Biomechanical evaluation of compression buttress screw and medial plate fixation for the treatment of vertical femoral neck fractures |
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| Institution: | 1. Department of Orthopaedic Surgery, Shanghai Sixth People''s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 YiShan Road, Shanghai 200233, China;2. Department of Emergency Medicine, Shanghai Sixth People''s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 YiShan Road, Shanghai 200233, China;3. Department of Orthopaedic and Physical Medicine, Medical University of South Carolina, Charleston, SC, 29425, United States of America;4. Orthopaedic Biomechanical Laboratory, Department of Orthopaedic Surgery, Shanghai Sixth People''s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 YiShan Road, Shanghai 200233, China;1. Department of Orthopedics, The Fourth Medical Center, Chinese PLA General Hospital, Beijing, China;2. China National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, No. 51 Fucheng Road, Haidian District, Beijing 100048, China;1. Department of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne;2. Center for Orthopedics and Trauma Surgery, Philipps University Marburg;3. Department of Health Science and Medicine, University of Lucerne;1. Department of Orthopaedics, \"Georgios Gennimatas\" General Hospital, Athens, Greece;2. Department of Adult Reconstruction, Orthopaedic Clinic, Patras University Hospital, Patras, Greece;3. Laboratory of Biomechanics and Biomedical Physics, Department of Mechanics, School of Applied Mathematical and Physical Sciences, NTUA, Greece;4. Department of Mechanical Engineering, School of Engineering, University of the Peloponnese, Patras, Greece;5. Laboratory of Technology and Strength of Materials, Department of Mechanical Engineering and Aeronautics, University of Patras, Patras, Greece;6. Department of Medical Physics, School of Medicine, University of Patras, Greece;1. Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada;2. Bioventus International, Taurusavenue, Hoofddorp, the Netherlands;3. Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA;4. Department of Orthopaedic Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands;5. Department of Surgery, McMaster University, Hamilton, Ontario, Canada;6. Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, New Orleans, LA, USA;1. Trabzon Kanuni Training and Research Hospital, Department of Orthopaed & Traumatol, 61000 Trabzon, Turkey;2. Recep Tayyip Erdogan University, Biomedical Engineering MSc Program, 53100 Rize, Turkey;3. Recep Tayyip Erdogan University, Department of Civil Engineering, 53100 Rize, Turkey;4. Kocaeli University, Department of Biomedical Engineering, 41380 Kocaeli, Turkey;5. Recep Tayyip Erdogan University, Department of Neurosurgery, 53100 Rize, Turkey;6. Karadeniz Technical University, Surmene Faculty of Marine Science, 61530 Trabzon, Turkey;7. Department of Civil Engineering, Artvin Coruh University, 08100 Artvin, Turkey;8. Fatih State Hospital, Orthopaed & Traumatol, 61100 Trabzon, Turkey |
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| Abstract: | ObjectiveTo compare the biomechanical properties of compression buttress screw (CBS) fixation with three plate fixation methods for the treatment of vertical femoral neck fractures (FNFs).MethodsA total of forty synthetic femoral models with simulated Pauwels type III fractures (angle of 70°) were equally assigned to one of four fixation groups: CBS fixation, anteromedial plate fixation (AMP), medial buttress plate fixation (MBP) and medial buttress plate fixation without proximal screw (MBPw). Within each group, half of the specimens were randomly assigned to two loading settings, an axial compression loading test and a hip-flexion torsion test.ResultsThere were no significant differences in axial load to failure, axial stiffness, torsional strength, or torsional stiffness when comparing CBS with MBP (p>0.05). In the axial compression loading test, both CBS and MBP showed higher load to failure and axial stiffness than MBPw (p<0.05). In torsional testing, AMP exhibited superior torsional strength and torsional stiffness than both MBPw and MBP (all p<0.05) and a higher torsional strength than CBS fixation (p<0.05). There were no significant differences in torsional stiffness between the CBS and AMP fixation groups (p>0.05).ConclusionThe biomechanical parameters of CBS fixation are comparable to that of AMP and MBP, and demonstrate superior axial stiffness than MBPw fixation. Although the CBS method for surgical fixation of vertical FNF holds promise as a less invasive surgical technique than plate fixation with similar biomechanical assessments, further clinical evaluation is warranted. |
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