title: Intraprosthetic fixation techniques in the treatment of periprosthetic fractures-A biomechanical study.
abstract: OBJECTIVE
  To develop new fixation techniques for the treatment of periprosthetic fractures using intraprosthetic screw fixation with inserted threaded liners.
  
  
  METHODS
  A Vancouver B1 periprosthetic fracture was simulated in femur prosthesis constructs using sawbones and cemented regular straight hip stems. Fixation was then performed with either unicortical locked-screw plating using the less invasive stabilization system-plate or with intraprosthetic screw fixation using inserted liners. Two experimental groups were formed using either prostheses made of titanium alloy or prostheses made of cobalt chrome alloy. Fixation stability was compared in an axial load-to-failure model. Drilling was performed using a specially invented prosthesis drill with constantly applied internal cooling.
  
  
  RESULTS
  The intraprosthetic fixation model with titanium prostheses was superior to the unicortical locked-screw fixation in all tested devices. The intraprosthetic fixation model required 10 456 N ± 1892 N for failure and the unicortical locked-screw plating required 7649 N ± 653 N (P < 0.05). There was no significant difference between the second experimental group and the control group.
  
  
  CONCLUSIONS
  Intraprosthetic screw anchorage with special threaded liners enhances the primary stability in treating periprosthetic fractures by internal fixation.
authors: Stephan Brand, Maximilian Petri, Carl Haasper, Christian Krettek, Thomas Goesling, Department of Trauma, Medical School Hannover (MHH), D-30625 Hannover, Germany.
authors: Stephan
authors: S
authors: Brand
authors: Johannes
authors: J
authors: Klotz
authors: Thomas
authors: T
authors: Hassel
authors: Maximilian
authors: M
authors: Petri
authors: Carl
authors: C
authors: Haasper
authors: Friedrich-Wilhelm
authors: FW
authors: Bach
authors: Christian
authors: C
authors: Krettek
authors: Thomas
authors: T
authors: Goesling
keywords: Axial load-to-failure; Biomechanical testing; Intraprosthetic screw fixation; Less invasive stabilization system; Material science; Periprosthetic fracture; Plate fixation