Minimally Invasive Internal Fixation of Femoral Shaft Fractures—A Biomechanical Study with a Disruptive Technique

(1) Background: In polytrauma patients, femur fractures are usually stabilised by external fixation for damage control, later being treated with definitive plate or nail osteosynthesis. Screw/rod systems established in spinal surgery might be inserted for internal fixation, providing sufficient frac...

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Autores principales:	Frank Layher, Georg Matziolis, Leos N. Kayhan, Matthias Bungartz, Olaf Brinkmann
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	femur fracture biomechanical study sawbone internal fixator disruptive technique Science Q
Acceso en línea:	https://doaj.org/article/6c6a1d3eefbc4acf8a79d34a79e852a4
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spelling	oai:doaj.org-article:6c6a1d3eefbc4acf8a79d34a79e852a42021-11-25T18:11:36ZMinimally Invasive Internal Fixation of Femoral Shaft Fractures—A Biomechanical Study with a Disruptive Technique10.3390/life111112542075-1729https://doaj.org/article/6c6a1d3eefbc4acf8a79d34a79e852a42021-11-01T00:00:00Zhttps://www.mdpi.com/2075-1729/11/11/1254https://doaj.org/toc/2075-1729(1) Background: In polytrauma patients, femur fractures are usually stabilised by external fixation for damage control, later being treated with definitive plate or nail osteosynthesis. Screw/rod systems established in spinal surgery might be inserted for internal fixation, providing sufficient fracture stability that subsequent intervention is unnecessary. This was to be investigated biomechanically. (2) Methods: The unilaterally applied spinal internal fixator (IF) was subjected to load and deformation analysis on artificial femurs with 32-A3 fracture according to AO classification. Distance of screws to fracture and rod to cortical bone were analysed as parameters influenced surgically as stiffness and deformation of the treated fracture. In addition, the stability of another construct with a second screw/rod system was determined. The axial load in stance phase during walking was simulated. The results were compared against an established fixed-angle plate osteosynthesis (IP). (3) Results: There were no implant failures in the form of fractures, avulsions or deformations. All unilateral IF combinations were inferior to IP in terms of stability and stiffness. The bilateral construct with two screw/rod systems achieved biomechanical properties comparable to IP. 4) Conclusion: Biomechanically, a biplanar screw/rod system is suitable for definitive fracture stabilisation of the femur, despite a damage control approach.Frank LayherGeorg MatziolisLeos N. KayhanMatthias BungartzOlaf BrinkmannMDPI AGarticlefemur fracturebiomechanical studysawboneinternal fixatordisruptive techniqueScienceQENLife, Vol 11, Iss 1254, p 1254 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	femur fracture biomechanical study sawbone internal fixator disruptive technique Science Q
spellingShingle	femur fracture biomechanical study sawbone internal fixator disruptive technique Science Q Frank Layher Georg Matziolis Leos N. Kayhan Matthias Bungartz Olaf Brinkmann Minimally Invasive Internal Fixation of Femoral Shaft Fractures—A Biomechanical Study with a Disruptive Technique
description	(1) Background: In polytrauma patients, femur fractures are usually stabilised by external fixation for damage control, later being treated with definitive plate or nail osteosynthesis. Screw/rod systems established in spinal surgery might be inserted for internal fixation, providing sufficient fracture stability that subsequent intervention is unnecessary. This was to be investigated biomechanically. (2) Methods: The unilaterally applied spinal internal fixator (IF) was subjected to load and deformation analysis on artificial femurs with 32-A3 fracture according to AO classification. Distance of screws to fracture and rod to cortical bone were analysed as parameters influenced surgically as stiffness and deformation of the treated fracture. In addition, the stability of another construct with a second screw/rod system was determined. The axial load in stance phase during walking was simulated. The results were compared against an established fixed-angle plate osteosynthesis (IP). (3) Results: There were no implant failures in the form of fractures, avulsions or deformations. All unilateral IF combinations were inferior to IP in terms of stability and stiffness. The bilateral construct with two screw/rod systems achieved biomechanical properties comparable to IP. 4) Conclusion: Biomechanically, a biplanar screw/rod system is suitable for definitive fracture stabilisation of the femur, despite a damage control approach.
format	article
author	Frank Layher Georg Matziolis Leos N. Kayhan Matthias Bungartz Olaf Brinkmann
author_facet	Frank Layher Georg Matziolis Leos N. Kayhan Matthias Bungartz Olaf Brinkmann
author_sort	Frank Layher
title	Minimally Invasive Internal Fixation of Femoral Shaft Fractures—A Biomechanical Study with a Disruptive Technique
title_short	Minimally Invasive Internal Fixation of Femoral Shaft Fractures—A Biomechanical Study with a Disruptive Technique
title_full	Minimally Invasive Internal Fixation of Femoral Shaft Fractures—A Biomechanical Study with a Disruptive Technique
title_fullStr	Minimally Invasive Internal Fixation of Femoral Shaft Fractures—A Biomechanical Study with a Disruptive Technique
title_full_unstemmed	Minimally Invasive Internal Fixation of Femoral Shaft Fractures—A Biomechanical Study with a Disruptive Technique
title_sort	minimally invasive internal fixation of femoral shaft fractures—a biomechanical study with a disruptive technique
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/6c6a1d3eefbc4acf8a79d34a79e852a4
work_keys_str_mv	AT franklayher minimallyinvasiveinternalfixationoffemoralshaftfracturesabiomechanicalstudywithadisruptivetechnique AT georgmatziolis minimallyinvasiveinternalfixationoffemoralshaftfracturesabiomechanicalstudywithadisruptivetechnique AT leosnkayhan minimallyinvasiveinternalfixationoffemoralshaftfracturesabiomechanicalstudywithadisruptivetechnique AT matthiasbungartz minimallyinvasiveinternalfixationoffemoralshaftfracturesabiomechanicalstudywithadisruptivetechnique AT olafbrinkmann minimallyinvasiveinternalfixationoffemoralshaftfracturesabiomechanicalstudywithadisruptivetechnique
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Minimally Invasive Internal Fixation of Femoral Shaft Fractures—A Biomechanical Study with a Disruptive Technique

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