1. XXVI SICOT TRIENNIAL WORLD CONGRESS
BIOMECHANICAL ANALYSIS OF OSTEOSYNTHESIS IN UNSTABLE FEMORAL NECK FRACTURES
Hip Surgeons:
MD. Marcelo Ferrer;
MD. Anderson Freitas;
MD. Patrick Godinho;
MD. George Neri
MD. Diogo Ranier

2. XXVI SICOT TRIENNIAL WORLD CONGRESS
BIOMECHANICAL ANALYSIS OF OSTEOSYNTHESIS IN UNSTABLE FEMORAL NECK FRACTURES
Don’t have
Conflict of interest

3. XXVI SICOT TRIENNIAL WORLD CONGRESS
BIOMECHANICAL ANALYSIS OF OSTEOSYNTHESIS IN UNSTABLE FEMORAL NECK FRACTURES
Acknowledgment
Orthopedics fellows at the regional hospital of Gama ( HRG - DF)

4. BIOMECHANICAL ANALYSIS OF OSTEOSYNTHESIS IN UNSTABLE FEMORAL NECK FRACTURES
Objectives
To statistically analyse the results obtained in the biomechanical tests of four methods for the fixation of unstable femoral neck fractures using osteoporotic synthetic bones, and to compare these results with a control group for suggesting the most biomechanically stable method.

5. Results of Internal Fixation of Pauwels Type-3 Vertical Femoral Neck Fractures
Frank Liporace, MD; Robert Gaines, MD; Cory Collinge, MD; George J.Haidukewych, MD
J Bone Joint Surg Am, 2008 Aug 01;90(8):

6. Results of Internal Fixation of Pauwels Type-3 Vertical Femoral Neck Fractures
Liporace, J Bone Joint Surg Am, 2008 Aug 01;90(8):
95 patients with mean age 45
19% Nounion with screws
8% Nounion with Fixed angle divece
11% Osteonecrosis

7. Results of Internal Fixation of Pauwels Type-3 Vertical Femoral Neck Fractures
Liporace, J Bone Joint Surg Am, 2008 Aug 01;90(8):
95 patients with mean age 45
19% Nounion with screws
8% Nounion with Fixed angle divece
11% Osteonecrosis

8. Separated in 5 groups with 5 units
Materials and Methods
Separated in 5 groups with 5 units

9. Materials and Methods
1° - Step
Density analysis in all synthetic bone

10. Materials and Methods
1° - Step
Density analysis in all synthetic bone

11. Materials and Methods
1° - Step
Density analysis in all synthetic bone

12. Materials and Methods
1° - Step
Density analysis
calculate the uncertainty
Mass
Volume
Density

13. Materials and Methods
1° - Step
Density analysis
calculate the uncertainty
Mass
Volume
Density

14. Materials and Methods
1° - Step
Density analysis
calculate the uncertainty
Mass
Volume
Density

15. Mean density all the sintetics bones = 0.1520 g/cm³
Materials and Methods
1° - Step
Density analysis
Mean density all the sintetics bones = g/cm³

16. Materials and Methods
2 ° - Step ( Analysis in the control group )
Length analysis for the femoral neck fracture originate in the control group
The load and extension displacement values for the femoral neck fracture originate in the control group.

17. Materials and Methods
2° - Step
Length analysis

18. Materials and Methods
2° - Step
Length analysis

19. Materials and Methods
2° - Step
Length analysis

20. Materials and Methods
2° - Step
Length analysis

21. Materials and Methods
2° - Step
Length analysis

22. Materials and Methods
2° - Step
Length analysis

23. Materials and Methods
2° - Step
Length analysis

24. The control group length = 150 mm
Materials and Methods
2° - Step
Length analysis for the femoral neck fracture originate in the control group
The control group length = 150 mm

25. The control group Load mean = 1329 N
Materials and Methods
2° - Step
* The load values
Control Group
Unit
Máx. Load (N) 1
1544 2
1110 3
1359 4
1194 5
1437
Mean
1329 SD
177
The control group Load mean = 1329 N

26. The control group extension = 10.86 mm
Materials and Methods
2° - Step
* Extension displacement
The control group extension = mm

27. Materials and Methods
3° - Step ( Preparation the test groups )
osteotomy 70° ( Pauwels III )
Fixations ( DHS, cannulated screws type1, cannulated screws type2, DCS )
X- Ray
Rotational control tag

28. Materials and Methods
3° - Step ( Preparation the test groups )
osteotomy 70° ( Pauwels III )

29. Materials and Methods
3° - Step ( Preparation the test groups )
Fixations
DHS + anti-rotational screw

30. Materials and Methods
3° - Step ( Preparation the test groups )
Fixations
Cannulated screws
Type 1 ( ASNIS )

31. Materials and Methods
3° - Step ( Preparation the test groups )
Fixations
Cannulated screws
Type 2 ( No parallel )

32. Materials and Methods
3° - Step ( Preparation the test groups )
Fixations
DCS

33. Materials and Methods
3° - Step ( Preparation the test groups )
X- Ray

34. Materials and Methods
3° - Step ( Preparation the test groups )
Rotational control tag

35. Materials and Methods
4° - Step (Biomechanical analysis in the test groups )

36. Results Control Group Max Load (N) 1544 1110 1359 1194 1437 1329
Unit
Max
Load
(N) 1
1544 2
1110 3
1359 4
1194 5
1437
Mean
1329
Standard Desviation
177

37. Results DHS Group Control Max Load (N) 2064 1544 1895 1110 1682 1359
Unit
Max
Load
(N) 1
2064
1544 2
1895
1110 3
1682
1359 4
1713
1194 5
1354
1437
Mean
1742
1329
Standard Desviation
265
177

38. Results DHS Group CS 1 Control Max. Load (N) 2064 860 1544 1895 607
Unit
Max.
Load
(N) 1
2064
860
1544 2
1895
607
1110 3
1682
614
1359 4
1713
658
1194 5
1354
743
1437
Mean
1742
696
1329
Standard Desviation
265
106
177

39. Results DHS Group CS1 Goup CS2 Control Max. Load (N) 2064 860 640 1544
Unit
Max.
Load
(N) 1
2064
860
640
1544 2
1895
607
555
1110 3
1682
614
801
1359 4
1713
658
593
1194 5
1354
743
655
1437
Mean
1742
696
649
1329
Standard Desviation
265
106 94
177

40. Results DHS Group DCS CS1 Goup CS2 Control Max. Load (N) 2064 1438 860
Unit
Max.
Load
(N) 1
2064
1438
860
640
1544 2
1895
1409
607
555
1110 3
1682
1323
614
801
1359 4
1713
1186
658
593
1194 5
1354
1321
743
655
1437
Mean
1742
1335
696
649
1329
Standard Desviation
265 98
106 94
177

41. Results DHS Group DCS CS1 CS2 UNIT Rotation (mm) Rotation degrees 1
1,5
4,90
0,1
0,33
1,0
3,27
2,2
7,16 2
1.0
0,0
0,5
1,64
1,1
3,60 3
0,8
2,62
1,6
5,22 4
0,2
0,66
1,7
5,55
2,0
6,52
1,2
3,29 5
0,3
0,98
Mean
0,67
2,42
0,42
1,37
1,02
3,33
1,20
3,79
Standard Desviation
0,62
1,81
0,72
2,37
0,81
2,63
2,03

42. Kruskal–Wallis ANOVA analysis Dunn’s multiple comparison test ( 5%)
Results
Statistical analysis
Kruskal–Wallis ANOVA analysis
The significant difference in the maximum force for 10-mm dislocation was observed between the groups (p = ).
Dunn’s multiple comparison test ( 5%)
DHS > DCS ≈ control > PC1 ≈ PC2

43. There was no statistical difference with control group DHS DCS
Conclusion
There was no statistical difference with control group
DHS
DCS
Statistical difference with control group
CS1
CS2

44. Dunn’s multiple comparison test ( 5%)
Results
Statistical analysis
Dunn’s multiple comparison test ( 5%)
DHS > DCS ≈ control > PC1 ≈ PC2

45. *WAS ROTATIONAL DEVIATIONS IN ALL GROUPS
Conclusion
BUT
*WAS ROTATIONAL DEVIATIONS IN ALL GROUPS

46. THANKS