hip fracture fixation with x-bolt
DESCRIPTION
X-Bolt Expanding Bolt Osteosynthesis Product rationale, testing and clinical techniqueTRANSCRIPT
X-BOLT®Expanding Bolt Osteosynthesisfor the Proximal Femur
40% treated with hemi/THR
40% treated with DHS
20% treated with hip nail
70,000 hips fractures p.a. in UK
£10,000Average in-patient cost per patient episode
The problem of ‘Cut-Out’
0% 2% 4% 6% 8% 10% 12% 14%0
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2008 Cochrane Review: DHS ‘cut-out’ rates
Sample Size 4% Average
‘Cut-Out’ Rate
DHS ‘cut-out’ rate
DHS ‘cut-out’ rates by year of publication
1990-1994 1995-1999 2000-2004 2005-20060.0%
1.0%
2.0%
3.0%
4.0%
5.0%
4% ‘Cut-Out’ rate 1600 Patients affected per year in UK
£40M Additional care costs
Economic Impact of ‘Cut-Out’
• 60% larger frontal load area• Strong, secure fixation • Rotationally stable• One shot (centre-centre) fixation • Dynamic sliding compression• Reversible & removable
Get your (femoral) head fixed right
Perpendicular Expansion = No Disruption
Perpendicular Expansion = No Disruption
Perpendicular Expansion = No Disruption
Compacts bone = better stability
‘Tip-Apex’ distance
Tip-Apex Distance (combined >25mm) is a major factor in predicting cut-outBaumgaertner et al. JBJS Am 1995; 77:1058-64
‘Tip-Apex’ fixation maintained
‘Tip-Apex’ fixation maintained
‘Tip-Apex’ fixation maintained
Best bone quality & trabecular lines
Snug fit in drill-hole
Not so snug
Biomechanical testing vs. DHS Screw
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ad (N
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Displacement (mm)
Push-out test for DHS lag screwin synthetic bone
Load
(N)
Displacement (mm)
Push-out test for X-BOLTin synthetic bone
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X-BOLT®Dynamic Hip PlatingSurgical Technique
X-BOLT®Expanding Bolt Osteosynthesisfor the Proximal Femur
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