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Article

A biomechanical analysis of the effect of hydroxyapatite augmentation for trochanteric femoral fractures

  • Authors:
    • Takuya Usami
    • Naoya Takada
    • Hidetoshi Iwata
    • Hiroaki Sakai
    • Yusuke Hattori
    • Isato Sekiya
    • Yoshino Ueki
    • Yuko Nagaya
    • Hideki Murakami
    • Gen Kuroyanagi
  • View Affiliations / Copyright

    Affiliations: Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467‑8601, Japan, Department of Orthopedic Surgery, Kainan Hospital, Yatomi, Aichi 498‑8502, Japan, Department of Orthopedic Surgery, Nagoya City University East Medical Center, Nagoya, Aichi 464‑8547, Japan
  • Article Number: 256
    |
    Published online on: April 18, 2023
       https://doi.org/10.3892/etm.2023.11955
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Abstract

Hydroxyapatite (HA) augments are used to treat trochanteric femoral fractures. However, the efficacy of HA augmentation has not been fully described in trochanteric femoral fracture surgery. In total, 85 patients were enrolled in the present study; all had trochanteric femoral fractures between January 2016 and October 2020, 45 with HA (HA group) and 40 without HA (N group). The intraoperative lag screw insertion torque was directly measured and the amount of lag screw telescoping with and without HA augmentation after surgery was analyzed. Maximum lag screw insertion torque (max‑torque), bone mineral density in the opposite femoral neck (n‑BMD), tip apex distance (TAD) of the lag screw, radiographic findings including fracture union, the amounts of lag screw telescoping and occurrence of complications were evaluated. A total of 12 patients were excluded if they were aged under 60 years old, had ipsilateral surgery and disorders in the hip joint, TAD of the lag screw ≥26 mm on postoperative radiographs and had measurement errors. A total of 73 fractures could be analyzed: HA group (n=36) and N group (n=37). Max‑torque/n‑BMD ratios were higher in the HA group compared with in the N group (7.23±2.71 vs. 5.93±1.91 g/cm2·N·m; P=0.04). The amounts of lag screw telescoping in the HA group were smaller compared with the N group (1.41±2.00 vs. 2.58±2.34; P=0.05). Evaluation of screw insertion torque showed maximum screw insertion torque correlated well with n‑BMD in both groups, HA (R=0.57; P<0.01) and N group (R=0.64; P<0.01). No correlation was found between maximum screw insertion torque and TAD in both groups, HA (R=‑0.10; P=0.62) and N group (R=0.02; P=0.93). All fractures were radiographically united without any complications. These results support the effectiveness of HA augmentation, indicating higher resistance against rotational instability and reduced lag screw telescoping in trochanteric femoral fracture treatment.
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Copy and paste a formatted citation
Spandidos Publications style
Usami T, Takada N, Iwata H, Sakai H, Hattori Y, Sekiya I, Ueki Y, Nagaya Y, Murakami H, Kuroyanagi G, Kuroyanagi G, et al: A biomechanical analysis of the effect of hydroxyapatite augmentation for trochanteric femoral fractures. Exp Ther Med 25: 256, 2023.
APA
Usami, T., Takada, N., Iwata, H., Sakai, H., Hattori, Y., Sekiya, I. ... Kuroyanagi, G. (2023). A biomechanical analysis of the effect of hydroxyapatite augmentation for trochanteric femoral fractures. Experimental and Therapeutic Medicine, 25, 256. https://doi.org/10.3892/etm.2023.11955
MLA
Usami, T., Takada, N., Iwata, H., Sakai, H., Hattori, Y., Sekiya, I., Ueki, Y., Nagaya, Y., Murakami, H., Kuroyanagi, G."A biomechanical analysis of the effect of hydroxyapatite augmentation for trochanteric femoral fractures". Experimental and Therapeutic Medicine 25.6 (2023): 256.
Chicago
Usami, T., Takada, N., Iwata, H., Sakai, H., Hattori, Y., Sekiya, I., Ueki, Y., Nagaya, Y., Murakami, H., Kuroyanagi, G."A biomechanical analysis of the effect of hydroxyapatite augmentation for trochanteric femoral fractures". Experimental and Therapeutic Medicine 25, no. 6 (2023): 256. https://doi.org/10.3892/etm.2023.11955
Copy and paste a formatted citation
x
Spandidos Publications style
Usami T, Takada N, Iwata H, Sakai H, Hattori Y, Sekiya I, Ueki Y, Nagaya Y, Murakami H, Kuroyanagi G, Kuroyanagi G, et al: A biomechanical analysis of the effect of hydroxyapatite augmentation for trochanteric femoral fractures. Exp Ther Med 25: 256, 2023.
APA
Usami, T., Takada, N., Iwata, H., Sakai, H., Hattori, Y., Sekiya, I. ... Kuroyanagi, G. (2023). A biomechanical analysis of the effect of hydroxyapatite augmentation for trochanteric femoral fractures. Experimental and Therapeutic Medicine, 25, 256. https://doi.org/10.3892/etm.2023.11955
MLA
Usami, T., Takada, N., Iwata, H., Sakai, H., Hattori, Y., Sekiya, I., Ueki, Y., Nagaya, Y., Murakami, H., Kuroyanagi, G."A biomechanical analysis of the effect of hydroxyapatite augmentation for trochanteric femoral fractures". Experimental and Therapeutic Medicine 25.6 (2023): 256.
Chicago
Usami, T., Takada, N., Iwata, H., Sakai, H., Hattori, Y., Sekiya, I., Ueki, Y., Nagaya, Y., Murakami, H., Kuroyanagi, G."A biomechanical analysis of the effect of hydroxyapatite augmentation for trochanteric femoral fractures". Experimental and Therapeutic Medicine 25, no. 6 (2023): 256. https://doi.org/10.3892/etm.2023.11955
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