TY - JOUR
T1 - Prevention of hip lag screw cut-out by cement augmentation
T2 - Description of a new technique and preliminary clinical results
AU - Szpalski, Marek
AU - Descamps, Pierre Yves
AU - Hayez, Jean Pierre
AU - Raad, Emmanuel
AU - Gunzburg, Robert
AU - Keller, Tony S.
AU - Kosmopoulos, Victor
PY - 2004/1/1
Y1 - 2004/1/1
N2 - Cement augmentation of hip lag screws to avoid cut-out displacement is classically described, along with a number of technical drawbacks. In a series of six elderly patients with hip fractures in osteoporotic bone, we illustrate catheter-assisted delivery of limited amounts of a new bisphenol-a-glycidyl dimethacrylate (bis-GMA)-based composite into hip compression screw threads, enabling significant increase in insertional torque compared with unaugmented screws. In two patients, unaugmented screws that did not initially purchase were tightened with a minimum torque of 1 N-m after augmenting with bis-GMA-based composite. No screw or femoral head displacement relative to baseline (2 days postoperative) was seen in any patient on serial x-rays taken up to 6 months after surgery. This technique adds approximately 10 minutes to surgery time. Advantages of bis-GMA-based composite over traditional PMMA augmentation include mixing on-demand, the ability to make repeated injections over extended periods in the event of femoral head perforations (in one patient in this series), precise placement of adequately small volumes of material, and a lower exotherm. Potentially, this bis-GMA-based composite may reduce the frequency of cut-out complications by enhancing bone-implant interface.
AB - Cement augmentation of hip lag screws to avoid cut-out displacement is classically described, along with a number of technical drawbacks. In a series of six elderly patients with hip fractures in osteoporotic bone, we illustrate catheter-assisted delivery of limited amounts of a new bisphenol-a-glycidyl dimethacrylate (bis-GMA)-based composite into hip compression screw threads, enabling significant increase in insertional torque compared with unaugmented screws. In two patients, unaugmented screws that did not initially purchase were tightened with a minimum torque of 1 N-m after augmenting with bis-GMA-based composite. No screw or femoral head displacement relative to baseline (2 days postoperative) was seen in any patient on serial x-rays taken up to 6 months after surgery. This technique adds approximately 10 minutes to surgery time. Advantages of bis-GMA-based composite over traditional PMMA augmentation include mixing on-demand, the ability to make repeated injections over extended periods in the event of femoral head perforations (in one patient in this series), precise placement of adequately small volumes of material, and a lower exotherm. Potentially, this bis-GMA-based composite may reduce the frequency of cut-out complications by enhancing bone-implant interface.
KW - Bone void filler
KW - Cement augmentation
KW - Sliding compression screw fixation
KW - Trochanteric fractures
KW - bis-GMA
UR - http://www.scopus.com/inward/record.url?scp=0347286912&partnerID=8YFLogxK
U2 - 10.1097/00005131-200401000-00007
DO - 10.1097/00005131-200401000-00007
M3 - Article
C2 - 14676555
AN - SCOPUS:0347286912
SN - 0890-5339
VL - 18
SP - 34
EP - 40
JO - Journal of Orthopaedic Trauma
JF - Journal of Orthopaedic Trauma
IS - 1
ER -