Subscribe to RSS
DOI: 10.1055/s-0040-1714221
Mechanical Analysis after Proximal Femoral Reinforcement with Polymethylmethacrylate in Alternated Double Holes[*]
Article in several languages: português | English
Abstract
Objective To evaluate, through a biomechanical assay, the maximum load, energy, and displacement necessary for the occurrence of fractures in synthetic models of femurs after the removal of cannulated screws and the performance of a reinforcement technique with polymethylmethacrylate (PMMA) in different combined positions.
Methods In total, 25 synthetic bones were used, and they were divided into 4 groups: the control group (CG), with 10 models without perforation, and the test groups (A, B and C), with 5 models each. The test groups were fixed with cannulated screws using the Asnis technique, and they had the synthesis removed, and two of the holes formed by the reinforcement technique with PMMA were filled. The biomechanical analysis was performed simulating a fall on the large trochanter using a servo-hydraulic machine.
Results All specimens of the CG and of groups A, B and C presented basal-cervical fracture of the femoral neck, except for a single model in group B, which presented a longitudinal fracture. An average of 5.4 mL of PMMA were used to reinforce the groups with filling. According to the analysis of variance (ANOVA) and the Tukey multiple comparison test, at the level of 5%, we observed that the CG presented significant differences in relation to groups A and C in the following parameters: maximum load, energy up to the fracture, and displacement.
Conclusion We observed that groups A and C, when compared to the CG, showed significant differences in the observation of displacement, maximum load, and energy until the fracture.
* Study developed by the Orthopedics and Traumatology Service, Hospital Regional do Gama, and by Instituto de Pesquisa e Ensino do Hospital Ortopédico e Medicina Especializada (IPE-HOME), Brasília, DF, Brazil.
Publication History
Received: 24 February 2020
Accepted: 15 April 2020
Article published online:
25 September 2020
© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
Referências
- 1 Souza Júnior EA, Ferreira NF, Lopes PE, Torres MS, Baumfeld DS, Andrade MA. Significado e considerações sobre a osteoporose por mulheres com e sem diagnóstico da doença. ABCS Health Sci 2019; 44 (01) 22-27
- 2 Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporos Int 1997; 7 (05) 407-413
- 3 Yang JH, Jung TG, Honnurappa AR. et al. The Analysis of Biomechanical Properties of Proximal Femur after Implant Removal. Appl Bionics Biomech 2016; 2016: 4987831
- 4 March LM, Chamberlain AC, Cameron ID. et al. Fractured Neck of Femur Health Outcomes Project Team. How best to fix a broken hip. Med J Aust 1999; 170 (10) 489-494
- 5 Tosounidis TH, Castillo R, Kanakaris NK, Giannoudis PV. Common complications in hip fracture surgery: Tips/tricks and solutions to avoid them. Injury 2015; 46 (Suppl. 05) S3-S11
- 6 Eberle S, Wutte C, Bauer C, von Oldenburg G, Augat P. Should extramedullary fixations for hip fractures be removed after bone union?. Clin Biomech (Bristol, Avon) 2011; 26 (04) 410-414
- 7 Basile R, Pepicelli GR, Takata ET. Osteosynthesis of femoral neck fractures: two or three screws?. Rev Bras Ortop 2015; 47 (02) 165-168
- 8 Kukla C, Pichl W, Prokesch R. et al. Femoral neck fracture after removal of the standard gamma interlocking nail: a cadaveric study to determine factors influencing the biomechanical properties of the proximal femur. J Biomech 2001; 34 (12) 1519-1526
- 9 Mahaisavariya B, Sitthiseripratip K, Suwanprateeb J. Finite element study of the proximal femur with retained trochanteric gamma nail and after removal of nail. Injury 2006; 37 (08) 778-785
- 10 Anderson F, Ramos LS, Dantas EL. Giordano Neto V, Godinho PF, Shimano AC. Ensaio biomecânico após retirada de parafusos canulados do fêmur proximal (análise in vitro). Rev Bras Ortop 2019; 54 (04) 416-421
- 11 Beckmann J, Ferguson SJ, Gebauer M, Luering C, Gasser B, Heini P. Femoroplasty--augmentation of the proximal femur with a composite bone cement--feasibility, biomechanical properties and osteosynthesis potential. Med Eng Phys 2007; 29 (07) 755-764
- 12 Fliri L, Sermon A, Wähnert D, Schmoelz W, Blauth M, Windolf M. Limited V-shaped cement augmentation of the proximal femur to prevent secondary hip fractures. J Biomater Appl 2013; 28 (01) 136-143
- 13 Basafa E, Murphy RJ, Otake Y. et al. Subject-specific planning of femoroplasty: an experimental verification study. J Biomech 2015; 48 (01) 59-64
- 14 Strauss EJ, Pahk B, Kummer FJ, Egol K. Calcium phosphate cement augmentation of the femoral neck defect created after dynamic hip screw removal. J Orthop Trauma 2007; 21 (05) 295-300
- 15 Heini PF, Franz T, Fankhauser C, Gasser B, Ganz R. Femoroplasty-augmentation of mechanical properties in the osteoporotic proximal femur: a biomechanical investigation of PMMA reinforcement in cadaver bones. Clin Biomech (Bristol, Avon) 2004; 19 (05) 506-512