Journal List > J Korean Orthop Assoc > v.28(3) > 1113783

Lee, Ko, and Park: A Biomechanical Study of Two Methods of Internal Fixation of Fractures of Femoral Neck

Abstract

The fractures of femoral neck are one of the most common traumatic injuries in patients above 60 years of age. Despite many advances in the field of geriatric medicine and orthopedic surgery, the morbidity and mortality due to the fractures of the femoral neck are still significant problem in old age. Recently the incidence of femoral neck fracture seems to increase because of increasing average life span. Many trials to reduce the mortality and complication of this fracture have been performed, however the best method of fixation for this fracture has not been determined. Although hemiarthroplasty is one option most commonly chosen in the elderly, reduction and internal fixation may be a more viable alternative in younger patients and in older patients who have good bone quality. The first internal fixation for the fracture of femoral neck was performed by Langenbeck in 1850, and recently multiple Knowles pinning and compression screw with plate combination are the most popular methods for the internal fixation of femoral neck fracture. But there is not absolutely recommended internal fixation device for the fractures of femoral neck. To know the adequate internal fixation device for the fractures of femoral neck, the author made 30°, 50°, 70° femoral neck fracture by the Pauwels classification at the 12 cadaverous femurs as the experimental group and the other 4 femurs were used for the control group. After the fixation with Knowles pin and compression hip screw with plate to twelve femoral neck fractures as the experimental group, the author measured and compared the maximal loading force and maximal torsion strength in the control and experimental groups. The results obtained are as follows; l. Average maximal loading force of normal femoral neck was 625kg and average maximal torsion strength was 504kg cm in control group. 2. Maximal loading force in the specimen fixed with Knowles pin and compression hip screw with plate was 400kg and 125kg at Pauwels angle 30°. Maximal torsion strength in the specimen fixed with Knowles pin and compression hip screw with plate was 100kg cm and 80kg cm at Pauwels angle 30°. 3. Maximal loading force in the specimen fixed with Knowles pin and compression hip screw with plate was 137.5kg and 375kg at Pauwels angle 50°. Maximal torsion strength in the specimen fixed with Knowles pin and compression hip screw with plate was 45kg cm and 45kg cm at Pauwels angle 50°. 4. Maximal loading force in the specimen fixed with Knowles pin and compression hip screw with plate was 137.5kg and 397.5kg at Pauwel's angle 70°. Maximal torsion strength in the specimen fixed with Knowles pin and compression hip screw with plate was 105kg cm and 100kg cm at Pauwel's angle 70°. 5. When the group fixed with Knowles pins is compared with compression hip screw with plate, Knowles pin group was superior to compression hip screw with plate group in both compression and torsion test at Pauwels angle 30°. At Pauwels angle 50° and 70°, compression hip screw with plate group was superior to Knowles pin group in compression test, but Knowles pin group was superior in torsion test.

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