The hip head-conserving management of traumatic medial cervical hip fractures with big-fragment screws: a biomechanical examination

• Published in: Zeitschrift für orthopädie und ihre grenzgebiete Vol. 143; no. 4; p. 412
• Main Authors: Kühling, J, Schmidt, J, Dahn, T, Niebergall, U, Bogusch, G
• Format: Journal Article
• Language: German
• Published: Germany 01.07.2005
• Subjects: Adult; Aged; Aged, 80 and over; Biomechanical Phenomena; Bone Screws; Equipment Failure; Female; Femoral Neck Fractures - physiopathology; Femoral Neck Fractures - surgery; Femur Neck - physiopathology; Fracture Fixation, Internal - methods; Humans; Male; Middle Aged; Models, Theoretical; Outcome and Process Assessment (Health Care) - statistics & numerical data; Postoperative Complications - physiopathology
• ISSN: 0044-3220
• DOI: 10.1055/S-2005-836807

With the growing number of elderly people in the population and the increasing incidence of proximal hip fractures the question of how to manage the medial hip head fracture is of increasing importance. Especially in Hungary and the Scandinavian countries surgeons prefer hip head-conserving therapy although the redislocation of this fracture and necrosis of the hip head opposes this point of view. Encouraged by two theoretical and mathematical calculations, we tested two different possibilities to screw hip head fractures. Our results show that the hip head-conserving therapy with two cranial screws and a three-point-supported screw at Adam's arc has essential biomechanical advantages compared with the situation after conventional osteosynthesis. This result encourages us to prefer the minimally invasive head-conserving therapy of medial hip head fractures, especially for treatment of Pauwell's I and II injuries.