Stabilization and prosthetic replacement in difficult fractures and bone tumors

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Trauma management

Background:

• Comminuted femoral shaft fractures, particularly with hip involvement, pose significant treatment challenges.
• Failures in cemented total hip arthroplasties necessitate advanced, durable solutions.
• Pathologic fractures due to secondary tumors require effective stabilization methods.

Purpose of the Study:

• To evaluate the efficacy of a four-sided titanium alloy locking nail for complex fractures.
• To introduce and assess a cementless, modular hip implant for arthroplasty and bone reconstruction.
• To report on the stabilization of bones with pathologic fractures.

Main Methods:

• Utilized a four-sided titanium alloy locking nail with transfixing screws for fracture fixation.
• Employed a cementless, modular titanium alloy and alumina hip implant with porous ceramic coating for bone ingrowth.
• Applied various implants for stabilizing pathologic fractures in the femur, humerus, tibia, and ulna.

Main Results:

• Successfully treated 171 difficult fractures in long bones with the locking nail, allowing early weight-bearing.
• Performed 54 hip and 2 shoulder replacements using the cementless modular implant since January 1983.
• Stabilized 285 bones with pathologic fractures between 1972 and 1986.

Conclusions:

• The titanium alloy locking nail is effective for complex fractures, facilitating early patient mobilization.
• The cementless modular hip implant offers a viable alternative for hip arthroplasty and reconstruction, promoting bone ingrowth and immediate weight-bearing.
• The described implants provide robust solutions for challenging orthopedic conditions, including trauma and tumor-related fractures.