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  4. Periprosthetic and interimplant femoral fractures: Biomechanical analysis
 
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Periprosthetic and interimplant femoral fractures: Biomechanical analysis

Publikationstyp
Journal Article
Date Issued
2014-06-05
Sprache
German
Author(s)
Rupprecht, Martin  
Schlickewei, Carsten  
Fensky, Florian  
Morlock, Michael  
Püschel, Klaus  
Rueger, Johannes M.  
Lehmann, Wolfgang  
Institut
Biomechanik M-3  
TORE-URI
http://hdl.handle.net/11420/6489
Journal
Der Unfallchirurg  
Volume
118
Issue
12
Start Page
1025
End Page
1032
Citation
Unfallchirurg 12 (118): 1025-1032 (2015)
Publisher DOI
10.1007/s00113-014-2591-6
Scopus ID
2-s2.0-85028240142
Publisher
Springer
The requirements for treatment of femoral fractures are increasing with the rising age of the patients. The aim of this study was to evaluate femoral stiffness and the fracture risk after inserting different implants and implant combinations. Methods: A total of 48 cadaveric femors were harvested and 8 groups were randomized on the basis of the bone mineral density (BMD). Different osteosyntheses following prosthetic stem implantation (hip and knee prostheses) were performed and compared with native femurs. All specimens were biomechanically tested in a four-point bending until fracture. Results: The insertion of a femoral stem decreases the stiffness by approximately 33%. Ipsilateral retrograde nailing reduces the force to failure even more. This instable situation can be stabilized by a lateral locking compression plate. The most stable situation occurred in the presence of two cemented stems. Conclusion: Taken together these results clearly indicate that a hip prosthesis significantly weakens the femur, whereas two stems produce the most stable situation at all. The situation of a hip prosthesis and an retrograde nail should be avoided or covered by a bridging-osteosynthesis. In clinical practice an extramedullary fixation technique for distal femoral fractures should be preferred.
Subjects
bridging osteosynthesis
fracture femoral
fracture interprosthetic
load stability
osteoporosis
DDC Class
610: Medizin
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