Open AccessThe role of the medial plate for Pauwels type III femoral neck fracture: a comparative mechanical study using two fixations with cannulated screws
Author(s) -
Giordano Vincenzo,
Alves Danilo Diniz,
Paes Roger Pletsch,
Amaral Arthur Bonfim,
Giordano Marcos,
Belangero William,
Freitas Anderson,
Koch Hilton A.,
Amaral Ney Pecegueiro
Publication year - 2019
Publication title -
journal of experimental orthopaedics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 18
ISSN - 2197-1153
DOI - 10.1186/s40634-019-0187-3
Subject(s) - buttress , femoral neck , fixation (population genetics) , internal fixation , orthodontics , biomechanics , dynamic hip screw , fracture (geology) , mechanical failure , anatomy , medicine , materials science , surgery , structural engineering , composite material , engineering , osteoporosis , population , environmental health , endocrinology
Background The biomechanical behavior of Pauwels type III fractures should be taken into consideration when performing internal fixation, since this repair should resist the shear force inherent in the vertical fracture line to the greatest extent possible. Recently, the use of a small fragment plate on the medial face of the femoral neck has been proposed by some authors, with satisfactory initial results. In the current study we analyze the mechanical role a medial plate used as a buttress plate for Pauwels type III femoral neck fractures, comparing the resistance of two fixation configurations using three cannulated screws. Methods Pauwels type III fractures were simulated in synthetic bones models and two groups were created, one of those using two parallel screws at the bottom of the femoral neck and the third screw crossing the fracture horizontally (G1), and the other fixed in the same arrangement as G1, but with the addition of a medial side plate at the apex of the fracture (G2). The constructs were subjected to axial loading until catastrophic failure. Results The addition of a medial plate buttressing the femoral neck increased significantly the resistance to maximum loading ( p = 0.003). Conclusion Use of a medial buttress plate results in a mechanically superior construction for Pauwels type III fractures fixed with multiple cannulated screws. Lebel of evidence Level IV. Biomechanical comparative study.