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 vounger patients and in older patients who have good bone quality.
The first internal fixation ofr the fracture of femoral neck was performed by Dr. Langenbeck in 1850, and recently multiple Knowles pinning and compression screw with plate combination are the most popular methods for the internal neck fracture.
But
there is not absolutely recommended internal fixation device of fractures of fecmoral neck.
To know the adequate internal fixation device of fractures of femoral neck, the author made 30°, 50°, 70°femoral neck fracture by the Pauwel's 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 comporession hip screw with plate to twelve femoral neck fractures as the experimental group, the atuthor measured and compared the maximal loading force and maximal torsion strength in
the
control and experimental groups.
@ES The results obtained are as follows;
@EN 1. 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 Pauwel's angle 30°.
Maximal torsion strength in specimen fixed with Knowles pin and ompression hip screw with plate was 100kg·cm and 80kg·cm at Pauwel's angle 30°.
3. Maximal loading force in the specimen fixed with Knowles pin and compression hip screw with plate was 137.5kg and 375 kg at Pauwel's angle 50°.
Mximal torsion strength in te specimen fixed with Knowles pin and compression hip screw with plate was 45kg/cm and 45kg·cm at pauwel's angle 50°.
4. Maximal loading force in the specimen fixed with Knowles pin and compression hip screw with plate was 137.5kg and 397kg at Pauwel's angle 70°.
Maxinal 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 Pauwel's angle 30°.
At Pauwel's 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.
|