Compressive loading causes unique mechanism of failure in second generation sliding hip screw

Monique Bethel, Jeffrey Levenda, Peter Hogg, Daniel Alge, T.M. Gabriel Chu, Brian Mullis

Research output: Contribution to journalArticle

Abstract

The sliding hip screw (SHS) has been used for the fixation of intertrochanteric hip fractures for decades. Newer devices have been designed to address persistent failures in SHS; however, the superiority of all new devices has not been established. We compared the stability of a classic SHS to a 2nd generation device. Intertrochanteric fractures were created in cadaveric and synthetic femurs, and then repaired with either a 1st generation SHS or a 2nd generation SHS. Fixation by both implants was tested by compressive loading. There was a significantly higher rate of failure via rotational instability of the proximal fragment (p < 0.05) with the 2nd generation SHS due to disengagement of an anti-rotational bushing mechanism. Further studies are needed to determine if this study translates to concerns for higher failure rates in the clinical setting, however our results suggest that there is no benefit to the use of this 2nd generation device.

Original languageEnglish
Pages (from-to)311-320
Number of pages10
JournalInternational Journal of Medical Engineering and Informatics
Volume5
Issue number4
DOIs
StatePublished - 2013

Fingerprint

Hip
Hip Fractures
Equipment and Supplies
Bushings
Femur

Keywords

  • Biomechanics
  • DHS
  • Dynamic helical hip screw
  • Dynamic hip screw
  • Helical blade
  • Intertrochanteric hip fracture
  • Locking sliding hip screw
  • Spiral blade

ASJC Scopus subject areas

  • Biomedical Engineering
  • Health Informatics
  • Medicine (miscellaneous)
  • Biomaterials

Cite this

Compressive loading causes unique mechanism of failure in second generation sliding hip screw. / Bethel, Monique; Levenda, Jeffrey; Hogg, Peter; Alge, Daniel; Chu, T.M. Gabriel; Mullis, Brian.

In: International Journal of Medical Engineering and Informatics, Vol. 5, No. 4, 2013, p. 311-320.

Research output: Contribution to journalArticle

@article{44c3964d00aa4733a1c2d4f2dc09de7d,
title = "Compressive loading causes unique mechanism of failure in second generation sliding hip screw",
abstract = "The sliding hip screw (SHS) has been used for the fixation of intertrochanteric hip fractures for decades. Newer devices have been designed to address persistent failures in SHS; however, the superiority of all new devices has not been established. We compared the stability of a classic SHS to a 2nd generation device. Intertrochanteric fractures were created in cadaveric and synthetic femurs, and then repaired with either a 1st generation SHS or a 2nd generation SHS. Fixation by both implants was tested by compressive loading. There was a significantly higher rate of failure via rotational instability of the proximal fragment (p < 0.05) with the 2nd generation SHS due to disengagement of an anti-rotational bushing mechanism. Further studies are needed to determine if this study translates to concerns for higher failure rates in the clinical setting, however our results suggest that there is no benefit to the use of this 2nd generation device.",
keywords = "Biomechanics, DHS, Dynamic helical hip screw, Dynamic hip screw, Helical blade, Intertrochanteric hip fracture, Locking sliding hip screw, Spiral blade",
author = "Monique Bethel and Jeffrey Levenda and Peter Hogg and Daniel Alge and Chu, {T.M. Gabriel} and Brian Mullis",
year = "2013",
doi = "10.1504/IJMEI.2013.057185",
language = "English",
volume = "5",
pages = "311--320",
journal = "International Journal of Medical Engineering and Informatics",
issn = "1755-0653",
publisher = "Inderscience Enterprises Ltd",
number = "4",

}

TY - JOUR

T1 - Compressive loading causes unique mechanism of failure in second generation sliding hip screw

AU - Bethel, Monique

AU - Levenda, Jeffrey

AU - Hogg, Peter

AU - Alge, Daniel

AU - Chu, T.M. Gabriel

AU - Mullis, Brian

PY - 2013

Y1 - 2013

N2 - The sliding hip screw (SHS) has been used for the fixation of intertrochanteric hip fractures for decades. Newer devices have been designed to address persistent failures in SHS; however, the superiority of all new devices has not been established. We compared the stability of a classic SHS to a 2nd generation device. Intertrochanteric fractures were created in cadaveric and synthetic femurs, and then repaired with either a 1st generation SHS or a 2nd generation SHS. Fixation by both implants was tested by compressive loading. There was a significantly higher rate of failure via rotational instability of the proximal fragment (p < 0.05) with the 2nd generation SHS due to disengagement of an anti-rotational bushing mechanism. Further studies are needed to determine if this study translates to concerns for higher failure rates in the clinical setting, however our results suggest that there is no benefit to the use of this 2nd generation device.

AB - The sliding hip screw (SHS) has been used for the fixation of intertrochanteric hip fractures for decades. Newer devices have been designed to address persistent failures in SHS; however, the superiority of all new devices has not been established. We compared the stability of a classic SHS to a 2nd generation device. Intertrochanteric fractures were created in cadaveric and synthetic femurs, and then repaired with either a 1st generation SHS or a 2nd generation SHS. Fixation by both implants was tested by compressive loading. There was a significantly higher rate of failure via rotational instability of the proximal fragment (p < 0.05) with the 2nd generation SHS due to disengagement of an anti-rotational bushing mechanism. Further studies are needed to determine if this study translates to concerns for higher failure rates in the clinical setting, however our results suggest that there is no benefit to the use of this 2nd generation device.

KW - Biomechanics

KW - DHS

KW - Dynamic helical hip screw

KW - Dynamic hip screw

KW - Helical blade

KW - Intertrochanteric hip fracture

KW - Locking sliding hip screw

KW - Spiral blade

UR - http://www.scopus.com/inward/record.url?scp=84886492803&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84886492803&partnerID=8YFLogxK

U2 - 10.1504/IJMEI.2013.057185

DO - 10.1504/IJMEI.2013.057185

M3 - Article

AN - SCOPUS:84886492803

VL - 5

SP - 311

EP - 320

JO - International Journal of Medical Engineering and Informatics

JF - International Journal of Medical Engineering and Informatics

SN - 1755-0653

IS - 4

ER -