ArticleBMC musculoskeletal disorders2011
Is the rotation of the femoral head a potential initiation for cutting out? A theoretical and experimental approach.
Article in BMC musculoskeletal disorders, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- Cement augmentation for trochanteric femur fractures: A meta-analysis of randomized clinical trials and observational studies.PloS one · 2021Pooled it
- [Hip fractures in the elderly : Osteosynthesis versus joint replacement].Der Orthopade · 2014Pooled it
- Gamma 3 vs Gamma 3 RC in Unstable Extracapsular Hip Fractures: A Prospective Randomized study.International orthopaedics · 2026Trial
- The accumulation of technical errors exponentially increases the risk of screw cut-out in femoral intramedullary nailing.Archives of orthopaedic and trauma surgery · 2026Observational
- Exploring Appropriate Positioning of the Spiral Blade in Treatment of Subtrochanteric Fractures of the Femur Using Proximal Femoral Nail Antirotation.Orthopaedic surgery · 2025Article
- Safety of Cement-augmented Femoral Cephalomedullary Nails: A Meta-analysis and Systematic Review.Hip & pelvis · 2025Review
- The effectiveness of fixation of hydroxyapatite-coated helical blade in preventing of the cut-out observed in treatment with proximal femoral nail of fractures of the femur intertrochanteric in elderly.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2023Article
- Biomechanical analysis analyzing association between bone mineral density and lag screw migration.Scientific reports · 2023Article
- The correlation between cutout and eccentric distance (ED) of the cephalic fixator tip in geriatric intertrochanteric fractures with internal fixation.Journal of orthopaedic surgery and research · 2022Article
- Short vs. long intramedullary nail systems in trochanteric fractures: A randomized prospective single center study.Experimental and therapeutic medicine · 2022Article
- Eccentric distance zone analysis system: New regional evaluation of cephalic fixator tip location for predicting cut-out in geriatric intertrochanteric fractures with internal fixation.Frontiers in surgery · 2022Article
- Conventional versus helical blade screw insertion following the removal of the femoral head screw: a biomechanical evaluation using trochanteric gamma 3 locking nail versus PFN antirotation.BMC musculoskeletal disorders · 2021Article
- A unique cause of Gamma 3 cut-out: A case report and literature review.Journal of clinical orthopaedics and trauma · 2021Article
- PFNA and DHS for AO/OTA 31-A2 fractures: radiographic measurements, morbidity and mortality.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2020Article
- Is rotation the mode of failure in pertrochanteric fractures fixed with nails? Theoretical approach and illustrative cases.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2020Review
- Design of Improved Intertrochanteric Fracture Treatment (DRIFT) Study: Protocol for Biomechanical Testing and Finite Element Analysis of Stable and Unstable Intertrochanteric Fractures Treated With Intramedullary Nailing or Dynamic Compression Screw.JMIR research protocols · 2019Article
- Screw-blade fixation systems in Pauwels three femoral neck fractures: a biomechanical evaluation.International orthopaedics · 2018Article
- Biomechanical Comparison of Three Different Intramedullary Nails for Fixation of Unstable Basicervical Intertrochanteric Fractures of the Proximal Femur: Experimental Studies.BioMed research international · 2018Article
- Treatment With Helical Blade Cephalomedullary Nail for Two-Part Basicervical Proximal Femoral Fracture in Elderly Patients: A Retrospective Observational Study.Geriatric orthopaedic surgery & rehabilitation · 2017Article
- [The rotationally stable screw-anchor with trochanteric stabilizing plate (RoSA/TSP) : First results in unstable trochanteric femur fractures].Der Unfallchirurg · 2017Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSince cut-out still remains one of the major clinical challenges in the field of osteoporotic proximal femur fractures, remarkable developments have been made in improving treatment concepts. However, the mechanics of these complications have not been fully understood.We hypothesize using the experimental data and a theoretical model that a previous rotation of the femoral head due to de-central implant positioning can initiate a cut-out.
methodsIn this investigation we analysed our experimental data using two common screws (DHS/Gamma 3) and helical blades (PFN A/TFN) for the fixation of femur fractures in a simple theoretical model applying typical gait pattern on de-central positioned implants. In previous tests during a forced implant rotation by a biomechanical testing machine in a human femoral head the two screws showed failure symptoms (2-6Nm) at the same magnitude as torques acting in the hip during daily activities with de-central implant positioning, while the helical blades showed a better stability (10-20Nm).To calculate the torque of the head around the implant only the force and the leverarm is needed (N [Nm] = F [N] * × [m]). The force F is a product of the mass M [kg] multiplied by the acceleration g [m/s2]. The leverarm is the distance between the center of the head of femur and the implant center on a horizontal line.
resultsUsing 50% of 75 kg body weight a torque of 0.37Nm for the 1 mm decentralized position and 1.1Nm for the 3 mm decentralized position of the implant was calculated. At 250% BW, appropriate to a normal step, torques of 1.8Nm (1 mm) and 5.5Nm (3 mm) have been calculated.Comparing of the experimental and theoretical results shows that both screws fail in the same magnitude as torques occur in a more than 3 mm de-central positioned implant.
conclusionWe conclude the center-center position in the head of femur of any kind of lag screw or blade is to be achieved to minimize rotation of the femoral head and to prevent further mechanical complications.
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