Unstable Vancouver B1 Periprosthetic Femoral Fracture Fixation: A Biomechanical Comparison Between a Novel C-shaped Memory Alloy Implant and Cerclage Wiring

Overview

Journal J Int Med Res

Publisher Sage Publications

Specialty General Medicine

Date 2024 Mar 27

PMID 38534086

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

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Pilot study on the feasibility of shape memory alloy implantation for Vancouver type B1 periprosthetic femoral fractures in a canine model: a step toward advancing treatment modalities.

Kim H, Kang K, Chekalkin T, Park J, Chung H, Kang B J Orthop Surg Res. 2024; 19(1):510.

PMID: 39192290 PMC: 11348569. DOI: 10.1186/s13018-024-05011-4.

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