Abstract
Aim: Periprosthetic fractures are usually difþcult to be stabilized using plates and screws because of the presence of the underlying intramedullary stem, PMMA cement and thin periprosthetic femoral cortex. Modern techniques using cerclages and bands may be useful. Material & Methods: This study compares Ç in vitro È the mechanical performance of þve different osteosynthesis techniques applied on a oak femoral model obliquely oscillated to mimic a short oblique fracture: (a) double stainless steel wiring, (b) two 4.5 mm lag screws, © combination of one 4.5 mm cortical screw and one stainless steel wire, (d) one titanium cerclage CCG (Compression Cerclage Gudolf) combined with one 4.5 mm screw, and (e) double CCG Cerclage. The þve þxation constructs were subjected to a non-cyclic destructive axial compression and torsional loading. Results: The highest torque stiffness showed the double CCG and the double screw constructs, followed by and combination of CCG-screw and double wire constructs. The mode of failure in torque was a longitudinal crack close to screw tip and loosening of CCG and wire. The double screw, double CCG and screw- CCG constructs provided the highest stiffness in axial compressive forces. The mode of failure under compression was either loosening of CCG and wire or bending of the screw. Conclusions: This comparative study showed that double CCG can used in the treatment of oblique periprosthetic femoral fractures with the advantages of the simple technique, biocompatibility of titanium, no interference in modern imaging techniques and avoidance of stripping of muscles and degloving of bone surfaces as in platting often happens.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
