Biomechanical Testing of a 3-Hole Versus a 4-Hole Sliding Hip Screw in the Presence of a Retrograde Intramedullary Nail for Ipsilateral Intertrochanteric and Femur Shaft Fractures

Michael Olsen; Peter Goshulak; Meghan C Crookshank; Joel Moktar; Ignace J Brazda; Emil H Schemitsch; Radovan Zdero

doi:10.1097/BOT.0000000000001179

Biomechanical Testing of a 3-Hole Versus a 4-Hole Sliding Hip Screw in the Presence of a Retrograde Intramedullary Nail for Ipsilateral Intertrochanteric and Femur Shaft Fractures

J Orthop Trauma. 2018 Aug;32(8):419-424. doi: 10.1097/BOT.0000000000001179.

Authors

Michael Olsen¹, Peter Goshulak², Meghan C Crookshank¹, Joel Moktar¹, Ignace J Brazda², Emil H Schemitsch^{2

3}, Radovan Zdero^{2

3

4

5}

Affiliations

¹ Faculty of Medicine, Department of Surgery, University of Toronto, Toronto, ON, Canada.
² Orthopaedic Biomechanics Lab, Victoria Hospital, London, ON, Canada.
³ Department of Surgery, Western University, London, ON, Canada.
⁴ Department of Mechanical and Materials Engineering, Western University, London, ON, Canada.
⁵ Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, ON, Canada.

PMID: 29664884
DOI: 10.1097/BOT.0000000000001179

Abstract

Objective: The goal of this study was to compare a 3-hole versus a 4-hole sliding hip screw (SHS) in the presence of a retrograde intramedullary (RIM) nail for fixing intertrochanteric and comminuted midshaft femur fractures.

Methods: Mechanical tests were performed on 10 matched pairs of human cadaveric femurs that were osteotomized and then fixed using a 3-hole SHS versus the traditional "gold standard" 4-hole SHS in the presence of an RIM nail.

Results: Data showed no differences between the 3-hole SHS with RIM nail versus 4-hole SHS with RIM nail for stiffness (281 ± 127 vs. 260 ± 118 N/mm, P = 0.76), clinical failure at 10 mm of hip displacement (2014 ± 363 vs. 2134 ± 614 N, P = 0.52), or ultimate mechanical failure (3476 ± 776 vs. 3669 ± 755 N, P = 0.12).

Conclusions: For this fracture pattern, a 3-hole SHS with RIM nail may be a suitable surgical alternative to the traditional "gold standard" method because it provides the same biomechanical properties while potentially reducing surgical time, blood loss, and hardware used.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Biomechanical Phenomena
Bone Nails*
Bone Screws*
Cadaver
Female
Fracture Fixation, Internal / methods*
Fractures, Comminuted / diagnosis
Fractures, Comminuted / surgery*
Hip Fractures / diagnosis
Hip Fractures / surgery*
Humans
Male
Materials Testing / methods*
Middle Aged