Schaasberg W, van der Steenhoven T J, van de Velde S K, Nelissen R G H H, Valstar E R
Leiden University Medical Center, Department of Orthopaedics, Leiden, The Netherlands.
Leiden University Medical Center, Department of Surgery, Leiden, The Netherlands.
Clin Biomech (Bristol). 2014 Aug;29(7):742-6. doi: 10.1016/j.clinbiomech.2014.06.006. Epub 2014 Jun 21.
In vitro cadaveric studies showed that elastomer femoroplasty prevents displacement of fracture parts after proximal hip fracture allowing for conservative treatment. In the event that secondary displacement does occur, the purpose of this present study was to determine the feasibility of performing osteosynthesis of a fractured hip after preventive treatment with elastomer femoroplasty.
Ten pairs of human cadaveric femurs were fractured in a simulated fall configuration. From each pair, one femur was randomly selected for elastomer femoroplasty prior to fracture generation and the contralateral femur was used as control. Following hip fracture generation, osteosynthesis was performed in all femurs. The operative time per case, technical difficulties during the procedure, and postoperative energy-to-failure load were recorded.
The mean (SD) time to perform osteosynthesis was 20 (6) minutes in the control-group and 19 (5) minutes in the elastomer femoroplasty-group (P=0.69). During osteosynthesis of the fractured hip in the elastomer femoroplasty-group, no difficulties including the need for additional instruments to remove elastomer from the proximal femur were recorded. Postoperative energy-to-failure load was similar in the control-group and the elastomer femoroplasty-group.
Fixation with routine osteosynthesis of displaced cadaveric hip fractures is not hindered by the presence of previously injected elastomer.
体外尸体研究表明，弹性体股骨成形术可防止髋部近端骨折后骨折部位移位，从而允许进行保守治疗。如果确实发生二次移位，本研究的目的是确定在用弹性体股骨成形术进行预防性治疗后对骨折髋部进行骨合成的可行性。
十对人体尸体股骨以模拟跌倒姿势造成骨折。从每对中随机选择一根股骨在骨折前进行弹性体股骨成形术，对侧股骨用作对照。髋部骨折后，对所有股骨进行骨合成。记录每例手术时间、手术过程中的技术难度以及术后破坏能量负荷。
对照组进行骨合成的平均（标准差）时间为20（6）分钟，弹性体股骨成形术组为19（5）分钟（P = 0.69）。在弹性体股骨成形术组髋部骨折的骨合成过程中，未记录到任何困难，包括不需要额外器械从股骨近端移除弹性体。对照组和弹性体股骨成形术组术后破坏能量负荷相似。
先前注射的弹性体的存在并不妨碍对移位的尸体髋部骨折进行常规骨合成固定。
