Unstable Vancouver B1 periprosthetic femoral fracture fixation: A biomechanical comparison between a novel C-shaped memory alloy implant and cerclage wiring

Background To compare the biomechanical stability of a novel, C-shaped nickel–titanium shape memory alloy (SMA) implant (C-clip) with traditional cerclage wiring in the fixation of a Vancouver B1 (VB1) periprosthetic femoral fracture (PFF). Methods In total, 18 synthetic femoral fracture models were...

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Bibliographic Details
Main Authors: Seog-Hyun Oh, Yu-Sung Suh, Emmanuel Eghan-Acquah, Kollerov Mikhail Yurevich, Sung-Hun Won, Min Jung Baek, Sung-Jae Lee, Sung-Woo Choi
Format: Article
Language:English
Published: SAGE Publishing 2024-03-01
Series:Journal of International Medical Research
Online Access:https://doi.org/10.1177/03000605241240946
Description
Summary:Background To compare the biomechanical stability of a novel, C-shaped nickel–titanium shape memory alloy (SMA) implant (C-clip) with traditional cerclage wiring in the fixation of a Vancouver B1 (VB1) periprosthetic femoral fracture (PFF). Methods In total, 18 synthetic femoral fracture models were constructed to obtain unstable VB1 fracture with an oblique fracture line 8 cm below the lesser trochanter. For each model, the distal portion was repaired using a 10-hole locking plate and four distal bi-cortical screws. The proximal portion was repaired using either three, threaded cerclage wirings or three, novel C-shaped implants. Specimens underwent biomechanical testing using axial compression, torsional and four-point bending tests. Each test was performed on three specimens. Results The C-clip was statistically significantly stronger (i.e., stiffer) than cerclage wiring in the three biomechanical tests. For axial compression, medians (ranges) were 39 (39–41) and 35 (35–35) N/mm, for the C-clip and cerclage wiring, respectively. For torsion, medians (ranges) were, 0.44 (0.44–0.45) and 0.30 (0.30–0.33) N/mm for the C-clip and cerclage wiring, respectively. For the four-point bending test, medians (ranges) were 39 (39–41) and 28 (28–31) N/mm; for the C-clip and cerclage wiring, respectively. Conclusion Results from this small study show that the novel, C-shaped SMA appears to be biomechanically superior to traditional cerclage wiring in terms of stiffness, axial compression, torsion and four-point bending, and may be a valuable alternative in the repair of VB1 PFF. Further research is necessary to support these results.
ISSN:1473-2300