The effect of moment arm length on high angled femoral neck fractures (Pauwels’ III)

Matthew S. LePine, William R. Barfield, John D. DesJardins, Langdon A. Hartsock
DOI: 10.4236/jbise.2010.35062                

Abstract

This study investigated loads among five fixation types (FT) [three cannulated screws (CS), dynamic hip screws with and without derotational screws (DHS-DS and DHS), and dynamic helical hip screws with and without derotational screws (DHHS-DS and DHHS)] across three fracture moment lengths (ML) in Pauwels’ Type III fractures. Methods: Seventy-five sawbones were tested (5 FT × 5 trials × 3 ML). The study hypothesis was that significant differences in axial loading to failure would be demonstrated when CS was compared with the other four FT at the three MLs. Each construct was exposed to an axial compressive load to failure. Construct failure was defined as 5 mm of migration at the fracture site or fixation failure. Shapiro-Wilk was used to test for data normality. Subsequently, independent t-tests with Bonferroni correction was used for paired comparisons. Results: At fracture Moments A and B there were no statistical differences between CS and the other FT. At fracture Moment C all four FT yielded significantly higher (p ≤ 0.001) loads compared with CS. Conclusions: for basicervical fractures CS is a suboptimal form of fixation compared with DHS and DHHS both with and without derotation screws.

Keywords

Pauwels’ Fracture, Biomechanical Testing, Fixation

Conflicts of Interest

The authors declare no conflicts of interest.

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