The effect of the degree of screw tension on interfragmentary displacement in stabilized fractures of the femoral neck

Hdl Handle:
http://hdl.handle.net/10149/95848
Title:
The effect of the degree of screw tension on interfragmentary displacement in stabilized fractures of the femoral neck
Authors:
Bradley, E. J. (Edward); Nabhani, F. (Farhad); Spears, I. R. (Iain)
Affiliation:
University of Teesside. School School of Science and Technology; University of Teesside. School of Social Science and Law.
Citation:
Bradley, E. J., Nabhani, F. and Spears, I. R. (2009) 'The effect of the degree of screw tension on interfragmentary displacement in stabilized fractures of the femoral neck', Current Orthopaedic Practice, 20 (3), pp.291-299.
Publisher:
Wolters Kluwer/ Lippincott, Williams & Wilkins
Journal:
Current Orthopaedic Practice
Issue Date:
Jun-2009
URI:
http://hdl.handle.net/10149/95848
DOI:
10.1097/BCO.0b013e3181972894
Abstract:
Background: It is important that axial and shear movements can be measured when determining the stability of a femoral neck fracture. Axial movement has been reported as being beneficial to bone healing, while shear movement is inhibitory to early callus formation. Screw tightening presently is performed at the surgeon's own choice, with no known levels for optimizing the amount of axial or shear displacement. Methods: A Pauwels type II osteotomy and a realistic vertical fracture were created in the femoral neck of a composite femur and stabilized using a triangular configuration of cannulated screws. Paired markers less than 1mm in diameter were attached to the cortical surface at the fracture interface. A load of 800N was applied to the femoral head at a rate of 80Nsec-1, and relative movement of the markers was captured using a digital camcorder. The movement was digitized with markers selected frame by frame. Axial and shear displacements were calculated by transforming the global coordinate system to a local system relative to the fracture plane. Four levels of screw tightening were examined, up to two full revolutions. Results: The internal consistency of marker selection was high (Cronbach's alpha > 0.9). Measurements of displacement fall within the tolerance limits defined in the literature for fracture gap increases. Screw tightening improved stability, with one and two revolutions reducing the interfragmentary movement and axial displacements by over 70%, compared to no tightening. Conclusion: Screw tension was important in stabilizing the fracture and improving the chance of primary bone healing.
Type:
Article
Language:
en
Keywords:
axial and shear displacement; femoral neck fracture; interfragmentary movement; motion analysis; screw tightening
ISSN:
1940-7041
Rights:
Subject to restrictions, author can archive post-print (ie final draft post-refereeing). For full details see http://www.sherpa.ac.uk/romeo/ [Accessed 07/04/2010]
Citation Count:
0 [Scopus, 07/04/2010]

Full metadata record

DC FieldValue Language
dc.contributor.authorBradley, E. J. (Edward)en
dc.contributor.authorNabhani, F. (Farhad)en
dc.contributor.authorSpears, I. R. (Iain)en
dc.date.accessioned2010-04-07T11:21:08Z-
dc.date.available2010-04-07T11:21:08Z-
dc.date.issued2009-06-
dc.identifier.citationCurrent Orthopaedic Practice; 20 (3): 291-299en
dc.identifier.issn1940-7041-
dc.identifier.doi10.1097/BCO.0b013e3181972894-
dc.identifier.urihttp://hdl.handle.net/10149/95848-
dc.description.abstractBackground: It is important that axial and shear movements can be measured when determining the stability of a femoral neck fracture. Axial movement has been reported as being beneficial to bone healing, while shear movement is inhibitory to early callus formation. Screw tightening presently is performed at the surgeon's own choice, with no known levels for optimizing the amount of axial or shear displacement. Methods: A Pauwels type II osteotomy and a realistic vertical fracture were created in the femoral neck of a composite femur and stabilized using a triangular configuration of cannulated screws. Paired markers less than 1mm in diameter were attached to the cortical surface at the fracture interface. A load of 800N was applied to the femoral head at a rate of 80Nsec-1, and relative movement of the markers was captured using a digital camcorder. The movement was digitized with markers selected frame by frame. Axial and shear displacements were calculated by transforming the global coordinate system to a local system relative to the fracture plane. Four levels of screw tightening were examined, up to two full revolutions. Results: The internal consistency of marker selection was high (Cronbach's alpha > 0.9). Measurements of displacement fall within the tolerance limits defined in the literature for fracture gap increases. Screw tightening improved stability, with one and two revolutions reducing the interfragmentary movement and axial displacements by over 70%, compared to no tightening. Conclusion: Screw tension was important in stabilizing the fracture and improving the chance of primary bone healing.en
dc.language.isoenen
dc.publisherWolters Kluwer/ Lippincott, Williams & Wilkinsen
dc.rightsSubject to restrictions, author can archive post-print (ie final draft post-refereeing). For full details see http://www.sherpa.ac.uk/romeo/ [Accessed 07/04/2010]en
dc.subjectaxial and shear displacementen
dc.subjectfemoral neck fractureen
dc.subjectinterfragmentary movementen
dc.subjectmotion analysisen
dc.subjectscrew tighteningen
dc.titleThe effect of the degree of screw tension on interfragmentary displacement in stabilized fractures of the femoral necken
dc.typeArticleen
dc.contributor.departmentUniversity of Teesside. School School of Science and Technology; University of Teesside. School of Social Science and Law.en
dc.identifier.journalCurrent Orthopaedic Practiceen
ref.citationcount0 [Scopus, 07/04/2010]en
or.citation.harvardBradley, E. J., Nabhani, F. and Spears, I. R. (2009) 'The effect of the degree of screw tension on interfragmentary displacement in stabilized fractures of the femoral neck', Current Orthopaedic Practice, 20 (3), pp.291-299.-
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