uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Resorbable cement for augmentation of internally fixed unstable trochanteric fractures: A prospective randomised multicenter study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
Show others and affiliations
2005 (English)In: Journal of Bone and Joint Surgery, ISSN 0301-620X, Vol. 87, no 9, 1203-1209 p.Article in journal (Refereed) Published
Abstract [en]

We undertook a multicentre, prospective study of a series of 112 unstable trochanteric fractures in order to evaluate if internal fixation with a sliding screw device combined with augmentation using a calcium phosphate degradable cement (Norian SRS) could improve the clinical, functional and radiological outcome when compared with fractures treated with a sliding screw device alone. Pain, activities of daily living, health status (SF-36), the strength of the hip abductor muscles and radiological outcome were analysed. Six weeks after surgery, the patients in the augmented group had significantly lower global and functional pain scores (p < 0.003), less pain after walking 50 feet (p < 0.01), and a better return to the activities of daily living (p < 0.05). At follow-up at six weeks and six months, those in the augmented group showed a significant improvement compared with the control group in the SF-36 score. No other significant differences were found between the groups. We conclude that augmentation with calcium phosphate cement in unstable trochanteric fractures provides a modest reduction in pain and a slight improvement in the quality of life during the course of healing when compared with conventional fixation with a sliding screw device alone.

Place, publisher, year, edition, pages
2005. Vol. 87, no 9, 1203-1209 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-93144DOI: 10.1302/0301-620X.87B9.15792PubMedID: 16129742OAI: oai:DiVA.org:uu-93144DiVA: diva2:166531
Available from: 2005-05-04 Created: 2005-05-04 Last updated: 2013-06-14Bibliographically approved
In thesis
1. Resorbable Bone Cement for Augmentation of Hip Fracture
Open this publication in new window or tab >>Resorbable Bone Cement for Augmentation of Hip Fracture
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Surgical treatment of hip fractures is frequently associated with secondary fracture displacement, in part due to weak osteoporotic bone. So far, improvements have focused on new metal implants although an alternative could be to augment the bone that surrounds the implant.

The aim of this thesis was to evaluate the use of calcium phosphate cement (Norian SRS) for augmentation of internally fixed hip fractures. Norian SRS is an injectable, biocompatible cement that hardens in situ without exothermic reaction. Over time it is remodeled and replaced by host bone.

In a biomechanical study the holding characteristics for different implants was measured when inserted with or without augmentation. The study showed that conventional bone cement (PMMA) improved maximum torque and pull-out for almost all modalities while Norian SRS increased the holding power mainly in low-density bone.

In a prospective and randomized study, patients with displaced femoral neck fractures were operated with internal fixation using screws alone or combined with Norian SRS for augmentation. The result showed improved stability when measured with radiostereometry (RSA) for the augmented fractures during the early rehabilitation period. The clinical evaluation of 118 patients included pain, walking aid, activities of daily living (ADLs), abductor muscle strength, mobility and range of motion. During the early course the augmented patients did better in some variables although over the total two-year study period there was no major difference between groups. Scintigraphic evaluation indicated that augmentation might compromise the circulation to the femoral head.

The final part included unstable trochanteric fractures fixed with a sliding screw device alone or the same device combined with Norian SRS for augmentation. Using RSA it was shown that augmentation significantly improved the fracture stability until healing. In a randomized multicenter study including 112 patients, augmentation with Norian SRS reduced pain during early rehabilitation and improved quality of life until healing.

In conclusion, augmentation with Norian SRS improved the early fracture stability in displaced femoral neck fractures while there was no major difference in clinical outcome. In unstable trochanteric fractures augmentation provided improved fracture stability and improved clinical course until healing.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2005. 53 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 46
Surgery, Kirurgi
National Category
urn:nbn:se:uu:diva-5822 (URN)91-554-6271-5 (ISBN)
Public defence
2005-05-31, Grönwallsalen, Akademiska sjukhuset, ing. 70, Uppsala, 09:15
Available from: 2005-05-04 Created: 2005-05-04Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Mattsson, PerLarsson, Sune
By organisation
In the same journal
Journal of Bone and Joint Surgery
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 182 hits
ReferencesLink to record
Permanent link

Direct link