| 1. |
- Buciuto, Robert, et al.
(författare)
-
Fatigue Strength of a New Device for Treatment of Unstable Trochanteric Hip Fractures
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The fatigue resistance of a new type of flxation device for the treatment of unstable trochanteric fractures of the hip was determined. The new device (RAB-plate= Rigidity Augmentation Baixauli) is designed as a fixed, cannulated, 120 degrees angled blade plate with a buttress rod for support of the proximal, lower surface of the blade. A cyclic loading of four times body weight of a 65 kg person was used. Two types of 135 degrees compression hip screw were tested for comparison. The RAB-plate had a significantly higher fatigue resistance than the compared hip screw plates (p< 0,02 and p< 0,01; respectively).
|
|
| 2. |
- Buciuto, Robert, et al.
(författare)
-
RAB-Plate versus Sliding Hip Screw for Unstable Trochanteric Hip Fractures : Stability of the Fixation and Modes of Failure-Radiographic Analysis of 218 Fractures
- 2001
-
Ingår i: The Journal of Trauma and Acute Care Surgery. - 2163-0755. ; 50:3, s. 545-550
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The sliding hip screw has gained considerable acceptance in the treatment of unstable trochanteric fractures. However, the new type of 120 degrees fixed angle blade-plate with a buttress rod (RAB-plate) showed encouraging clinical results. The purpose of this study was to assess stability of fixation and analyze modes of failure in unstable trochanteric hip fractures treated with these devices.Methods: A retrospective radiographic review of 218 unstable fractures was performed. Linear and angular displacements of the major fragments and implant migration into the femoral head during healing were assessed. Additionally, adequacy of the reduction and the location of the implant within the femoral head as predictors of fixation failure were evaluated.Results: The postreduction neck-shaft angle was maintained in the majority of the fractures in both groups. However, there was a significantly higher incidence of varus angulation by 10 degrees or more by the completion of healing among fractures treated with the sliding hip screw (p = 0.04). There was no statistically significant difference in vertical migration of the device into the femoral head between the implants used (p = 0.3). There was a significant relationship between failure of the fixation and varus reduction (p = 0.04) as well as screw/neck angle deviation more than 20 degrees in the lateral projection (p = 0.005) or if the implant was in a superior or posterior position (p = 0.02).Conclusion: The RAB-plate provided a more stable fixation, especially with regard to maintained postoperative alignment. However, positive predictors for fixation failure were identical for both devices. Here, the screw/neck angle deviation has had the strongest significance for prediction of fixation failure.
|
|
| 3. |
- Buciuto, Robert, et al.
(författare)
-
RAB-plate vs Medoff sliding plate for fixation of unstable trochanteric hip fractures : A prospective randomized study of 138 fractures with 1-year follow-up
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Between January 199 5 and January 1997 138 unstable trochanteric hip fractures were prospectively randomized to treatment with a fixed angle blade plate with a buttress rod (RAB-plate, group A, n= 59) or a 135° two-way compression hip screw (Medoff sliding plate, group B, n= 79). The minimum follow-up time was 1-year. 44 (91 %) fractures in group A and 32 (46%) fractures in group B healed without any complication (p<0.0001). The ratio of technical failure was 4% in group A and 10% in group B (p=O.S). The most common complication in group B was significant and symptomatic leg-length shortening which was observed in 26 patients. No such complication was registered in group A.
|
|
| 4. |
- Buciuto, Robert, et al.
(författare)
-
RAB-plate vs Richards CHS plate for unstable trochanteric hip fractures : A randomized study of 233 patients with 1-year follow-up
- 1998
-
Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682 .- 0001-6470. ; 69:1, s. 25-28
-
Tidskriftsartikel (refereegranskat)abstract
- We prospectively randomized 233 patients with unstable trochanteric hip fractures for treatment with a 120° fixed angle blade-plate having a buttress rod (group A, n 111) or a 135° compression hip screw (group B, n 122). the minimum follow-up time was 1 year. the ratio of technical failure was 9% in group A and 19% in group B (p = 0.06). 79 (87%) fractures in group A and 65 (68%) fractures in group B healed without any complication (p = 0.003). Malunion occurred in 2 cases in group A and in 15 cases in group B (p = 0.002).
|
|
| 5. |
- Buciuto, Robert, et al.
(författare)
-
Spontaneous Subcapital Femoral Neck Fracture After Healed Trochanteric Fracture
- 1997
-
Ingår i: Clinical Orthopaedics and Related Research. - 0009-921X .- 1528-1132. ; 352, s. 156-163
-
Tidskriftsartikel (refereegranskat)abstract
- Two hundred thirty-three patients with an unstable trochanteric hip fracture were randomized prospectively for stabilization with a fixed angle blade plate or a compression hip screw. Twenty patients had the implant removed after the fracture was healed (average, 20.5 months; range, 12-42 months). In seven of these 20 patients, a spontaneous fracture of the femoral neck occurred at an average of 19 days after implant removal. Four of the these seven patients had been treated with the fixed angle blade plate and three with the sliding screw plate. The histologic examination of three specimens was inconclusive. The authors have not observed subcapital fracture among patients whose implants were not removed. The mechanism behind this complication is unknown.
|
|
| 6. |
- Buciuto, Robert
(författare)
-
Treatment of unstable trochanteric hip fractures : A clinical, mechanical and radiographic evaluation of the RAB-plate
- 2000
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The problems associated with the management of proximal femoral fractures gain more attention as the elderly population continue to increase. It has been estimated that the total number of hip fractures in the world will increase from 1.7 million per year in 1990 to 6.3 million per year in 2050 (Cooper et al 1992). Operative treatment of these fractures is a challenge for the orthopaedic surgeon mainly due to poor bone quality, which increases the risk of fixation failure.More than 50% of the total number of hip fractures are extracapsular fractures. Mortality, morbidity and costs as a result of trochanteric fracture are higher than those for a cervical fracture. The consequence is increased resource consumption in the national health-care system. The estimated total cost of treatment increase 3-fold in case of a complication. Therefore, a variety of different devices have been designed in order to decrease the ratio of complications. However, in spite of this, the reported ratio of fixation failure continues be high and may reach 25% following treatment of unstable trochanteric fractures. We evaluated a new type of fixation device, the RAB-plate (Rigidity Augmentation Baixauli), for the treatment of unstable trochanteric hip fractures. The RAB-plate is a fixed 120-degree angle blade-plate with a buttress rod.We performed three clinical trials where 391 unstable trochanteric fractures were stabilised with the RAB-plate or a Sliding Hip Screw (SHS). The results showed a statistically significant lower number of complications in fractures stabilised with the RAB-plate.The fatigue resistance of the RAB-plate was evaluated in a cyclic loading test model. The RAB-plate had a statistically significant higher fatigue strength than two different designs of the SHS.Stability of the fixation and modes of failure were radiographically analysed in a series of 218 unstable trochanteric fractures treated with the RAB-plate or the SHS. The RAB-plate provided a more stable fixation especially with regard to maintained postoperative alignment. However, positive predictors for fixation failure e.g.implant position within the femoral head, varus reduction in anteroposterior projection and screw/neck angle deviation in the lateral projection were identical for both devices.Spontaneous femoral neck fracture after removal of the fixation device in healed unstable trochanteric fractures was investigated in a series of 7 patients. Our results indicate that implant-induced osteoporosis (stress protection) is a possible cause of subsequent fracture.Our conclusions are that the RAB-plate is a safe implant for fixation of unstable trochanteric hip fractures and results in lower incidence of complications compared to SHS. Therefore, the RAB can be recommended for fixation of unstable trochanteric fractures.
|
|
| 7. |
- Uhlin, Bo, et al.
(författare)
-
A pilot study describing a new device for the fixation of unstable trochanteric fractures of the hip
- 1995
-
Ingår i: International Journal of Orthopaedic Trauma. - 0960-2941. ; 5, s. 69-71
-
Tidskriftsartikel (refereegranskat)abstract
- A new fixed 120o angled blade-plate with a buttress rod was used in a consecutive series of 27 trochanteric hip-fractures. Twenty fractures were classified as unstable. There were 20 women and seven men. The mean ages was 79 years (range:63-92). There were two intraoperative complications registered at surgery. All patients were allowed full weightbearing from the first day after surgery. Three patients dies and another four were not available for follow-up or were followed-up less than three months. Three cases were considered to be failures, The remaining 17 patients were followed-up at an avarage of 16 months. In these 17 patients, of which 12 were classified as unstable, the fractures healed with no change in position. In conclusion, we have found this new device to be a relatively simple method for the fixation of unstable trochanteric fractures. In addition, and of decisive importance, the mechanical properties seem to be sufficient for early full unaided weightbearing without risk of implant railure or non-union of the fractures.
|
|
