title: [The hip head-conserving management of traumatic medial cervical hip fractures with big-fragment screws: a biomechanical examination].
abstract: OBJECTIVE
  With the growing number of elderly people in the population and the increasing incidence of proximal hip fractures the question of how to manage the medial hip head fracture is of increasing importance. Especially in Hungary and the Scandinavian countries surgeons prefer hip head-conserving therapy although the redislocation of this fracture and necrosis of the hip head opposes this point of view.
  
  
  METHODS
  Encouraged by two theoretical and mathematical calculations, we tested two different possibilities to screw hip head fractures.
  
  
  RESULTS
  Our results show that the hip head-conserving therapy with two cranial screws and a three-point-supported screw at Adam's arc has essential biomechanical advantages compared with the situation after conventional osteosynthesis.
  
  
  CONCLUSIONS
  This result encourages us to prefer the minimally invasive head-conserving therapy of medial hip head fractures, especially for treatment of Pauwell's I and II injuries.
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie im HELIOS Klinikum Berlin, Klinikum Buch. jkuehling@berlin.helios-kliniken.de
authors.forename: J
authors.initials: J
authors.lastname: Kühling
authors.forename: J
authors.initials: J
authors.lastname: Schmidt
authors.forename: T
authors.initials: T
authors.lastname: Dahn
authors.forename: U
authors.initials: U
authors.lastname: Niebergall
authors.forename: G
authors.initials: G
authors.lastname: Bogusch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D001863:Bone Screws; D004868:Equipment Failure; D005260:Female; D005265:Femoral Neck Fractures / Q000503:physiopathology / Q000601:surgery*; D005272:Femur Neck / Q000503:physiopathology; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000503:physiopathology*