The Dynamic Hip Screw Implant System

ISBN-13: 9783642699276 / Angielski / Miękka / 2011 / 51 str.

P. Regazzoni; T. R. Edi; R. Winquist

Opis

The AOjASIF* dynamic hip screw (DRS) has been designed primarily to stabilize trochanteric fractures of the hip. Selected fractures of the femoral neck and some subtrochanteric fractures are further indications for the DRS 40, 46]. The dynam ic condylar screw (DCS) has been developed for fractures of the distal femur and is now being tested clinically. The DRS and DCS are carefully coordinated with the preexisting ASIF standard sets of equipment for internal fixation of fractures. The concept of a sliding screw for trochanteric fractures is not new. The first author describing such an implant was Schumpelick 44]; he gives credit to Pohl 22], who was primarily a manufacturer working for Gerhardt Kiinscher. Re described the possibility of impaction at the fracture site with a sliding device. In the United States Clawson 7, 8] introduced the hip screw and found it to be extremely beneficial in trochanteric fractures. At approximately the same time, Massie 31, 32] and Pugh 39] designed the sliding-type flange nails, which offer similar intramedullary splinting with the possibility of fracture impaction. The following chapters describe the concept and design features of the DRS, as well as the details of the surgical technique. The application of the DRS for different types of fractures is illustrated with clinical examples. The results of 268 cases of trochanteric fractures treated with the DRS are presented and compared with results using the angled blade plate and Ender's nails. Finally, some laboratory tests are described."

Spis treści

1 Introduction.- 2 The Problem of Trochanteric Fractures.- Classification.- Problems in Fixation.- 3 DHS Implant System.- Design Features.- Standard Surgical Technique.- Trochanteric Fracture — 135° DHS.- Exposure.- Wound Closure and Postoperative Management.- Implant Removal.- Particular Technical Problems.- Femoral Neck Fractures.- Unstable Trochanteric Fractures with Posteromedial Comminution.- Four-Part Fractures.- 4 Application of the DHS: Clinical Examples.- 5 Clinical Results: A Comparison.- Dynamic Hip Screw.- Angled Blade Plates.- Ender’s Nails.- 6 Laboratory Tests with the DHS.- Methods and Materials.- Results and Discussion.- Mechanical Strength of Hip Plates.- Sliding Characteristics of the Screw.- Conclusions.- 7 Summary.- 8 References.- 9 Subject Index.