A Biomechanical Comparison of Trochanteric Versus Piriformis Reconstruction Nails for Femoral Neck Fracture Prophylaxis.

Autor:	Shieh AK; Department of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, CA; and., Bravin DA; Department of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, CA; and., Shelton TJ; Department of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, CA; and., Garcia-Nolen TC; Department of Veterinary Medicine, University of California Davis, Davis, CA., Lee MA; Department of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, CA; and., Eastman JG; Department of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, CA; and.
Jazyk:	angličtina
Zdroj:	Journal of orthopaedic trauma [J Orthop Trauma] 2021 Aug 01; Vol. 35 (8), pp. e293-e297.
DOI:	10.1097/BOT.0000000000002023
Abstrakt:	Objectives: To compare piriformis fossa to greater trochanteric entry cephalomedullary implants in an evaluation of femoral neck load to failure when the device is used for femoral shaft fractures with prophylaxis of an associated femoral neck fracture. Methods: Thirty fourth-generation synthetic femur models were separated into 5 groups: intact femora, entry sites alone at the piriformis fossa or greater trochanter, and piriformis fossa and greater trochanteric entry sites after the insertion of a cephalomedullary nail. Each model was mechanically loaded with a flat plate against the superior femoral head along the mechanical axis and load to failure was recorded. Results: Mean load to failure was 5487 ± 376 N in the intact femur, 3126 ± 387 N in the piriformis fossa entry site group, 3772 ± 558 N in the piriformis entry nail, 5332 ± 292 N for the greater trochanteric entry site, and 5406 ± 801 N for the greater trochanteric nail group. Both piriformis groups were significantly lower compared with the intact group. Both greater trochanteric groups were similar to the intact group and were statistically higher than the piriformis groups. Conclusions: A piriformis fossa entry site with or without an intramedullary implant weakens the femoral neck in load to failure testing. A greater trochanteric entry yields a load to failure equivalent to that of an intact femoral neck. Instrumentation with a greater trochanteric cephalomedullary nail is significantly stronger than a piriformis fossa cephalomedullary nail during axial loading in a composite femur model. Competing Interests: The authors report no conflict of interest. (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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