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The treatment of periprosthetic fractures with locking plates: effect of drill and screw type on cement mantles: a biomechanical analysis

  • Orthopaedic Surgery
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Abstract

Introduction

Periprosthetic fractures after cemented hip replacement are a challenging problem to manage. Biomechanical studies have suggested the benefit of using locking screws for plate fixation, but there are concerns whether screws damage the cement mantle and promote crack propagation leading to construct failure.

Method

In this biomechanical study, different screw types were implanted into the cement mantle after pre-drilling holes of different sizes, in unicortical and bicortical configuration. The presence of cracks and the pull-out resistance of these screws were then evaluated.

Results

No unicortical screw induced cracks. Screws with a shortened tip, smaller flutes and double threads were significantly better for pull-out resistance. Bicortical screws were associated with a risk of local cement mantle damage, but also with a significantly greater holding power. By increasing the drill diameter, the onset of cracks decreased, but so does the pull-out resistance.

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Acknowledgment

This study was supported by the APOS (Asia Pacific Orthopaedic Symposium) research grant. We kindly thank Zimmer and Synthes who provided screws and cement for this study. We acknowledge the assistance of Albert Hansma and Rochelle Nicholls from Fremantle Hospital for their help at performing this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Fremantle Hospital, P.O. Box 480, Fremantle, WA, 6160, Australia

    Jorg Kampshoff & Piers J. Yates

  2. Department of Orthopaedic Surgery, Kantonsspital St. Gallen, Rohrschacher Strasse, 9007, St. Gallen, Switzerland

    Johannes B. Erhardt & Markus S. Kuster

  3. Department of Orthopaedic Surgery, Kantonsspital Graubunden, Loestrasse 170, 7000, Chur, Switzerland

    Karl K. Stoffel

  4. The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia

    Jorg Kampshoff, Karl K. Stoffel, Piers J. Yates & Markus S. Kuster

Authors
  1. Jorg Kampshoff
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  2. Karl K. Stoffel
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  3. Piers J. Yates
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  4. Johannes B. Erhardt
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  5. Markus S. Kuster
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Corresponding author

Correspondence to Jorg Kampshoff.

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Kampshoff, J., Stoffel, K.K., Yates, P.J. et al. The treatment of periprosthetic fractures with locking plates: effect of drill and screw type on cement mantles: a biomechanical analysis. Arch Orthop Trauma Surg 130, 627–632 (2010). https://doi.org/10.1007/s00402-009-0952-3

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  • DOI: https://doi.org/10.1007/s00402-009-0952-3

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