Helical blade versus sliding hip screw for treatment of unstable intertrochanteric hip fractures: A biomechanical evaluation

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Abstract

Objective: To compare the fixation stability in the femoral head with sliding hip screw versus helical blade designs for unstable, intertrochanteric hip fractures. Methods: A simulated, unstable intertrochanteric hip fracture was created in six pairs of cadaveric femurs. One of each pair was treated using an intramedullary nail with a sliding hip screw (ITST) for femoral head fixation and the other was treated with a nail with a helical blade (TFN). Each specimen was cyclically loaded with 750 N vertical loads applied for 10, 100, 1000 and 10,000 cycles. Measurements for femoral head displacement, fracture fragment opening and sliding were made. Specimens were then loaded to failure. Results: There was significantly more permanent inferior femoral head displacement in the ITST samples compared to the TFN samples after each cyclic loading (all p values < 0.05). There was significantly more permanent fracture site opening and inferior displacement in the ITST group compared with the TFN group at 1000 and 10,000 cycles (p < 0.05). Final loads to failure were not significantly different (p = 0.51) between the two treatment groups. Nine specimens demonstrated fracture extension into the anteromedial cortex and subtrochanteric region and three specimens, which had an ITST implant, demonstrated a splitting fracture of the femoral head. Conclusion: This study demonstrated that fixation of the femoral head with a helical blade was biomechanically superior to fixation with a standard sliding hip screw in a cadaveric, unstable intertrochanteric hip fracture model. © 2006 Elsevier Ltd. All rights reserved.

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Strauss, E., Frank, J., Lee, J., Kummer, F. J., & Tejwani, N. (2006). Helical blade versus sliding hip screw for treatment of unstable intertrochanteric hip fractures: A biomechanical evaluation. Injury, 37(10), 984–989. https://doi.org/10.1016/j.injury.2006.06.008

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