Evaluation of various fixation methods for proximal femoral periprosthetic fractures under axial loading (biomechanical study)

2. ABSTRACT:EVALUATION OF VARIOUS FIXATION METHODS FOR PROXIMAL FEMORALPER PROSTHET C FRACTURES UNDER AXIAL LOADING(BIOMECHANICAL STUDY)Dr. Mehmet Gül enDokuz Eylül Üniversitesi T p FakültesiOrtopedi ve Travmatoloji Anabilim Dal#nciralt -#zmirPeriprosthetic femoral fractures occuring peroperatively has been morefrequent complication due to the widely use of both primary or revision hip prosthesisespecially in uncemented and press fit types. Such fractures are treated eitherconservatively or surgically due to the stabilitey of the prosthesis. the aim of thepresent study is to determine the affects of Mallory type 2 proximal femoral fracture tothe stability of the prosthesis and to compare the axial stability provided by differentfixation methods.The series included 8 left composite femurs (Sawbone) which were testedunder axial loading. Groups from 1 to 6 included, only composite bone, compositebone with Versys femoral stem (Zimmer, Warsaw,IN,USA), Mallory type 2 fracturemodel without fixation, fixation with Cable Ready (Zimmer, Warsaw,IN,USA), fixationwith Cable Ready and cortical strut graft, trochanteric plate fixed with Cable gripsystem (Zimmer, Warsaw,IN,USA) respectively. Load-stroke graphs were obtainedfollowing axial loading tests. Freom these graphs yield point and rigidity of allspecimens were recorded. Statistical analyses were performed with Mann Whitney Utest.Less axial loading resulted in deformation in specimens with fractures (group3). More load was necessary fort he same deformation in groups with fixation but thedifference in these groups was not significant.We conclude that the manuel evaluation of the stability of the fracture andprosthesis may be misleading and these fractures should be fixed. There is nodifference amang the fixation methods under axial loading.Key words: Fracture, total hip, arthroplasty, femur