Abstract
BackroundPurpose of this experimental study was to investigate the influence of cerclages on the primary stability of the MUTARS® system using distally fractured synthetic femora. Methods4 MUTARS® prostheses were implanted in synthetic femora respectively. Groups consisted of 4 intact bones, 4 fractured with cerclages and 4 fractured bones without cerclages. Spatial micromovements were measured with a high-precision rotational setup. FindingsThe order from the weakest to the strongest torque transmission of the intact bones was rm1-rm4-rm2-rm3 (p=0.011) and of the fractured bones with cerclages rm4-rm1-rm3-rm2 (p=0.013). The MUTARS® stems broke out of the fractured femoral shaft by removing cerclages (p<0.001) and by the influence of bone defect A (p<0.001). Overall micromovements of the intact bones were lower than those of the fractured bones without cerclages (p<0.001) and overall micromovements of the fractured bones with cerclages were lower than those of bones without cerclages (p<0.001). InterpretationDue to high press-fit at the proximal and distal isthmus region fissural fractures of the femur may occur. This should always be taken into account. It is advisable to secure them and provide a prophylaxis for these fissural fractures by means of cerclages.
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