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Hip Fracture Fixation with X-Bolt
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X-Bolt Expanding Bolt Osteosynthesis Product rationale, testing and clinical technique
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Hip Fracture Fixation with X-Bolt
1.
X-BOLT® Expanding Bolt Osteosynthesis for
the Proximal Femur
2.
70,000 hips fractures
p.a. in UK 40% treated with hemi/THR 40% treated with DHS 20% treated with hip nail £10,000 Average in-patient cost per patient episode
3.
The problem of
‘Cut-Out’
4.
2008 Cochrane Review:
DHS ‘cut-out’ rates Sample 4% Average Size ‘Cut-Out’ Rate 250 200 150 100 50 0 0% 2% 4% 6% 8% 10% 12% 14% DHS ‘cut-out’ rate
5.
DHS ‘cut-out’ rates
by year of publication 5.0% 4.0% 3.0% 2.0% 1.0% 0.0% 1990-1994 1995-1999 2000-2004 2005-2006
6.
Economic Impact of
‘Cut-Out’ 4% ‘Cut-Out’ rate 1600 Patients affected per year in UK £40M Additional care costs
7.
8.
Get your (femoral)
head fixed right • 60% larger frontal load area • Strong, secure fixation • Rotationally stable • One shot (centre-centre) fixation • Dynamic sliding compression • Reversible & removable
9.
Perpendicular Expansion =
No Disruption
10.
Perpendicular Expansion =
No Disruption
11.
Perpendicular Expansion =
No Disruption
12.
Compacts bone =
better stability
13.
‘Tip-Apex’ distance Tip-Apex Distance
(combined >25mm) is a major factor in predicting cut-out Baumgaertner et al. JBJS Am 1995; 77:1058-64
14.
‘Tip-Apex’ fixation maintained
15.
‘Tip-Apex’ fixation maintained
16.
‘Tip-Apex’ fixation maintained
17.
Best bone quality
& trabecular lines
18.
Snug fit in
drill-hole
19.
Not so snug
20.
Biomechanical testing vs.
DHS Screw
21.
Push-out test for
DHS lag screw in synthetic bone 500 450 400 350 300 Load (N) 250 200 150 100 50 0 0 1 2 3 4 5 6 7 8 9 10 Displacement (mm)
22.
Push-out test for
X-BOLT in synthetic bone 500 450 400 350 300 Load (N) 250 200 150 100 50 0 0 1 2 3 4 5 6 7 8 9 10 Displacement (mm)
23.
X-BOLT® Dynamic Hip Plating Surgical
Technique
24.
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X-BOLT® Expanding Bolt Osteosynthesis for
the Proximal Femur Visit www.x-bolt.com for videos, news & downloads
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