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Surgical Treatment of Femoral Neck Fractures (CD Included) (Hardcover)
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Surgical Treatment of Femoral Neck Fractures (CD Included) (Hardcover)
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While arthroplasty is the preferred treatment for most elderly
patients with displaced femoral neck fractures, internal fixation
is the treatment of choice in the majority of patients below the
age of 65 as a joint-preserving procedure. The osteosynthesis of
fractures of the femoral neck in the elderly has been partly
abandoned during the last years due to the poor clinical outcomes
following the conventional fixation with parallel screws or DHS.
Based on clinical evidence and laboratory testing, the novel method
of biplane double-supported screw fixation (BDSF) offers much
better fixation stability, reflecting in excellent clinical
outcomes. With its innovative biomechanic principle, the BDSF
method provides supreme stability for cannulated screw fixation,
achieving up to 44% higher axial fixation strength in vitro, and a
rate of bone union reaching up to 96.6% in clinical practice, which
is much higher than the conventional parallel screw fixation data.
The method of BDSF provides supreme stability by buttressing two
out of three medially diverging cannulated screws on the inferior
femoral neck cortex and supporting the steeper inferior screw on
the posterior femoral neck cortex. The two calcar screws are
oriented in different coronal inclinations intended to provide
constant fixation strength during different patient activities and
load directions. Biomechanically, the most effective component is
the inferior screw placed at an obtuse angle and supported on a
large area along the inferior and posterior cortex of the femoral
neck following its spiral anterior curve. Given the clinical
outcomes, BDSF is the perfect technique for femoral neck fracture
fixation, as the fracture healing rate is high at 96% with this
approach. Therefore, BDSF is not only a treatment alternative to
conventional fixation, but also a much better procedure. Thus, BDSF
should be routinely applied, and conventional fixation gradually
abandoned in clinical practice (this has been the approach in our
institution over the last ten years). This book describes the full
surgical technique of the method of BDSF for femoral neck fracture
osteosynthesis; quality criteria and surgical recommendations for
successful BDSF implementation, according to the vast clinical
experience of ten years with this highly effective method. A novel
surgical approach for hip arthroplasty is described in this book.
The current trends aimed at decreasing operative trauma and blood
loss have been not entirely satisfied with respect to most of the
standard approaches for hip arthroplasty. These surgeries are often
associated with considerable blood loss and the necessity for
restricting patients' activities in the postoperative period due to
impaired joint stability and risk of dislocations. This book
describes the full surgical technique of the novel anatomical
direct lateral approach for hip arthroplasty, aimed at decreasing
blood loss, minimizing operative trauma, and optimizing joint
stability. This technique is associated with minimal blood loss and
high joint stability. Patients are allowed to perform activities
within the normal range of motion in the early postoperative
period. This book describes also the history of internal fixation
in femoral neck fractures, as well as the biomechanics of femoral
neck fracture osteosynthesis and the role of the implants.
General
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