Biomechanical Research of Three Parallel Cannulated Compression Screws in Oblique Triangle Configuration for Fixation of Femoral Neck Unstable Fractures
Objective Surgical treatment with internal fixation, specifically percutaneous fixation with three cannulated compression screws (CCSs), is the preferred choice for young and middle‐aged patients. The mechanical advantage of the optimal spatial configuration with three screws provides maximum disper...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-04-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.14004 |
| _version_ | 1827299738734559232 |
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| author | Ru‐Yi Zhang Wu‐Peng Zhang Guang‐Min Yang Dao‐Feng Wang Peng Su Yi Zhang Shao‐Bo Nie Jia Li Zhe Zhao Jian‐Tao Li Li‐Cheng Zhang Pei‐Fu Tang |
| author_facet | Ru‐Yi Zhang Wu‐Peng Zhang Guang‐Min Yang Dao‐Feng Wang Peng Su Yi Zhang Shao‐Bo Nie Jia Li Zhe Zhao Jian‐Tao Li Li‐Cheng Zhang Pei‐Fu Tang |
| author_sort | Ru‐Yi Zhang |
| collection | DOAJ |
| description | Objective Surgical treatment with internal fixation, specifically percutaneous fixation with three cannulated compression screws (CCSs), is the preferred choice for young and middle‐aged patients. The mechanical advantage of the optimal spatial configuration with three screws provides maximum dispersion and cortical support. We suspect that the spatial proportion of the oblique triangle configuration (OTC) in the cross‐section of the femoral neck isthmus (FNI) may significantly improve shear and fatigue resistance of the fixed structure, thereby stabilizing the internal fixation system in femoral neck fracture (FNF). This study aims to explore the mechanical features of OTC and provide a mechanical basis for its clinical application. Methods Twenty Sawbone femurs were prepared as Pauwels type III FNF models and divided equally into two fixation groups: OTC and inverted equilateral triangle configuration (IETC). Three 7.3 mm diameter cannulated compression screws (CCSs) were used for fixation. The specimens of FNF after screw internal fixation were subjected to static loading and cyclic loading tests, respectively, with five specimens for each test. Axial stiffness, 5 mm failure load, ultimate load, shear displacement, and frontal rotational angle of two fragments were evaluated. In the cyclic loading test, the load sizes were 700 N, 1400 N, and 2100 N, respectively, and the fracture end displacement was recorded. Results were presented as means ± SD. Data with normal distributions were compared by the Student's t test. Results In the static loading test, the axial stiffness, ultimate load, shear displacement, and frontal rotational angle of two fragments were (738.64 vs. 620.74) N/mm, (2957.61 vs. 2643.06) N, (4.67 vs. 5.39) mm, and (4.01 vs. 5.52)° (p < 0.05), respectively. Comparison between the femoral head displacement after 10,000 cycles of 700N cyclic loading and total displacement after 20,000 cycles of 700–1400N cyclic loading showed the OTC group was less than the IETC group (p < 0.05). A comparison of femoral head displacement after 10,000 cycles of 1400N and 2100N cycles and total displacement after 30,000 cycles of 700–2100N cycles showed the OTC group was less than another group, but the difference was not significant (p > 0.05). Conclusion When three CCSs are inserted in parallel to fix FNF, the OTC of three screws has obvious biomechanical advantages, especially in shear resistance and early postoperative weight‐bearing, which provides a mechanical basis for clinical selection of ideal spatial configuration for unstable FNF. |
| first_indexed | 2024-04-24T15:38:55Z |
| format | Article |
| id | doaj.art-c3c3c8b5809a46898d59d6d3f12302d9 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-24T15:38:55Z |
| publishDate | 2024-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-c3c3c8b5809a46898d59d6d3f12302d92024-04-02T01:03:25ZengWileyOrthopaedic Surgery1757-78531757-78612024-04-0116495396410.1111/os.14004Biomechanical Research of Three Parallel Cannulated Compression Screws in Oblique Triangle Configuration for Fixation of Femoral Neck Unstable FracturesRu‐Yi Zhang0Wu‐Peng Zhang1Guang‐Min Yang2Dao‐Feng Wang3Peng Su4Yi Zhang5Shao‐Bo Nie6Jia Li7Zhe Zhao8Jian‐Tao Li9Li‐Cheng Zhang10Pei‐Fu Tang11Department of Orthopaedics Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital Beijing ChinaDepartment of Orthopedics The Fourth Medical Center of Chinese PLA General Hospital Beijing ChinaDepartment of Orthopaedics Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University Beijing ChinaDepartment of Sports Medicine Sports Medicine Service, Beijing Jishuitan Hospital, Capital Medical University Beijing ChinaDepartment of Orthopaedics Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital Beijing ChinaDepartment of Orthopaedics Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital Beijing ChinaDepartment of Orthopedics The Fourth Medical Center of Chinese PLA General Hospital Beijing ChinaDepartment of Orthopedics The Fourth Medical Center of Chinese PLA General Hospital Beijing ChinaDepartment of Orthopaedics Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University Beijing ChinaDepartment of Orthopedics The Fourth Medical Center of Chinese PLA General Hospital Beijing ChinaDepartment of Orthopedics The Fourth Medical Center of Chinese PLA General Hospital Beijing ChinaDepartment of Orthopedics The Fourth Medical Center of Chinese PLA General Hospital Beijing ChinaObjective Surgical treatment with internal fixation, specifically percutaneous fixation with three cannulated compression screws (CCSs), is the preferred choice for young and middle‐aged patients. The mechanical advantage of the optimal spatial configuration with three screws provides maximum dispersion and cortical support. We suspect that the spatial proportion of the oblique triangle configuration (OTC) in the cross‐section of the femoral neck isthmus (FNI) may significantly improve shear and fatigue resistance of the fixed structure, thereby stabilizing the internal fixation system in femoral neck fracture (FNF). This study aims to explore the mechanical features of OTC and provide a mechanical basis for its clinical application. Methods Twenty Sawbone femurs were prepared as Pauwels type III FNF models and divided equally into two fixation groups: OTC and inverted equilateral triangle configuration (IETC). Three 7.3 mm diameter cannulated compression screws (CCSs) were used for fixation. The specimens of FNF after screw internal fixation were subjected to static loading and cyclic loading tests, respectively, with five specimens for each test. Axial stiffness, 5 mm failure load, ultimate load, shear displacement, and frontal rotational angle of two fragments were evaluated. In the cyclic loading test, the load sizes were 700 N, 1400 N, and 2100 N, respectively, and the fracture end displacement was recorded. Results were presented as means ± SD. Data with normal distributions were compared by the Student's t test. Results In the static loading test, the axial stiffness, ultimate load, shear displacement, and frontal rotational angle of two fragments were (738.64 vs. 620.74) N/mm, (2957.61 vs. 2643.06) N, (4.67 vs. 5.39) mm, and (4.01 vs. 5.52)° (p < 0.05), respectively. Comparison between the femoral head displacement after 10,000 cycles of 700N cyclic loading and total displacement after 20,000 cycles of 700–1400N cyclic loading showed the OTC group was less than the IETC group (p < 0.05). A comparison of femoral head displacement after 10,000 cycles of 1400N and 2100N cycles and total displacement after 30,000 cycles of 700–2100N cycles showed the OTC group was less than another group, but the difference was not significant (p > 0.05). Conclusion When three CCSs are inserted in parallel to fix FNF, the OTC of three screws has obvious biomechanical advantages, especially in shear resistance and early postoperative weight‐bearing, which provides a mechanical basis for clinical selection of ideal spatial configuration for unstable FNF.https://doi.org/10.1111/os.14004BiomechanicsCannulated Compression ScrewFemoral Neck FractureOblique TriangleSpatial Configuration |
| spellingShingle | Ru‐Yi Zhang Wu‐Peng Zhang Guang‐Min Yang Dao‐Feng Wang Peng Su Yi Zhang Shao‐Bo Nie Jia Li Zhe Zhao Jian‐Tao Li Li‐Cheng Zhang Pei‐Fu Tang Biomechanical Research of Three Parallel Cannulated Compression Screws in Oblique Triangle Configuration for Fixation of Femoral Neck Unstable Fractures Orthopaedic Surgery Biomechanics Cannulated Compression Screw Femoral Neck Fracture Oblique Triangle Spatial Configuration |
| title | Biomechanical Research of Three Parallel Cannulated Compression Screws in Oblique Triangle Configuration for Fixation of Femoral Neck Unstable Fractures |
| title_full | Biomechanical Research of Three Parallel Cannulated Compression Screws in Oblique Triangle Configuration for Fixation of Femoral Neck Unstable Fractures |
| title_fullStr | Biomechanical Research of Three Parallel Cannulated Compression Screws in Oblique Triangle Configuration for Fixation of Femoral Neck Unstable Fractures |
| title_full_unstemmed | Biomechanical Research of Three Parallel Cannulated Compression Screws in Oblique Triangle Configuration for Fixation of Femoral Neck Unstable Fractures |
| title_short | Biomechanical Research of Three Parallel Cannulated Compression Screws in Oblique Triangle Configuration for Fixation of Femoral Neck Unstable Fractures |
| title_sort | biomechanical research of three parallel cannulated compression screws in oblique triangle configuration for fixation of femoral neck unstable fractures |
| topic | Biomechanics Cannulated Compression Screw Femoral Neck Fracture Oblique Triangle Spatial Configuration |
| url | https://doi.org/10.1111/os.14004 |
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