Fatigue fracture of a femoral sliding compression screw-plate device after bone union.

A failure of a femoral screw compression plate is described, the first such case to be reported after bone union. A fatigue fracture had started from an internal screw thread, near a keyway. Design improvements, such as lengthening the barrel around the lag screw, are suggested. The question as to whether keyways are necessary for the function of such devices is discussed. The morbidity of removal operations in elderly patients means that fatigue life improvements are needed, to avoid increasing numbers of failed implants in the continuing epidemic of fractures of the proximal femur.

[1]  K. Harrington,et al.  The management of comminuted unstable intertrochanteric fractures. , 1973, The Journal of bone and joint surgery. American volume.

[2]  R. Oppermann.  Strength of materials, part 2, advanced theory and problems , 1941 .

[3]  Wroblewski Bm.  A method of management of the fractured stem in total hip replacement. , 1979 .

[4]  L. Engel,et al.  An Atlas of Polymer Damage: Surface Examination by Scanning Electron Microscope , 1981 .

[5]  Mulholland Rc,et al.  Sliding screw plate fixation of intertrochanteric femoral fractures. , 1972 .

[6]  Rudolph Earl Peterson,et al.  Stress concentration design factors : charts and relations useful in making strength calculations for machine parts and structural elements , 1953 .

[7]  M. Ecker,et al.  The treatment of trochanteric hip fractures using a compression screw. , 1975, The Journal of bone and joint surgery. American volume.

[8]  Evans Em.  THE TREATMENT OF TROCHANTERIC FRACTURES OF THE FEMUR , 1949 .

[9]  J. Charnley.  Fracture of femoral prostheses in total hip replacement. A clinical study. , 1975, Clinical orthopaedics and related research.

[10]  J. P. Paul.  Approaches to design - Force actions transmitted by joints in the human body , 1976, Proceedings of the Royal Society of London. Series B. Biological Sciences.

[11]  L. Morawa,et al.  Treatment of femoral neck fractures with the sliding compression screw. , 1982, Clinical orthopaedics and related research.

[12]  L. Sloter,et al.  Corrosion-Fatigue Performance of Stainless Steel Hip Nails—Jewett Type , 1979 .

[13]  J. Lyden,et al.  Intertrochanteric fractures of the hip treated with the hip compression screw: analysis of problems. , 1979, Clinical orthopaedics and related research.

[14]  J. Rao,et al.  Treatment of unstable intertrochanteric fractures with anatomic reduction and compression hip screw fixation. , 1983, Clinical orthopaedics and related research.

[15]  Wolf Gl,et al.  Treatment of intertrochanteric fracture of the femur using sliding screw plate fixation. , 1982, Clinical orthopaedics and related research.