title: Greater trochanteric fixation using a cable system for partial hip arthroplasty: a clinical and finite element analysis.
abstract: The aim of the study was to investigate the efficacy of greater trochanteric fixation using a multifilament cable to ensure abductor lever arm continuity in patients with a proximal femoral fracture undergoing partial hip arthroplasty. Mean age of the patients (12 men, 20 women) was 84.12 years. Mean follow-up was 13.06 months. Fixation of the dislocated greater trochanter with or without a cable following load application was assessed by finite element analysis (FEA). Radiological evaluation was based on the distance between the fracture and the union site. Harris hip score was used to evaluate final results: outcomes were excellent in 7 patients (21.8%), good in 17 patients (53.1%), average in 5 patients (15.6%), and poor in 1 patient (9.3%). Mean abduction angle was 20.21°. Union was achieved in 14 patients (43.7%), fibrous union in 12 (37.5%), and no union in 6 (18.7%). FEA showed that the maximum total displacement of the greater trochanter decreased when the fractured bone was fixed with a cable. As the force applied to the cable increased, the displacement of the fractured trochanter decreased. This technique ensures continuity of the abductor lever arm in patients with a proximal femoral fracture who are undergoing partial hip arthroplasty surgery.
authors.affiliation: Department of Orthopedics and Traumatology, Kayseri Training and Research Hospital, 38010 Kayseri, Turkey.
authors.forename: Fırat
authors.initials: F
authors.lastname: Ozan
authors.affiliation: Department of Orthopedics and Traumatology, İzmir Bozyaka Training and Research Hospital, 35110 İzmir, Turkey.
authors.forename: Semmi
authors.initials: S
authors.lastname: Koyuncu
authors.affiliation: Department of Mechanical Engineering, Faculty of Engineering, Ege University, 35040 İzmir, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Pekedis
authors.affiliation: Department of Orthopedics and Traumatology, İzmir Bozyaka Training and Research Hospital, 35110 İzmir, Turkey.
authors.forename: Taşkın
authors.initials: T
authors.lastname: Altay
authors.affiliation: Department of Mechanical Engineering, Faculty of Engineering, Ege University, 35040 İzmir, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Yıldız
authors.affiliation: Department of Orthopedics and Traumatology, İzmir Bozyaka Training and Research Hospital, 35110 İzmir, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Toker
mesh_terms: D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods; D003198:Computer Simulation; D005260:Female; D005264:Femoral Fractures / Q000503:physiopathology* / Q000601:surgery*; D020342:Finite Element Analysis; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006621:Hip Joint / Q000503:physiopathology* / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008954:Models, Biological; D017755:Prosthesis Fitting / Q000295:instrumentation / Q000379:methods; D013314:Stress, Mechanical; D013718:Tensile Strength; D016896:Treatment Outcome; D016474:Weight-Bearing