ORIGINAL RESEARCH article
Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 13 - 2025 | doi: 10.3389/fbioe.2025.1604441
This article is part of the Research TopicEnhancing Sports Injury Management through Medical-Engineering InnovationsView all 10 articles
Cementless Long-Stem Fixation in periprosthetic clamshell fracture: A Biomechanical Investigation
Provisionally accepted
- The 909th Hospital, School of Medicine, Xiamen University, Xiamen, Fujian Province, China
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Objective: To investigate the biomechanical strength of cementless long-stem fixation for the treatment of periprosthetic clamshell fracture.Methods: Eighteen Sawbones artificial femur models were used and divided into three groups. Group A had an intact medial wall. Group B, the proximal periprosthetic femoral medial wall was osteotomized to simulate periprosthetic clamshell fractures.Group C, following identical osteotomy to Group B, cerclage wiring was applied to fix the medial wall fracture fragment. After molding, the cementless long-stem were implanted in all models, which were then evaluated through axial compression tests, torsion tests, and axial failure tests. The axial stiffness, axial displacement, torsional stiffness, torque, and maximum failure load were recorded and statistically analyzed.In the axial compression tests, no statistically significant differences were observed among Groups A, B, and C in terms of axial displacement, axial stiffness, or maximum failure load (the displacement greater than 3mm). However, in the torsional tests, Group B showed significantly lower torsional stiffness or torque compared to Groups A and C (p < 0.05). No significant differences in torsional stiffness or torque were detected between Groups A and C.The integrity of the femoral medial wall is crucial for femoral stem stability. In case of medial wall fracture, while cementless long-stem implantation can achieve satisfactory axial stability, its torsional stability remains inadequate. The application of supplemental cerclage wiring for medial wall fragment fixation provides reliable improvement in torsional stability of the stem.
Keywords: periprosthetic clamshell fracture, cementless long-stem, Revision hip arthroplasty, Biomechanics, Periprosthetic femoral fractures
Received: 01 Apr 2025; Accepted: 09 May 2025.
Copyright: © 2025 Zhu, Xie, He, Miao, Zhou, Huang, Liu, Xie and Zhai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wei Xie, The 909th Hospital, School of Medicine, Xiamen University, Xiamen, 361005, Fujian Province, China
Wenliang Zhai, The 909th Hospital, School of Medicine, Xiamen University, Xiamen, 361005, Fujian Province, China
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