CYCLIC LOADING OF PERIPROSTHETIC FRACTURE FIXATION CONSTRUCTS

E. H Schemitsch; R. Zdero

doi:10.1302/0301-620X.91BSUPP_II.0910255c

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CYCLIC LOADING OF PERIPROSTHETIC FRACTURE FIXATION CONSTRUCTS

E. H Schemitsch
R. Zdero

CYCLIC LOADING OF PERIPROSTHETIC FRACTURE FIXATION CONSTRUCTS

Schemitsch EH, Zdero R. CYCLIC LOADING OF PERIPROSTHETIC FRACTURE FIXATION CONSTRUCTS. Orthop Procs. 2009;91-B(SUPP_II):255-255. doi:10.1302/0301-620X.91BSUPP_II.0910255c

Schemitsch, E. H, and R. Zdero. “CYCLIC LOADING OF PERIPROSTHETIC FRACTURE FIXATION CONSTRUCTS.” Orthopaedic Proceedings, vol. 91-B, no. SUPP_II, 2009, pp. 255-255., https://doi.org/10.1302/0301-620X.91BSUPP_II.0910255c

Schemitsch, E. H., & Zdero, R. (2009). CYCLIC LOADING OF PERIPROSTHETIC FRACTURE FIXATION CONSTRUCTS. Orthopaedic Proceedings, 91-B(SUPP_II), 255-255. https://doi.org/10.1302/0301-620X.91BSUPP_II.0910255c

Schemitsch, E. H. and Zdero, R. (2009) “CYCLIC LOADING OF PERIPROSTHETIC FRACTURE FIXATION CONSTRUCTS.” Orthopaedic Proceedings, 91-B(SUPP_II), pp. 255-255. Available at: https://doi.org/10.1302/0301-620X.91BSUPP_II.0910255c

Schemitsch, E. H, and R. Zdero. “CYCLIC LOADING OF PERIPROSTHETIC FRACTURE FIXATION CONSTRUCTS.” Orthopaedic Proceedings 91-B, no. SUPP_II (2009): 255-255. https://doi.org/10.1302/0301-620X.91BSUPP_II.0910255c

Schemitsch EH, Zdero R. CYCLIC LOADING OF PERIPROSTHETIC FRACTURE FIXATION CONSTRUCTS. Orthop Procs. 2009 May 1;91-B(SUPP_II):255-255. https://doi.org/10.1302/0301-620X.91BSUPP_II.0910255c

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Abstract

Femur fractures are a complication of hip arthroplasty. When the stem is well fixed, fracture fixation is the preferred treatment option. Numerous fixation methods have been advocated, using plates and/or allograft struts. The study was conducted to determine the biomechanical characteristics of three constructs currently used for fixation of these fractures.

Vancouver type B1 periprosthetic femur fractures were created distal to a cemented hip stem implanted in third generation composite femurs. The fractures were fixed with one of three constructs: 1- A non-locking plate and allograft strut (NLP-A) 2- A locking plate and allograft strut (LP-A) 3- A locking plate alone. (LP) The struts were held in place with cables. There were five specimens in each group. Following fixation, the constructs underwent sinusoidal cyclic loading from 200 to 1200 N for 100000 cycles. Stiffness of the constructs was determined in bending, torsion and axial compression before and after cyclic loading. Axial load to failure was also determined.

Overall, cyclic loading had little effect on the mechanical properties of these constructs. The two constructs with allografts were significantly stiffer in coronal plane bending than the construct consisting of only a locking plate. There were no significant differences in axial or torsional stiffness between the constructs. Load to failure of the NLP-A (4095 N) and LP-A (4007 N) constructs was significantly greater than the LP construct (3398 N) (p=0.023 and p=0.044 respectively).

All three constructs tested retained their mechanical characteristics following 100000 cycles of loading. Our initial concerns that the cables holding the allograft strut would loosen appear unfounded. Allograft strut-plate constructs are stiffer in bending and have a higher load to failure than a stand-alone locking plate. When an allograft plate construct is chosen, locking screws provide no mechanical advantage in this experimental model.

Correspondence should be addressed to: Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada