ABSTRACT:
Femoral neck fractures are one of the most common fracture types in elderly
patients. These fractures have always presented great challenges to orthopaedic
surgeons and remain in many ways as the unsolved fracture as far as treatment and
results are concerned.
Failure of the internal fixation may develop, because most of the patients are aged
and osteoporotic. The correlation between fracture stability and union has been shown
in many studies. Dedicated screws were designed or augmented with different materials
(PMMA, Calsium phosphate) to increase the holding power at the femoral head for
better fixation.
In our study 48 human femoral heads divided into two groups after measuring bone
mineral densities by Q-CT. In the control group 7 mm cannulated screws and in the
study group 7 mm cannulated screws with holes between the threads augmented by
cement (PMMA) were used. Each group was divided into three subgroups and in each
subgroup eight femoral heads were used. Pull out, maximum extraction torque and cut
out strength values were compared after mating these subgroups by similar bone
mineral densities.
In the pull out group maximum holding strength (N) was measured after
applying 0.5 mm/sec. axial pull out force by Instron testing. The difference between the
measured values of two subgroups after force application was significant (p<0.011).
In the cut out group load applied using 5 N followed by 2 mm/min. axial loading
force after fixing the femoral heads to the Instron testing. The procedure was
continued until at least 5 mm displacement occured. The difference between two
subgroups was found significant (p<0.05).
In the maximum extraction torque group 4°/sec. torque force (Nm) was applied in
reverse direction by torquemeter. During the extraction highest torque was determined
and difference between the measured values of two subgroups was found very
significant (p<0.0001).
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The designed screw augmented by PMMA has found to be worth in this
experimental study to be further studied in the clinical application of the femoral neck
fractures.
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