Nicole M van Veelen1, Frank Jp Beeres1, Björn-Christian Link1, Reto Babst2,3. 1. Klinik für Orthopädie und Unfallchirurgie, Luzerner Kantonsspital, Spitalstraße, 6000, Luzern 16, Schweiz. 2. Klinik für Orthopädie und Unfallchirurgie, Luzerner Kantonsspital, Spitalstraße, 6000, Luzern 16, Schweiz. Reto.babst@luks.ch. 3. Departement Gesundheitswissenschaften und Medizin, Universität Luzern, Frohburgstraße 3, 6002, Luzern, Schweiz. Reto.babst@luks.ch.
Abstract
BACKGROUND: Proximal humeral and trochanteric femoral fractures in older patients are typically caused by low-energy trauma and are therefore often associated with osteoporosis. The treatment of such fragility fractures can be difficult as implant purchase is reduced in osteoporotic bone. By augmenting the fixation with cement the contact surface between implant and bone can be increased, which improves the stability of the osteosynthesis. OBJECTIVE: This article describes the operative technique for the augmentation of trochanteric femoral fractures treated with the Trochanteric Fixation Nail-Advanced (TFNA, DePuy Synthes, Oberdorf BL, Switzerland) and proximal humeral fractures stabilized with a PHILOS plate (DePuy Synthes). Furthermore, the evidence for the augmentation of these two fracture types is elucidated. RESULTS: Biomechanical studies could show an improved stability of the osteosynthesis after successful augmentation for both fracture types. The current evidence also indicates a clinical reduction of fixation failure. Whether the augmentation has an influence on the functional result could so far not yet clearly be proven. CONCLUSION: Augmentation seems to be a safe and valuable addition to available treatment options especially for patients with fragility fractures.
BACKGROUND: Proximal humeral and trochanteric femoral fractures in older patients are typically caused by low-energy trauma and are therefore often associated with osteoporosis. The treatment of such fragility fractures can be difficult as implant purchase is reduced in osteoporotic bone. By augmenting the fixation with cement the contact surface between implant and bone can be increased, which improves the stability of the osteosynthesis. OBJECTIVE: This article describes the operative technique for the augmentation of trochanteric femoral fractures treated with the Trochanteric Fixation Nail-Advanced (TFNA, DePuy Synthes, Oberdorf BL, Switzerland) and proximal humeral fractures stabilized with a PHILOS plate (DePuy Synthes). Furthermore, the evidence for the augmentation of these two fracture types is elucidated. RESULTS: Biomechanical studies could show an improved stability of the osteosynthesis after successful augmentation for both fracture types. The current evidence also indicates a clinical reduction of fixation failure. Whether the augmentation has an influence on the functional result could so far not yet clearly be proven. CONCLUSION: Augmentation seems to be a safe and valuable addition to available treatment options especially for patients with fragility fractures.
Authors: Frank J P Beeres; N D L Hallensleben; S J Rhemrev; J C Goslings; F Oehme; S A G Meylaerts; R Babst; N W L Schep Journal: Arch Orthop Trauma Surg Date: 2017-09-19 Impact factor: 3.067
Authors: Felix Brunner; Christoph Sommer; Christian Bahrs; Rainer Heuwinkel; Christian Hafner; Paavo Rillmann; Georges Kohut; Anders Ekelund; Mathias Muller; Laurent Audigé; Reto Babst Journal: J Orthop Trauma Date: 2009-03 Impact factor: 2.512