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Titel: Screw-blade fixation systems for implant anchorage in the femoral head : Horizontal blade orientation provides superior stability
VerfasserIn: Schopper, Clemens
Keck, Katharina
Zderic, Ivan
Migliorini, Filippo
Link, Björn-Christian
Beeres, Frank J. P.
Babst, Reto
Nebelung, Sven
Eschbach, Daphne
Knauf, Tom
Ganse, Bergita
Schoeneberg, Carsten
Hildebrand, Frank
Gueorguiev, Boyko
Knobe, Matthias
Sprache: Englisch
Titel: Injury
Bandnummer: 52
Heft: 7
Seiten: 1861-1867
Verlag/Plattform: Elsevier
Erscheinungsjahr: 2021
Freie Schlagwörter: Rotationally Stable Screw-Anchor
U-Blade
Gamma3 Rotation Control Lag Screw
biomechanical testing
proximal femoral fracture
screw-blade fixation systems
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Objectives: Despite continual improvement in the methods and devices used for treatment of proximal femoral fractures, unacceptably high failure rates remain. Novel screw-blade implant systems, combining a lag screw with a blade – the latter adding rotational stability to the femoral head – offer improvement of osseous purchase, especially in osteoporotic bone. The aim of this study was to compare biomechanically the head element (HE) anchorage of two screw-blade implant systems differing in blade orientation in the femoral head – vertical versus horizontal. Methods: Twenty paired human cadaveric femoral heads were assigned to four groups (n = 10), implanted with either Rotationally Stable Screw-Anchor HE (RoSA-HE, vertical blade orientation) or Gamma3 Rotation Control Lag Screw (Gamma-RC, horizontal blade orientation) in center or off-center position, and biomechanically tested until failure under progressively increasing cyclic loading at 2 Hz. Results: Cycles to failure and failure load were significantly higher for Gamma-RC versus RoSA-HE in center position and not significantly different between them in off-center position, p = 0.03 and p = 0.22, respectively. In center position, the progression of both rotation around implant axis and varus deformation over time demonstrated superiority of the implant with horizontal versus vertical blade orientation. Compared with center positioning, off-center implant placement led to a significant decrease in stiffness, cycles to failure and failure load for Gamma-RC, but not for RoSA-HE, p < 0.01 and p = 0.99, respectively. Conclusion: Horizontal blade orientation of screw-blade implant systems demonstrates better anchorage in the femoral head versus vertical blade orientation in center position. As the stability of the implant system with horizontal blade orientation drops sharply in off-center position, central insertion is its placement of choice.
DOI der Erstveröffentlichung: 10.1016/j.injury.2021.04.058
URL der Erstveröffentlichung: https://doi.org/10.1016/j.injury.2021.04.058
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-385756
hdl:20.500.11880/34764
http://dx.doi.org/10.22028/D291-38575
ISSN: 0020-1383
Datum des Eintrags: 14-Dez-2022
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Chirurgie
Professur: M - Prof. Dr. med. Bergita Ganse
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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