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Application of Far Cortical Locking Technology in Periprosthetic Femoral Fracture Fixation: A Biomechanical Study

Moazen, Mehran; Leonidou, Andreas; Pagkalos, Joseph; Marghoub, Arsalan; Fagan, Michael J.; Tsiridis, Eleftherios

Authors

Mehran Moazen

Andreas Leonidou

Joseph Pagkalos

Arsalan Marghoub

Eleftherios Tsiridis

Abstract

© 2016 Elsevier Inc. Background Lack of fracture movement could be a potential cause of periprosthetic femoral fracture (PFF) fixation failures. This study aimed to test whether the use of distal far cortical locking screws reduces the overall stiffness of PFF fixations and allows an increase in fracture movement compared to standard locking screws while retaining the overall strength of the PFF fixations. Methods Twelve laboratory models of Vancouver type B1 PFFs were developed. In all specimens, the proximal screw fixations were similar, whereas in 6 specimens, distal locking screws were used, and in the other six specimens, far cortical locking screws. The overall stiffness, fracture movement, and pattern of strain distribution on the plate were measured in stable and unstable fractures under anatomic 1-legged stance. Specimens with unstable fracture were loaded to failure. Results No statistical difference was found between the stiffness and fracture movement of the two groups in stable fractures. In the unstable fractures, the overall stiffness and fracture movement of the locking group was significantly higher and lower than the far cortical group, respectively. Maximum principal strain on the plate was consistently lower in the far cortical group, and there was no significant difference between the failure loads of the 2 groups. Conclusion The results indicate that far cortical locking screws can reduce the overall effective stiffness of the locking plates and increase the fracture movement while maintaining the overall strength of the PFF fixation construct. However, in unstable fractures, alternative fixation methods, for example, long stem revision might be a better option.

Journal Article Type Article
Publication Date Aug 1, 2016
Journal The journal of arthroplasty
Print ISSN 0883-5403
Electronic ISSN 1532-8406
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 31
Issue 8
Pages 1849-1856
Institution Citation Moazen, M., Leonidou, A., Pagkalos, J., Marghoub, A., Fagan, M. J., & Tsiridis, E. (2016). Application of Far Cortical Locking Technology in Periprosthetic Femoral Fracture Fixation: A Biomechanical Study. Journal of Arthroplasty, 31(8), 1849-1856. https://doi.org/10.1016/j.arth.2016.02.013
DOI https://doi.org/10.1016/j.arth.2016.02.013
Keywords Fracture stability, Fracture movement, Strain, Stiffness, Biomechanics, Vancouver type B1, Far cortical locking screw
Publisher URL http://www.sciencedirect.com/science/article/pii/S0883540316001339
Additional Information This article is maintained by: Elsevier; Article Title: Application of Far Cortical Locking Technology in Periprosthetic Femoral Fracture Fixation: A Biomechanical Study; Journal Title: The Journal of Arthroplasty; CrossRef DOI link to publisher maintained version: http://dx.doi.org/10.1016/j.arth.2016.02.013; Content Type: article; Copyright: © 2016 Elsevier Inc. All rights reserved.

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