Severity of Complications after Locking Plate Osteosynthesis in Distal Femur Fractures.

: Locked plating for distal femur fractures is widely recommended and used. We systematically reviewed clinical studies assessing the benefits and harms of fracture fixation with locked plates in AO/OTA Type 32 and 33 femur fractures. : A comprehensive literature search of PubMed, Embase, Cinahl, Web of Science, and the Cochrane Database was performed.

Impact of Bone Cement Augmentation on the Fixation Strength of TFNA Blades and Screws.

Hip fractures constitute the most debilitating complication of osteoporosis with steadily increasing incidences in the aging population. Their intramedullary nailing can be challenging because of poor anchorage in the osteoporotic femoral head. Cement augmentation of Proximal Femoral Nail Antirotation (PFNA) blades demonstrated promising results by enhancing cut-out resistance in proximal femoral fractures.

Biphasic plating improves the mechanical performance of locked plating for distal femur fractures.

Internal fixation by plate osteosynthesis is the gold standard treatment for distal femur fractures. Despite improvements that preserve the biological conditions for bone healing, there are concerns standard locked plating constructs may be overly stiff. Biphasic plating is a novel concept designed to provide suitable fracture motion and increased implant strength to support early full weight-bearing.

Biomechanical evaluation of retrograde docking nailing to a total hip arthroplasty stem in a periprosthetic femur fracture model.

Introduction: Slotted nails allow a connection to a total hip arthroplasty (THA) stem and act as intramedullary load carrier. This study compares construct stiffness, cycles to failure and failure load between a retrograde slotted femur nail construct docked to a THA stem and a lateral locking plate in a human periprosthetic femur fracture model.

Materials And Methods: In seven pairs of fresh-frozen human anatomic femora with cemented THA, a transverse osteotomy was set simulating a Vancouver type B1 fracture.

Cement augmentation of calcar screws may provide the greatest reduction in predicted screw cut-out risk for proximal humerus plating based on validated parametric computational modelling: Augmenting proximal humerus fracture plating.

Aims: Fixation of osteoporotic proximal humerus fractures remains challenging even with state-of-the-art locking plates. Despite the demonstrated biomechanical benefit of screw tip augmentation with bone cement, the clinical findings have remained unclear, potentially as the optimal augmentation combinations are unknown. The aim of this study was to systematically evaluate the biomechanical benefits of the augmentation options in a humeral locking plate using finite element analysis (FEA).

Biphasic Plating - In vivo study of a novel fixation concept to enhance mechanobiological fracture healing.

Background: Fracture fixation has advanced significantly with the introduction of locked plating and minimally invasive surgical techniques. However, healing complications occur in up to 10% of cases, of which a significant portion may be attributed to unfavorable mechanical conditions at the fracture. Moreover, state-of-the-art plates are prone to failure from excessive loading or fatigue.

Influence of reduced tip-apex distance on helical blade fixation-a biomechanical study.

Migration profile of helical blades differs from conventional screw design. Tip-apex distance (TAD) greater than 25 mm is associated with early failure in hip screws. This study investigates the effect of a reduced TAD on helical blade fixation.

Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae.

Purpose: Subchondral screw abutment in osteosynthesis of joint fractures is an effective method to achieve sufficient screw grip. In this study we investigated if subchondral screw placement is possible without harming the overlying subchondral plate and joint cartilage iatrogenic.

Materials And Methods: A 3.

Prophylactic augmentation of the osteoporotic proximal femur-mission impossible?

The high incidence of secondary hip fractures and the associated markedly increased mortality call for preventive actions that could help to avoid these injuries. By providing immediate strengthening and not relying on patient compliance, internal prophylactic augmentation of the osteoporotic proximal femur may overcome the main limitations of systemic bone drugs and wearable protective pads. However, such a method would have to provide sufficient and reliable strengthening effect with minimal risks and side effects to justify the need of an invasive treatment.

Prophylactic augmentation of the proximal femur: an investigation of two techniques.

Introduction: Osteoporotic hip fractures are an increasing problem in an ageing population. They result in high morbidity, mortality and high socioeconomic costs. For patients with poor bone quality, prophylactic augmentation of the proximal femur might be an option for fracture prevention.

Cement augmentation of implants--no general cure in osteoporotic fracture treatment. A biomechanical study on non-displaced femoral neck fractures.

Femoral neck fractures in the elderly are a common problem in orthopedics. Augmentation of screw fixation with bone cement can provide better stability of implants and lower the risk of secondary displacement. This study aimed to investigate whether cement augmentation of three cannulated screws in non-displaced femoral neck fractures could increase implant fixation.

Does metaphyseal cement augmentation in fracture management influence the adjacent subchondral bone and joint cartilage?: an in vivo study in sheep stifle joints.

Augmentation of implants with polymethylmethacrylate (PMMA) bone cement in osteoporotic fractures is a promising approach to increase implant purchase. Side effects of PMMA for the metaphyseal bone, particularly for the adjacent subchondral bone plate and joint cartilage, have not yet been studied. The following experimental study investigates whether subchondral PMMA injection compromises the homeostasis of the subchondral bone and/or the joint cartilage.

Implant augmentation: adding bone cement to improve the treatment of osteoporotic distal femur fractures: a biomechanical study using human cadaver bones.

The increasing problems in the field of osteoporotic fracture fixation results in specialized implants as well as new operation methods, for example, implant augmentation with bone cement. The aim of this study was to determine the biomechanical impact of augmentation in the treatment of osteoporotic distal femur fractures.Seven pairs of osteoporotic fresh frozen distal femora were randomly assigned to either an augmented or nonaugmented group.

Assessment of intraosseous femoral head pressures during cement augmentation of the perforated proximal femur nail antirotation blade.

Objectives: The benefits of cement augmentation with fixation of osteoporotic pertrochanteric fractures have been previously demonstrated. The objective of this study was 3-fold: (1) To quantify the intraosseous pressure produced during cement augmentation of the perforated proximal femoral nail antirotation (PFNA) blades; (2) To assess whether the pressure generated is influenced by the injection rate; and (3) To assess the amount of force applied during the injection.

Methods: Six pairs of human cadaveric femurs were used in the study.

Metaphyseal screw augmentation of the LISS-PLT plate with polymethylmethacrylate improves angular stability in osteoporotic proximal third tibial fractures: a biomechanical study in human cadaveric tibiae.

Objectives: The incidence of osteoporotic proximal tibial fractures has increased during the last 2 decades. A promising approach in osteoporotic fracture fixation is polymethylmethacrylate-based cement augmentation of implants to gain better implant purchase in the bone. This study investigates the biomechanical benefits of screw augmentation in less invasive stabilization system-proximal lateral tibial (LISS-PLT) plates in cadaveric extraarticular comminuted proximal tibial fractures (OTA-41-A3.

Biomechanical in vitro assessment of screw augmentation in locked plating of proximal humerus fractures.

Introduction: Proximal humerus fracture fixation can be difficult because of osteoporosis making it difficult to achieve stable implant anchorage in the weak bone stock even when using locking plates. This may cause implant failure requiring revision surgery. Cement augmentation has, in principle, been shown to improve stability.

In vitro temperature evaluation during cement augmentation of proximal humerus plate screw tips.

Background: The treatment of proximal humerus fractures in patients with poor bone quality remains a challenge in trauma surgery. Augmentation with polymethylmethacrylate (PMMA) cement is a possible method to strengthen the implant anchorage in osteoporotic bone and to avoid loss of reduction and reduce the cut-out risk. The polymerisation of PMMA during cement setting leads, however, to an exothermic reaction and the development of supraphysiological temperatures may harm the bone and cartilage.