Comparative strength measurements of five different fixation systems applied on an in vitro model of femoral midshaft osteotomy.

Oblique midshaft fractures of long bones can be stabilized using either plates and screws, lag screws, wires, cerclages, or a combination of these methods. Fractures at the distal tip of a well-fixed femoral prosthesis are difficult to stabilize with plates and screws because of the underlying intramedullary stem, polymethylmetacrylate (PMMA) cement, and thin periprosthetic femoral cortex. In this study we compared in vitro the mechanical performance of five different osteosynthesis techniques applied on an oak femoral model obliquely oscillated to mimic a short oblique fracture: (a) Double stainless steel wiring; (b) two 4.