title: Comparison of fixation techniques in Vancouver type AG periprosthetic femoral fracture: a biomechanical study.
abstract: OBJECTIVE
  The purpose of this study was to biomechanically compare cable, trochanteric grip plate, and locking plate techniques in Vancouver type AG fracture model in an in vitro test environment.
  
  
  METHODS
  Fifteen pieces of fourth-generation synthetic femora were separated into 3 groups of 5 models each. A greater trochanteric fracture model was created after femoral stem implantation. Group 1 was fixated with only cable, Group 2 with trochanteric grip plate, and Group 3 with locking plate. Horizontal stiffness, axial stiffness, and failure loads were compared between the groups.
  
  
  RESULTS
  In horizontal compression tests, Group 3 had the highest values, but the only statistically significant difference was between the locking plate group and cable group. Axial distraction test results showed that mean stiffness of Group 1 was 94.6±9.44 N/mm, that of Group 2 was 174.8±28.64 N/mm, and that of Group 3 was 185.6±71.64 N/mm. While locking plate versus cable fixation and grip plate fixation versus cable fixation showed statistically significant differences (p<0.05), comparison of locking plate versus grip plate fixation showed no statistically significant difference (p>0.05). In axial failure load test, Group 3 had the highest results. The only significant difference was between the locking plate and cable groups (p<0.05).
  
  
  CONCLUSIONS
  In Vancouver type AG fractures stable fixation may be achieved with grip plate fixation and locking plates, with the former ensuring more stable osteosynthesis.
authors.affiliation: Acıbadem University Atakent Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey. ksariyilmaz@gmail.com.
authors.forename: Kerim
authors.initials: K
authors.lastname: Sarıyılmaz
authors.affiliation: Şişli Hamidiye Etfal Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Korkmaz
authors.affiliation: Acıbadem University Atakent Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors.forename: Okan
authors.initials: O
authors.lastname: Özkunt
authors.affiliation: Acıbadem University Atakent Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors.forename: Halil Can
authors.initials: HC
authors.lastname: Gemalmaz
authors.affiliation: Acıbadem University Atakent Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sungur
authors.affiliation: İstanbul Technical University Institute of Science and Technology, Department of Metallurgy and Materials Engineering, İstanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Baydoğan
authors.affiliation: Acıbadem University Atakent Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Kaya
authors.affiliation: Acıbadem University Atakent Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Dikici
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws; D005264:Femoral Fractures / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006622:Hip Prosthesis; D006801:Humans; D057068:Periprosthetic Fractures / Q000601:surgery*