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Biomechanics of dynamic hip screw

Chunlei Zhang, Bin Zhang, Qirong Dong, Dawei Ge
No abstract text is available yet for this article.
March 26, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Ken Hiragami, Jyunji Ishii
Objective The management of reverse oblique intertrochanteric femoral fractures is difficult because such fractures have unique biomechanical characteristics. This study was performed to review the results of treating reverse oblique intertrochanteric femoral fractures with a long cephalomedullary nail by embedding the lateral end of the lag screw to secure axial compression. Methods We herein report the surgical outcomes in seven patients with reverse oblique intertrochanteric fractures treated with our procedure...
January 1, 2017: Journal of International Medical Research
Mohit J Jain, Kinjal J Mavani, Dhaval Patel
INTRODUCTION: Proximal Femoral Nailing (PFN) in Intertrochanteric Fractures (IF) is becoming the choice of implant due to better biomechanics and prevention of varus collapse associated with Dynamic Hip Screw (DHS). Technical difficulties and implant related complications are yet to be addressed. AIM: To understand the technical difficulties involved in PFN and role of provisional fixation of fracture by Steinmann-pin. MATERIALS AND METHODS: In this study, 55 patients presented to a tertiary trauma center in India with trochanteric fractures from April 2010 to March 2012 were included and treated with PFN...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
Jonathan Bourget-Murray, Mahdi Bassi, Ariana Frederick, Jerod Hines, Peter F Jarzem
BACKGROUND: Spinal cord compression is a known cause of spinal cord injury. The purpose of this study is to measure pressure response during graded spinal cord compression. This information will be important in evaluating the amount of canal compromise that can be tolerated before risking neurological injury secondary to cord compression. To date, there is no published study that has evaluated pressure response to graded canal compromise in the thoracic and lumbar spine. MATERIALS AND METHODS: A comparative biomechanical investigation using an in vitro burst fracture model of graded spinal canal compromise was performed...
April 2017: Journal of Craniovertebral Junction and Spine
Dominik Rog, Phillip Grigsby, Zachary Hill, William Pinette, Serkan Inceoglu, Lee Zuckerman
OBJECTIVES: The objectives of this study were (1) to compare the axial and torsional stiffness of a dynamic hip screw with a two- and four-hole side-plate in a synthetic model of a healed and stable intertrochanteric femur fracture and (2) to evaluate the load to failure, as well as propensity to peri-implant fracture. METHODS: Fourth-generation synthetic composite femur models, simulating osteoporotic bone, were implanted with 135° dynamic hip screws (DHS) with either a two- or four-hole side-plate with or without a stable intertrochanteric fracture...
May 2017: Journal of Orthopaedic Surgery
Joey P Johnson, Todd R Borenstein, Gregory R Waryasz, Stephen A Klinge, Philip K McClure, Alison B Chambers, Roman A Hayda, Christopher T Born
OBJECTIVES: To compare the static and dynamic mechanical properties of a modified crossed cannulated screw (CS) configuration, the inverted triangle (IT) cannulated screw configuration, and a compression hip screw (CHS) with derotation screw in Pauwels type III femoral neck fractures. METHODS: Thirty synthetic femora were divided into 3 groups, and vertical femoral neck osteotomies were made. Ten osteotomized femora were fixed with a CS configuration, 10 were fixed with 3 parallel screws in an IT configuration, and the remaining 10 osteotomized femora were fixed with a CHS construct...
July 2017: Journal of Orthopaedic Trauma
Karl Stoffel, Ivan Zderic, Florian Gras, Christoph Sommer, Ursula Eberli, David Mueller, Martin Oswald, Boyko Gueorguiev
OBJECTIVES: To evaluate the biomechanical performance of femoral neck system (FNS) in comparison with established methods for fixation of femoral neck fractures in a cadaveric model. METHODS: Twenty pairs of fresh-frozen human cadaveric femora were instrumented either with dynamic hip screw and antirotation screw (DHS-screw), DHS-blade, 3 cannulated screws (3CS) or with FNS in a partially paired design. The specimens were randomized to 2 paired treatment groups based on the bone mineral density (BMD), namely DHS-screw/DHS-blade and FNS/3CS...
March 2017: Journal of Orthopaedic Trauma
Shabnam Samsami, Sadegh Saberi, Nima Bagheri, Gholamreza Rouhi
BACKGROUND: Vertical femoral neck fractures in the youth could be happened in high-energy accidents, and because of dominant shearing forces, this fracture is considered as a troublesome injury with a controversy regarding selection of the best fixation method. OBJECTIVE: The long term goal of this quasi-experimental study was to find the more stable fixation method among cannulated screws (CSs), proximal femoral locking plate (PFLP), and dynamic hip screw with derotational screw (DHS+DS) for this kind of fracture...
September 28, 2016: Bio-medical Materials and Engineering
Jae Hyuk Yang, Tae Gon Jung, Arjun Rupanagudi Honnurappa, Jae Min Cha, Chang Hwa Ham, Tae Yoon Kim, Seung Woo Suh
Introduction. To compare the biomechanical stability of the femur following the removal of proximal femoral nail antirotation (PFNA-II) and dynamic hip screw (DHS). Material and Methods. 56 paired cadaveric femurs were used as experimental and control groups. In the experimental group, PFNA-II and DHS were randomly inserted into femurs on both sides and then removed. Thereafter, compression load was applied until fracture occurred; biomechanical stability of the femurs and associated fracture patterns were studied...
2016: Applied Bionics and Biomechanics
Radek Bartoska, Vaclav Baca, Zdenek Horak, Maros Hrubina, Jiri Skala-Rosenbaum, Jiri Marvan, David Kachlik, Valer Dzupa
PURPOSE: Proximal femoral fractures are among the most commonly sustained fractures. The current treatment of stable proximal femoral fractures located in trochanteric region primarily involves the use of two systems: extramedullary dynamic hip screws and intramedullary hip nails. Given that these fractures are mainly found in the elderly population, the necessity of a repeat, due to failure of the first, may jeopardize the patient's life. Decisive factors contributing to the healing of a fracture (or the failure thereof) include fracture pattern, technical implementation of the operation (i...
July 2016: Surgical and Radiologic Anatomy: SRA
K Šmejkal, P Lochman, J Trlica, P Novotný, J Šimek, T Dědek
PURPOSE OF THE STUDY: The aim of the study was to analyse causes of impaired bone healing in femoral fractures and to present options of their management. MATERIAL AND METHODS: This is a retrospective study of the data on complications prospectively collected between 2008 and 2013. The patients admitted for primary treatment at the Trauma Centre of the Faculty of Medicine in Hradec Kralove from January 2008 to December 2013 included 1186 patients with injury severity scores (ISS) > 15 and 1340 patients with new injury severity scores (NISS) >15, all older than 16 years...
2015: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Y Imren, V Gurkan, K Bilsel, E E Desteli, M Tuna, C Gurcan, I Tuncay, C Sen
PURPOSE OF THE STUDY The objective of this study was to establish relative fixation strengths of proximal femoral nail (PFN), dynamic hip screw (DHS), monolateral external fixator (EF), and cannulated screw (CS) in basicervical hip fracture model. MATERIAL AND METHODS The study involved four groups of implanted composite proximal femoral synthetic bones of eight specimens per group; nailing with PFN, DHS, fixation with three cannulated screws, and EF. 70˚ osteotomy was performed to simulate a Pauwels Type 3 basicervical fracture...
2015: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Bryan G Vopat, Patrick M Kane, P Kaveh Mansuripur, David Paller, Sarath Koruprolu, Emily Abbood, Christopher T Born
OBJECTIVE: Many surgeons currently use long cephomedullary nails for the treatment of intertrochanteric fractures. The optimal indications for deploying distal interlocks are still debatable. This study examined the torsional biomechanical properties of 3-part intertrochanteric femur fractures in a cadaveric bone model using two different distal fixation strategies, an unlocked long cephalomedullary nail versus a dynamically locked nail. Our hypothesis is that a long cephalomedullary nail does not require distal locking fixation when used for treatment of a 3-part intertrochanteric fracture...
2015: SpringerPlus
Anderson Freitas, Gustavo Melo Torres, André Cezar de Andrade de Mello E Souza, Rafael Almeida Maciel, Diogo Ranier de Macedo Souto, George Neri de Barros Ferreira
OBJECTIVE: To statistically analyze the results obtained from biomechanical tests on fixation of femoral neck fractures of Pauwels III type, in synthetic bone, using the dynamic hip system with an anti-rotation screw, versus a control group. METHODS: Ten synthetic bones from a Brazilian manufacturer (model C1010) were used and divided into two groups: test and control. In the test group, fixation of an osteotomy was performed with 70° of inclination at the level of the femoral neck, using DHS with an anti-rotation screw...
November 2014: Revista Brasileira de Ortopedia
D Vermesan, R Prejbeanu, D V Poenaru, H Petrescu, E Apostol, F Inchingolo, G Dipalma, A Abbinante, M Caprio, M A Potenza, R Cagiano, G Malcangi, A D Inchingolo, H Haragus
BACKGROUND AND HYPOTHESIS: There is currently no consensus regarding superiority of the intramedullary fixation over the sliding hip screw. Regional variation remains high and not backed up by solid evidence. Given these premises we aimed to analyze weather implant preference can influence the postoperative survival. Secondary objectives were determining the trend for implant choice and confounding factors associated with intramedullary nails compared to sliding hip screws. PATIENTS AND METHODS: Retrospective data was obtained from patient charts with the main diagnosis of extracapsular/ trochanteric fractures, corresponding to ICD S72...
2015: La Clinica Terapeutica
Lukas Weiser, Andreas A Ruppel, Jakob V Nüchtern, Kay Sellenschloh, Johannes Zeichen, Klaus Püschel, Michael M Morlock, Wolfgang Lehmann
INTRODUCTION: Due to the demographic trend, pertrochanteric fractures of the femur will gain increasing importance in the future. Both extra- and intramedullary implants are used with good results in the treatment of these fractures. New, angular stable extramedullary implants promise increased postoperative stability even with unstable fractures. Additional trochanteric plates are intended to prevent secondary impaction, varisation and shortening of the fracture, as well as medialisation of the femoral shaft...
August 2015: Archives of Orthopaedic and Trauma Surgery
Korhan Ozkan, İsmail Türkmen, Adem Sahin, Yavuz Yildiz, Selim Erturk, Mehmet Salih Soylemez
BACKGROUND: The incidence of fractures in the trochanteric area has risen with the increasing numbers of elderly people with osteoporosis. Although dynamic hip screw fixation is the gold standard for the treatment of stable intertrochanteric femur fractures, treatment of unstable intertrochanteric femur fractures still remains controversial. Intramedullary devices such as Gamma nail or proximal femoral nail and proximal anatomic femur plates are in use for the treatment of intertrochanteric femur fractures...
May 2015: Indian Journal of Orthopaedics
C Fang, T W Lau, T M Wong, H L Lee, F Leung
The spiral blade modification of the Dynamic Hip Screw (DHS) was designed for superior biomechanical fixation in the osteoporotic femoral head. Our objective was to compare clinical outcomes and in particular the incidence of loss of fixation. In a series of 197 consecutive patients over the age of 50 years treated with DHS-blades (blades) and 242 patients treated with conventional DHS (screw) for AO/OTA 31.A1 or A2 intertrochanteric fractures were identified from a prospectively compiled database in a level 1 trauma centre...
March 2015: Bone & Joint Journal
Sarat C Kunapuli, Matthew J Schramski, Angela S Lee, John M Popovich, Jacek Cholewicki, N Peter Reeves, Renn J Crichlow
OBJECTIVES: To compare the strength of augmented versus nonaugmented fixation techniques for stabilizing vertical shear femoral neck fractures. METHODS: Two surgical screw constructs were tested with and without augmentation using 40 composite femurs: (1) 7.3-mm cannulated screws placed in an inverted triangular configuration and (2) 135-degree dynamic hip screw (DHS). The augmentation consisted of a 2.7-mm locking plate placed on the anterior-inferior femoral neck...
March 2015: Journal of Orthopaedic Trauma
Luc P Cloutier, G Yves Laflamme, Jeremie Menard, Yvan Petit
BACKGROUND: Greater trochanter fractures or osteotomies fixed with lateral plates still present high rates of complications. Unblocked greater trochanter anterior movement during hip extension might be a possible cause of failure. This study aimed to determine, under stair climbing conditions, the biomechanical behaviour of a greater trochanter fragment and the impact of an anterior locking plate on its migration. METHODS: Eighteen femurs paired from nine fresh frozen cadaveric specimens were tested on a quasi-dynamic stair climbing cycling test bench...
September 2014: Clinical Biomechanics
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