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Erschienen in: International Orthopaedics 1/2014

01.01.2014 | Original Paper

Biomechanical comparison of two angular stable plate constructions for periprosthetic femur fracture fixation

verfasst von: Dirk Wähnert, Richard Schröder, Martin Schulze, Peter Westerhoff, Michael Raschke, Richard Stange

Erschienen in: International Orthopaedics | Ausgabe 1/2014

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Abstract

Purpose

Fractures of the femur associated with total hip arthroplasty are a significant concern in orthopaedic and trauma surgery. However, little is known about the different biomechanical properties of internal fixation systems in combination with periprosthetic fractures. In this study two new internal fixation systems for periprosthetic fractures are investigated using a cadaver fracture model simulating a Vancouver B1 periprosthetic femur fracture.

Methods

Nine pairs of fresh-frozen cadaver femurs were scanned by dual X-ray absorptiometry. Cementless total hip prostheses were implanted and a periprosthetic femur fracture was simulated. Fractures were randomly fixed either with the fixed angle locking attachment plate (LAP®, Depuy Synthes®, Solothurn, Switzerland) or the variable angle non-contact bridging plate (NCB®, Zimmer GmbH, Winterthur, Switzerland). Each construct was cyclically loaded to failure in axial compression.

Results

Axial stiffness and cycles to failure were significantly higher in the NCB group. Both systems were able to be fixed well around the femoral stem.

Conclusion

The two different internal fixation systems for periprosthetic fractures differed significantly in our setup. The non-contact bridging plate system revealed significantly higher failure load and may be the preferred option where high stability and load capacity is needed right after operation.
Literatur
1.
Zurück zum Zitat Lindahl H, Malchau H, Oden A, Garellick G (2006) Risk factors for failure after treatment of a periprosthetic fracture of the femur. J Bone Joint Surg Br 88(1):26–30PubMedCrossRef Lindahl H, Malchau H, Oden A, Garellick G (2006) Risk factors for failure after treatment of a periprosthetic fracture of the femur. J Bone Joint Surg Br 88(1):26–30PubMedCrossRef
2.
Zurück zum Zitat Meek RM, Norwood T, Smith R, Brenkel IJ, Howie CR (2011) The risk of peri-prosthetic fracture after primary and revision total hip and knee replacement. J Bone Joint Surg Br 93(1):96–101PubMedCrossRef Meek RM, Norwood T, Smith R, Brenkel IJ, Howie CR (2011) The risk of peri-prosthetic fracture after primary and revision total hip and knee replacement. J Bone Joint Surg Br 93(1):96–101PubMedCrossRef
3.
Zurück zum Zitat Lindahl H (2007) Epidemiology of periprosthetic femur fracture around a total hip arthroplasty. Injury 38(6):651–654PubMedCrossRef Lindahl H (2007) Epidemiology of periprosthetic femur fracture around a total hip arthroplasty. Injury 38(6):651–654PubMedCrossRef
4.
Zurück zum Zitat Garbuz DS, Masri BA, Duncan CP (1998) Periprosthetic fractures of the femur: principles of prevention and management. Instr Course Lect 47:237–242PubMed Garbuz DS, Masri BA, Duncan CP (1998) Periprosthetic fractures of the femur: principles of prevention and management. Instr Course Lect 47:237–242PubMed
5.
Zurück zum Zitat Pike J, Davidson D, Garbuz D, Duncan CP, O’Brien PJ, Masri BA (2009) Principles of treatment for periprosthetic femoral shaft fractures around well-fixed total hip arthroplasty. J Am Acad Orthop Surg 17(11):677–688PubMed Pike J, Davidson D, Garbuz D, Duncan CP, O’Brien PJ, Masri BA (2009) Principles of treatment for periprosthetic femoral shaft fractures around well-fixed total hip arthroplasty. J Am Acad Orthop Surg 17(11):677–688PubMed
6.
Zurück zum Zitat Giannoudis PV, Kanakaris NK, Tsiridis E (2007) Principles of internal fixation and selection of implants for periprosthetic femoral fractures. Injury 38(6):669–687PubMedCrossRef Giannoudis PV, Kanakaris NK, Tsiridis E (2007) Principles of internal fixation and selection of implants for periprosthetic femoral fractures. Injury 38(6):669–687PubMedCrossRef
7.
Zurück zum Zitat Konstantinidis L, Hauschild O, Beckmann NA, Hirschmuller A, Sudkamp NP, Helwig P (2010) Treatment of periprosthetic femoral fractures with two different minimal invasive angle-stable plates: biomechanical comparison studies on cadaveric bones. Injury 41(12):1256–1261PubMedCrossRef Konstantinidis L, Hauschild O, Beckmann NA, Hirschmuller A, Sudkamp NP, Helwig P (2010) Treatment of periprosthetic femoral fractures with two different minimal invasive angle-stable plates: biomechanical comparison studies on cadaveric bones. Injury 41(12):1256–1261PubMedCrossRef
8.
Zurück zum Zitat Lever JP, Zdero R, Nousiainen MT, Waddell JP, Schemitsch EH (2010) The biomechanical analysis of three plating fixation systems for periprosthetic femoral fracture near the tip of a total hip arthroplasty. J Orthop Surg Res 5:45PubMedCentralPubMedCrossRef Lever JP, Zdero R, Nousiainen MT, Waddell JP, Schemitsch EH (2010) The biomechanical analysis of three plating fixation systems for periprosthetic femoral fracture near the tip of a total hip arthroplasty. J Orthop Surg Res 5:45PubMedCentralPubMedCrossRef
9.
Zurück zum Zitat Pletka JD, Marsland D, Belkoff SM, Mears SC, Kates SL (2011) Biomechanical comparison of 2 different locking plate fixation methods in Vancouver b1 periprosthetic femur fractures. Geriatr Orthop Surg Rehabil 2(2):51–55PubMedCentralPubMedCrossRef Pletka JD, Marsland D, Belkoff SM, Mears SC, Kates SL (2011) Biomechanical comparison of 2 different locking plate fixation methods in Vancouver b1 periprosthetic femur fractures. Geriatr Orthop Surg Rehabil 2(2):51–55PubMedCentralPubMedCrossRef
10.
Zurück zum Zitat Demos HA, Briones MS, White PH, Hogan KA, Barfield WR (2012) A biomechanical comparison of periprosthetic femoral fracture fixation in normal and osteoporotic cadaveric bone. J Arthroplasty 27(5):783–788PubMedCrossRef Demos HA, Briones MS, White PH, Hogan KA, Barfield WR (2012) A biomechanical comparison of periprosthetic femoral fracture fixation in normal and osteoporotic cadaveric bone. J Arthroplasty 27(5):783–788PubMedCrossRef
11.
Zurück zum Zitat Dennis MG, Simon JA, Kummer FJ, Koval KJ, DiCesare PE (2000) Fixation of periprosthetic femoral shaft fractures occurring at the tip of the stem: a biomechanical study of 5 techniques. J Arthroplasty 15(4):523–528PubMedCrossRef Dennis MG, Simon JA, Kummer FJ, Koval KJ, DiCesare PE (2000) Fixation of periprosthetic femoral shaft fractures occurring at the tip of the stem: a biomechanical study of 5 techniques. J Arthroplasty 15(4):523–528PubMedCrossRef
12.
Zurück zum Zitat Lehmann W, Rupprecht M, Nuechtern J, Melzner D, Sellenschloh K, Kolb J, Fensky F, Hoffmann M, Puschel K, Morlock M, Rueger JM (2012) What is the risk of stress risers for interprosthetic fractures of the femur? A biomechanical analysis. Int Orthop 36(12):2441–2446PubMedCentralPubMedCrossRef Lehmann W, Rupprecht M, Nuechtern J, Melzner D, Sellenschloh K, Kolb J, Fensky F, Hoffmann M, Puschel K, Morlock M, Rueger JM (2012) What is the risk of stress risers for interprosthetic fractures of the femur? A biomechanical analysis. Int Orthop 36(12):2441–2446PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Corten K, Vanrykel F, Bellemans J, Frederix PR, Simon JP, Broos PL (2009) An algorithm for the surgical treatment of periprosthetic fractures of the femur around a well-fixed femoral component. J Bone Joint Surg Br 91(11):1424–1430PubMedCrossRef Corten K, Vanrykel F, Bellemans J, Frederix PR, Simon JP, Broos PL (2009) An algorithm for the surgical treatment of periprosthetic fractures of the femur around a well-fixed femoral component. J Bone Joint Surg Br 91(11):1424–1430PubMedCrossRef
14.
Zurück zum Zitat Wahnert D, Hoffmeier K, Frober R, Hofmann GO, Muckley T (2011) Distal femur fractures of the elderly-different treatment options in a biomechanical comparison. Injury 42(7):655–659PubMedCrossRef Wahnert D, Hoffmeier K, Frober R, Hofmann GO, Muckley T (2011) Distal femur fractures of the elderly-different treatment options in a biomechanical comparison. Injury 42(7):655–659PubMedCrossRef
15.
Zurück zum Zitat Wahnert D, Lange JH, Schulze M, Lenschow S, Stange R, Raschke MJ (2013) The potential of implant augmentation in the treatment of osteoporotic distal femur fractures: a biomechanical study. Injury 44(6):808–812PubMedCrossRef Wahnert D, Lange JH, Schulze M, Lenschow S, Stange R, Raschke MJ (2013) The potential of implant augmentation in the treatment of osteoporotic distal femur fractures: a biomechanical study. Injury 44(6):808–812PubMedCrossRef
16.
Zurück zum Zitat Buttaro MA, Farfalli G, Paredes Nunez M, Comba F, Piccaluga F (2007) Locking compression plate fixation of Vancouver type-B1 periprosthetic femoral fractures. J Bone Joint Surg Am 89(9):1964–1969PubMedCrossRef Buttaro MA, Farfalli G, Paredes Nunez M, Comba F, Piccaluga F (2007) Locking compression plate fixation of Vancouver type-B1 periprosthetic femoral fractures. J Bone Joint Surg Am 89(9):1964–1969PubMedCrossRef
17.
Zurück zum Zitat Erhardt JB, Grob K, Roderer G, Hoffmann A, Forster TN, Kuster MS (2008) Treatment of periprosthetic femur fractures with the non-contact bridging plate: a new angular stable implant. Arch Orthop Trauma Surg 128(4):409–416PubMedCrossRef Erhardt JB, Grob K, Roderer G, Hoffmann A, Forster TN, Kuster MS (2008) Treatment of periprosthetic femur fractures with the non-contact bridging plate: a new angular stable implant. Arch Orthop Trauma Surg 128(4):409–416PubMedCrossRef
18.
Zurück zum Zitat Lenz M, Windolf M, Muckley T, Hofmann GO, Wagner M, Richards RG, Schwieger K, Gueorguiev B (2012) The locking attachment plate for proximal fixation of periprosthetic femur fractures—a biomechanical comparison of two techniques. Int Orthop 36(9):1915–1921PubMedCentralPubMedCrossRef Lenz M, Windolf M, Muckley T, Hofmann GO, Wagner M, Richards RG, Schwieger K, Gueorguiev B (2012) The locking attachment plate for proximal fixation of periprosthetic femur fractures—a biomechanical comparison of two techniques. Int Orthop 36(9):1915–1921PubMedCentralPubMedCrossRef
19.
Zurück zum Zitat El-Zayat BF, Ruchholtz S, Efe T, Fuchs-Winkelmann S, Kruger A, Kreslo D, Zettl R (2012) NCB-plating in the treatment of geriatric and periprosthetic femoral fractures. Orthop Traumatol Surg Res 98(7):765–772PubMedCrossRef El-Zayat BF, Ruchholtz S, Efe T, Fuchs-Winkelmann S, Kruger A, Kreslo D, Zettl R (2012) NCB-plating in the treatment of geriatric and periprosthetic femoral fractures. Orthop Traumatol Surg Res 98(7):765–772PubMedCrossRef
20.
Zurück zum Zitat Ruchholtz S, El-Zayat B, Kreslo D, Bucking B, Lewan U, Kruger A, Zettl R (2013) Less invasive polyaxial locking plate fixation in periprosthetic and peri-implant fractures of the femur—A prospective study of 41 patients. Injury 44(2):239–248PubMedCrossRef Ruchholtz S, El-Zayat B, Kreslo D, Bucking B, Lewan U, Kruger A, Zettl R (2013) Less invasive polyaxial locking plate fixation in periprosthetic and peri-implant fractures of the femur—A prospective study of 41 patients. Injury 44(2):239–248PubMedCrossRef
21.
Zurück zum Zitat Kammerlander C, Kates SL, Wagner M, Roth T (2013) Blauth M (2013) Minimally invasive periprosthetic plate osteosynthesis using the locking attachment plate. Oper Orthop Traumatol 25(4):398–410PubMedCrossRef Kammerlander C, Kates SL, Wagner M, Roth T (2013) Blauth M (2013) Minimally invasive periprosthetic plate osteosynthesis using the locking attachment plate. Oper Orthop Traumatol 25(4):398–410PubMedCrossRef
22.
Zurück zum Zitat Choi JK, Gardner TR, Yoon E, Morrison TA, Macaulay WB, Geller JA (2010) The effect of fixation technique on the stiffness of comminuted Vancouver B1 periprosthetic femur fractures. J Arthroplasty 25(6 Suppl):124–128PubMedCrossRef Choi JK, Gardner TR, Yoon E, Morrison TA, Macaulay WB, Geller JA (2010) The effect of fixation technique on the stiffness of comminuted Vancouver B1 periprosthetic femur fractures. J Arthroplasty 25(6 Suppl):124–128PubMedCrossRef
23.
Zurück zum Zitat Garcia-Cimbrelo E, Cruz-Pardos A, Madero R, Ortega-Andreu M (2003) Total hip arthroplasty with use of the cementless Zweymuller Alloclassic system. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 85-A(2):296–303PubMed Garcia-Cimbrelo E, Cruz-Pardos A, Madero R, Ortega-Andreu M (2003) Total hip arthroplasty with use of the cementless Zweymuller Alloclassic system. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 85-A(2):296–303PubMed
Metadaten
Titel
Biomechanical comparison of two angular stable plate constructions for periprosthetic femur fracture fixation
verfasst von
Dirk Wähnert
Richard Schröder
Martin Schulze
Peter Westerhoff
Michael Raschke
Richard Stange
Publikationsdatum
01.01.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 1/2014
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-2113-0

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