increased during the 6-month follow-up (P = 0.049). Union occurred in 6 (75%) patients after 6 months, while 2 patients were lost to follow up. Participants’ Harris Hip Score (HHS) had a significant improvement from 3 months to 6 months after surgery (P = 0.02). Conclusion: Augmentation of cannulated screws with medial buttress plate for unstable femoral neck fractures in patients has advantages in short-term clinical follow-up.

scholarly journals Biomechanical analysis of two medial buttress plate fixation methods to treat Pauwels type III femoral neck fractures

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Jichao Liu ◽  
Zhengwei Li ◽  
Jie Ding ◽  
Bingzhe Huang ◽  
Chengdong Piao
Keyword(s):  
Femoral Neck ◽  
Plate Fixation ◽  
Femoral Neck Fractures ◽  
Biomechanical Analysis ◽  
Axial Stiffness ◽  
Cannulated Screws ◽  
Fracture Fragment ◽  
Fixation Methods ◽  
Type Iii ◽  
Buttress Plate

Abstract Background Femoral neck fractures in young people are usually Pauwels Type III fractures. The common treatment method are multiple parallel cannulated screws or dynamic hip screw sliding compression fixation. Due to the huge shear stress, the rate of complications such as femoral head necrosis and nonunion is still high after treatment. The aim of our study was to compare the stabilities of two fixation methods in fixating pauwels type III femoral neck fractures. Methods All biomimetic fracture samples are fixed with three cannulated screws combined with a medial buttress plate. There were two fixation groups for the buttress plate and proximal fracture fragment: Group A, long screw (40 mm); Group B, short screw (6 mm). Samples were subjected to electrical strain measurement under a load of 500 N, axial stiffness was measured, and then the samples were axially loaded until failure. More than 5 mm of displacement or synthetic bone fracture was considered as construct failure. Results There were no significant differences in failure load (P = 0.669), stiffness (P = 0.842), or strain distribution (P > 0.05) between the two groups. Conclusions Unicortical short screws can provide the same stability as long screws for Pauwels Type III Femoral Neck Fractures.

scholarly journals Influence of the proximal screws of buttress plates on the stability of vertical femoral neck fractures: a finite element analysis

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Shi Zhan ◽  
Dajun Jiang ◽  
Jian Xu ◽  
Ming Ling ◽  
Kai Yang ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Femoral Neck ◽  
Biomechanical Properties ◽  
Femoral Neck Fractures ◽  
Cannulated Screws ◽  
Element Analysis ◽  
Proximal Screw ◽  
Buttress Plate ◽  
Plate System

Abstract Background The treatment of vertical femoral neck fractures (vFNFs) in young patients remains challenging, with a high complication rate by using traditional techniques. The use of cannulated screws (CSs) combined with a buttress plate represents an alternative approach for treating vFNFs. However, the biomechanical influence of the use or non-use of the proximal screws of buttress plates on vFNFs stability remains unclear. This study aims to analyse the biomechanics of buttress plate fixation with or without the use of proximal screws through finite element analysis (FEA) to further understand this approach. Methods We built five vFNFs (Pauwels angle 70°) finite element models treated using three cannulated screws (CS group) or three cannulated screws plus a locking buttress plate (buttress group). In the buttress group, use or non-use of proximal screws was carried out on two types of plates (4-hole & 6-hole). The following seven parameters were analysed to compare biomechanical properties of the five models: the stiffness; the maximal stress of the plate system (plate and screws), CSs and bone (MPS, MCS, MBS); the maximal displacement of internal fixations (plate system & CSs) and bone (MIFD, MBD); and the maximal relative displacement of interfragments (MID). Results Compared with CS model, the buttress models exhibited improved biomechanical properties, with increased stiffness and decreased MCS, MBS, MIFD, MBD and MID. The models fixed using buttress plates combined with a proximal screw showed greater stiffness (+ 3.75% & + 8.31% vs + 0.98% & + 4.57%) and MPS (795.6 & 947.2 MPa vs 294.9 & 556.2 MPa) values, and smaller MCS, MBS, MIFD, MBD and MID (− 3.41% to − 15.35% vs − 0.07% to − 4.32%) values than those using the same length plates without a proximal screw. Conclusions Based on the FEA results, buttress plates can improve construct mechanics, help to resist shear force and prevent varus collapse; under the modelling conditions, the use of a proximal screw on buttress plate may be a key technical feature in improving anti-shearing ability; additionally, this screw may be essential to reduce stress and prevent re-displacement of cannulated screws and fracture fragments.

HIP FRACTURES IN 5 YEARS AT HUE UNIVERSITY HOSPITAL

2014 ◽  
pp. 47-50
Author(s):  
Duy Binh Ho ◽  
Nghi Thanh Nhan Le ◽  
Maasalu Katre ◽  
Koks Sulev ◽  
Märtson Aare
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Hip Fractures ◽  
Age Groups ◽  
Femoral Fractures ◽  
Femoral Neck Fractures ◽  
University Hospital ◽  
High Risk Population ◽  
Intertrochanteric Fractures ◽  
Significant Difference

Aim: This study aimed to review the clinical findings and surgical intervention of the hip fracture at the Hue University Hospital in Vietnam. Methods:The data of proximal femoral fractures was collected retrospectively. All patients, in a period of 5 years, from Jan 2008 to December 2012, suffered either from intertrochanteric or femoral neck fractures. The numbers of patients were gathered separately for each year, by age groups (under 40, 40-49, 50-59, 60-69, 70-79, older) and by sex. We analyzed what kind of treatment options were used for the hip fracture. Results:Of 224 patients (93 men and 131 women) studied, 71% patients are over 70 years old, 103 women and 56 men (p<0.05). For patients under 40 years, there were 1 woman and 11 men (p<0.05). There were 88 intertrochanteric and 136 femoral neck fractures. There was no significant difference in the two fractures between men and women. The numbers of hip fracture increased by each year, 29/224 cases in 2010, 63/224 cases in 2011, 76/224 cases in 2012. Treatment of 88 intertrochanteric fractures: 49 cases (55.7%) of dynamic hip screw (DHS), 14 cases of hemiarthroplasty (15.9%), 2 cases of total hip replacement (2.3%). Treatment of 136 femoral neck fractures: 48 cases of total replacement (35.3%), 43 cases of hemiarthroplasty (31.6%), 15 cases of screwing (11%). In cases of 40 patients (17.9%) hip fracture was managed conservatively, 23 were femoral neck fractures and 17 were intertrochanteric fractures. Conclusions: Hip fracture is growing challenge in Hue medical university hospital. The conservative approach is still high in people who could not be operable due to severe medical conditions as well as for patients with economic difficulties. Over 70% of the hip fractures in people 70+ are caused by osteoporosis. The number of hip fracture is increasing in the following years, most likely due to the increase in the prevalence of osteoporosis. Early detection and prevention of osteoporosis should be addressed, particularly in high risk population. More aggressive surgical approach should be implemented in order to improve the quality of life in patients with hip fractures. Key words:Hip fracture.

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