Hansson

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H IP F R A C T U R E S Y S T E M S

PIN SYSTEM

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I N D E X

Introduction 2

Indications 3

Features & Benefits

Slipped Capital Femoral Epiphysis 4

Intracapsular Femoral Neck Fracture 5

Operative Technique

Slipped Capital Femoral Epiphysis

Introduction 8

1 Patient Positioning & Reduction 8

2 Stabilization Guide-Wire Insertion 9

3 Incision 94 Guide-Wire Insertion 9

5 Drilling & Measurement 10

6 Pin / Introducer Assembly 10

7 Pin Insertion 11

Case Report 12

Femoral Neck Fracture

1 Patient Positioning & Reduction 14

2 Incision 14

3 Distal Guide-Wire Insertion 14

4 Distal Drilling 15

5 Proximal Drilling 15

6 Proximal Drilling (cont.) 16

7 Pin / Introducer Assembly 16

8 Proximal Pin Insertion 17

9 Distal Pin Insertion 17

Case Report 18

Pin Removal 19

Ordering Information 20

References

1 Slipped Capital Femoral Epipysis 212 Femoral Neck Fractures 21 & 22

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2

I N T R O D U C T I O N

The Hansson Pin system, designed by Professor

Lars Ingvar Hansson at the University of Lund in

Sweden, was developed from research into the

effects of osteosynthetic devices on the bloodsupply to the femoral head.

Specifically developed for the treatment of

intracapsular femoral neck fractures, the Hansson

Pin system has been designed to minimise surgical

trauma to the patient and offer secure, stable

fixation with reduced risk of healing complications

for all grades of fracture.

Twenty years of successful clinical studies carriedout (6 theses and more than 70 published articles)

has enhanced the Hansson Pin System to its

current form.

References

1. Hannson L.I. (1982): Osteosynthesis with the Hook-Pin in Slipped Capital

Femoral Epiphysis. Acta Orthop. Scand. 53: 87-96

2. Stromqvist B., Hansson L.I. (1984): Femoral head vitality in femoral neck

fracture after Hook-Pin Internal Fixation. Clin. Orthop. 191: 105-1093. Stromqvist B., Hansson L.I., Nilsson L.T., and Thorngren K.G. (1987):

Hook-Pin Fixation in femoral neck fractures. A two year follow-up study of 300

cases. Clin. Orthop. 218: 58-62

4. Ceder L., Stromqvist B., Hansson L.I. (1987): Effects of strategy changes in thetreatment of femoral neck fractures during a 17 year period. Clin. Orthop.

218: 53-575. Bray T.J., Smith-Hoeffer B., Hooper A., Timmerman L. (1988): The displaced

femoral fracture. Clin. Orthop. 230: 127-1406. Comprehensive Care of Hip Fractures. Bauer G.C.H., Hansson L.I., Lidgren L.,

Stromqvist B., Thorngren K.G., Scientific Exhibit. A.A.O.S. - Las Vegas 1985.

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I N D I C A T I O N S

T r a n s c e r v i c a l a n dS u b c a p it a l N e c k

F r a c t u r e s

B a s a l N e c kF r a c t u r e s

S l ip p e d C a p i t a lF e m o r a l E p ip h y s i s

P E D I A T R I C :

A D U L T :

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F E A T U R E S & B E N E F I T S

P r e v e n t in g D ia s t a s is a n d f u r t h e rd i s p l a c e m e n t o f t h e e p ip h y s i s

The risk of further peroperative displacement of the

femoral head is reduced by drilling a channel for

the Hansson Pin with the femoral head fixed with

kirschner wires. The smooth outer pin allows the

surgeon to gently push the implant through the

channel, reducing the risk of diastasis between the

femoral neck and the head.1

L a s t in g f ix a t io n

The hook resists loosening of the fixation to the

femoral head as the longitudinal growth of the

femoral neck retracts the pin in the channel

thereby stabilizing the femoral head. Loosening of

the osteosynthetic material is reduced because of

resorption and growth of the femoral neck under

normal conditions.1

R e d u c in g t h e r i s k o f u n e q u a l b o n ele n g t h

The growth of the femoral neck in cases with

Slipped Capital Femoral Epiphysis, is an indication

of a lack of intra- and postoperative vascular

disturbance, as the nutrition for the proliferating

cells of the growth plate is provided by the

epiphysial vessels. By preserving the blood supply,

the Hansson Pin System is reducing the risk of

unequal bone length.1

E a s y e x t r a c t io n

The risk of the pin being trapped in the bone is

reduced as the pin surface is smooth. The hook is

easily withdrawn back into the body of the pin,

which can then be removed.1

Frontal view

Lateral view

S L IP P E D C A P IT A LF E M O R A L E P IP H Y S IS

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P R E S E R V E S B O N E IN T E G R IT Y

M in im u m B o n e In t e r f e r e n c e .

Creates minimum disruption to cancellous bone,

and no additional fixation points are required in

the femoral shaft.Reduces the risk of avascular necrosis. Reduces

the risk of secondary fracture.

P R E S E R V E S T H E B L O O D S U P P L Y

M in im u m S u r g ic a l T r a u m a .

Their smooth profile allows the pins to slide into

place without turning or hammering. This

minimises disruption to the blood supply and the

consequent danger of avascular necrosis.2

Reduces the risks of segmental collapse and

non-union.

R E D U C E S S U R G E R Y

S m a ll In c i s io n .

The complete procedure is carried out through a

4-5cm incision.

Short Procedure.

Simple instrumentation and uncomplicated

procedure allow fixation to be achieved within

an average of 15 minutes. The procedure lends

itself to spinal anaesthesia.

Simple Implant Removal.

The procedure for pin removal is quick and

straightforward.

Minimises anaesthetic related risks.

A L L O W S E A R LY M O B IL IS A T IO N

S t a b le F i x a t io n .

The security and stability of fixation allow most

patients to be mobilised during their first post-

operative day and discharged early.3

Minimises the risks of prolonged bed rest

following surgery. Offers potential cost savings

to the hospital.4

IN T R A C A P S U L A RF E M O R A L N E C KF R A C T U R E

Inferior pin contacts inferiorcortex of the femoral neck.

Superior pin contactsposterior cortex.

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P R O V ID E S S E C U R E F IX A T IO N

O p t im u m R e s is t a n c e t o R o t a t io n .

Peripheral pin placement within the neck

provides maximum resistance to rotation.5

Maximum Use of Cortical Bone.

Each pin contacts strong cortical bone in three

places to provide maximum stability.

Firm Anchorage.

The hook of each pin engages in subchondral

bone to provide secure anchorage and prevent

migration or backing out.

The Hansson Pin System does not rely on soft

cancellous bone for support in either fragment

and the risk of displacement is thereby

minimised.

Reduces the risks of redisplacement and non-

union.

M A IN T A I N S B O N Y C O N T A C T

P r e c is e P a r a l le l P l a c e m e n t .

Precise parallel placement enables the pins to

slide within the main bone fragment to ensurecontinuous bony contact even during resorption.

Allows physiological compression at the fracture

site.5

Reduces the risk of non-union.

Positively encourages bone healing.

6


Simple instrumentation ensuresprecise parallel placement.

Three point contact with cortical boneprovides maximum stability.

prox

dist

a ntpost

Parallel placement of thepins ensure continuouscompression at thefracture site.

Cross section of the

femoral neck

showing pinlocation in 70

consecutive

fractures6

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O P E R A T I V E T E C H N I Q U E

S L I P P E D C A P I T A LF E M O R A L E P I P H Y S I S

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O P E R A T I V E T E C H N I Q U ES L I P P E D C A P I T A L F E M O R A L E P I P H Y S I S

S T R O N G , S T A B L E F IX A T IO N

T H R O U G H A S IM P L E A N D

P R E C I S E P R O C E D U R E

The osteosynthesis consists of a cylindrical pin

inserted in a drill hole and attached to the

femoral head. The drill hole and pin runs at

right angles to the growth zone and is,

depending on the degree of slipping, relatively

centrally located in the femoral neck and

head. The pin is 10-20 mm longer than the

drill hole in order to permit growth in the

length of the femoral neck. Slipping up to 60

can be stabilised by osteosynthesis.

Frontal view Lateral view

1 P a t ie n t P o s i t io n in g & R e d u c t io nThe degree of slipping should be thoroughly

investigated by X-ray examination

preoperatively. Reduction should only be

performed if there is pronounced slipping

without signs of corresponding periosteal bone

formation in the femoral neck.

Fluoroscopy is recommended during theoperation. The image should include the head,

neck and proximal femur down to the lesser

trochanter. The proximal femur should be

positioned so that the neck is parallel to the

radiation beam in the lateral projection. The

foot should therefore be rotated inwards and

fixed in 30-60 inward rotation.

30-60

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2 S t a b i l i s a t io n G u i d e -W i r e In s e r t io nA guide wire is inserted percutaneously in the

trochanteric region into the femoral neck and

head for stabilisation during the operation.

3 I n c i s i o nA 10-20 mm longitudinal subtrochanteric

incision is made and the fascia lata is divided

in the direction of the fibres.

4 G u id e -W i r e In s e r t io nThe guide wire is inserted through the fascia.

In the AP-view the tip of the guide wire should

be level with the lesser trochanter. In the

lateral view it should be central in relation to

the femoral head and neck. Once the

alignment of the guide wire is satisfactory, it is

advanced to the subchondral bone of thefemoral head.

N O T E

To prevent unintended guide-wire

advancement and penetration in the

surrounding tissue, frequently check

the position of the guide-wire under

image intensification.

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5 D r i l l i n g & M e a s u r e m e n tThe cannulated drill and the protective

measuring sleeve are inserted over the end of

the guide wire. The protective sleeve is

pressed against the lateral cortex and the drillis advanced to the subchondral Bone of the

femoral head. The length of the pin is read off

the scale on the drill against the end of the

protective measuring sleeve.

The drill, guide wire and protective measuring

sleeve are removed.

N O T E

All Guide-wires are single use productsand therefore must be discardedat the end of

the surgical procedure.

6 P i n / In t r o d u c e r A s s e m b lyA pin of the length chosen for the proximal hole

is prepared for introduction by passing the inner

introducer through the outer introducer and

screwing it into the base of the pin. The unequal

lugs on the introducer correspond with slots in

the pin.The tip of the handle is inserted through

the hole in the inner introducer and rotated

clockwise until it meets resistance (ie until the tiptouches the base of the threaded inner portion of

the pin).

A pin that is 10-20mm longer than the

measured length is chosen in order to permit

growth of the femoral neck.

N O T E

It is important to make sure that the innerpin is in correct position in the window of

the outer pin prior to insertion.

Direct readingof the length

1 2 3

InnerIntroducer

Outer

Introducer

Hansson

Pin

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7 P i n in s e r t io nA pin of the selected length is introduced in

the drill hole, ensuring that the guide-line on

the outer introducer is pointing superiorly.

When the pin is seen to be in position, thehook is activated by turning the introducer

handle clockwiseas far as it will go. The

introducer assembly and the stabilisation

guide-wire are then removed and the wound is

closed.

N O T E

Bilateral Slipping

In view of the high rate of bilateral slipping,

operation of the contralateral hip is

recommended in cases of slipped capital

femoral epiphysis.1

Guide line facing

superiorly

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C A S E R E P O R TS L I P P E D C A P I T A L F E M O R A L E P I P H Y S I S

X - R A Y C A S E S

Fig.2

Both sides have been operated in the same

anaesthesia to avoid the high risk of later slipping

also on the unaffected side.

Fig. 4The physes are closed and the Hansson Pin seem

retracted into the bone. The positioning of the

hook is the same in the femoral head, showing

the elongation of the femoral neck.

Fig.1

A 15 year old boy with left-sided

Slipped Capital Femoral Epiphysis,

treated with a Hansson Pin

Fig.3View at 3 years, showing attained

size of the femoral neck

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O P E R A T I V E T E C H N I Q U E

F E M O R A L N E C KF R A C T U R E S

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O P E R A T I V E T E C H N I Q U EF E M O R A L N E C K F R A C T U R E S

S T R O N G , S T A B L E F IX A T IO NT H R O U G H A S I M P L E A N DP R E C IS E P R O C E D U R E

1 P a t ie n t P o s i t io n in g & R e d u c t io nReduction is obtained by gentle manipulationand held by immobilisation on a fracture

operating table. If adequate reduction cannot be

obtained, then arthroplasty should be

undertaken.

Hold the drill or the guide-wire, over the hip

joint over the skin surface, and angle under

image intensification so that it is positioned in

line with the femoral neck. With the guide-wire

placed at 135 angle, the pin crosses the lateral

cortex at the level of the lesser trochanter. Thepoint at which this instrument crosses the skin

line is the optimal point for skin incision.

2 I n c i s i o nA 10-20mm incision is made and the fascia lata

is divided in the direction of the fibres.

3 D is t a l G u i d e -W i r e In s e r t io nThe guide-wire together with the guide-wire

bush are inserted through the fascia to the lateral

cortex. In the frontal view the tip of the guide-

wire should be level with or just below the lower

edge of the lesser trochanter. In the lateral view it

should be central in relation to the femoral head

and neck. It is essential to have the guide-wire

very close to the inner medial cortex. Once thealignment of the guide-wire is satisfactory, the

guide-wire is advanced to the subchondral bone

of the femoral head.

The guide-wire bush is removed.

N O T E

To prevent unintended guide-wire

advancement and penetration in the

surrounding tissue, frequently check

the position of the guide-wire under

image intensification.

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4 D is t a l D r i l l in gThe short cannulated drill is inserted over the

end of the guide-wire. The protective measuring

sleeve is advanced to the lateral cortex and

drilling is carried out, using image intensificationto ensure that the drill follows the line of the

guide-wire accurately and does not cut through

the calcar. It is also important to ensure that the

guide-wire does not penetrate the pelvis. When

the drill is fully advanced in the femoral head,

the required length of pin is read off the scale

on the drill protruding from the sleeve. The

protective measuring sleeveand the guide-wire

are then removed.

15


5 P r o x i m a l D r i l l in gThe next stage is to drill a hole for the proximal

pin as close as possible to the posterior cortex of

the femoral neck. This is achieved by selecting

the drill guide which gives the widest possible

separation of the pins without cutting through

the posterior cortex. The incision is extended 20

to 30mm.

A check can be made, before drilling, to ensurethe correct drill guide has been selected. The

selected drill guide is then pushed over the distal

drill and rotated, in order that the new channel is

situated posteriorly to the distal drill. The sharp

tip of the guide is pushed into the cortex to aid

stability.

N O T E

Make sure that the protective

measuring sleeve is in contact

with the bone.

Direct readingof the length

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6 P r o x i m a l D r i l l in gEnsuring that the sharp tip of the drill guide is

firmly located against the femoral cortex, the

long solid drill is used to prepare the second

hole, using image intensification in both AP andlateral views to ensure that the drill does not cut

through the calcar. The hole is drilled up and

into the subchondral bone of the head. The

lateral view alone indicates whether the drill is

advanced sufficiently in the femoral head. The

length of pin required is again read off the scale

on the drill protruding from the drill guide. The

drill and drill guide are then removed.

7 P i n / In t r o d u c e r A s s e m b lyA pin of the length chosen for the proximal hole

is prepared for introduction by passing the inner

introducer through the outer introducer and

screwing it into the base of the pin. The unequal

lugs on the introducer correspond with slots in

the pin. The tip of the handle is inserted through

the hole in the inner introducer and rotated

clockwise until it meets resistance (ie until the tiptouches the base of the threaded inner portion of

the pin).

N O T E

It is important to clean the channel by

running the drill in forward motion as the

drill is removed.

N O T E

It is important to make sure that the inner

pin is in correct position in the window of

the outer pin prior to insertion.

1 2 3

Inner

Introducer

OuterIntroducer

HanssonPin

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8 P r o x im a l P i n In s e r t io nThe proximal pin is introduced first, ensuring

that the guide-line on the outer introducer is

pointing anteriorly. When the pin is seen to be in

position, the hook is activated by turning theintroducer handle clockwise as far as it will go.

The position of the introducer ensures that the

hook emerges anteriorly, maximising its fixation

in good quality bone. The introducer assembly is

then removed by unscrewing the inner

introducer anti-clockwise while holding the

outer introducer still. The distal drill and guide-

wireare then removed.

17


P o s t - O p e r a t iv e C a r e

Full weight-bearing may be allowed from the

first post-operative day as tolerated by the

patient, except in young patients with

displaced fractures: these can be prescribed

a six-week period of nonweight-bearing.

N O T E

Before turning the handle, make sure that the

guide wire has been removed.

9 D is t a l P i n In s e r t io nA pin of the length required for the distal hole

(usually 10 mm longer than the proximal pin) is

mounted on the introducer assembly and

inserted in the same way, but with the guide-line

on the introducer facing superiorly so that the

hook will also emerge superiorly. Again, both AP

and lateral image intensification is utilised to

ensure accurate placement.The wound is sutured and closed in the normal

manner.

Guide Line

A-PView

M-L View

Guide line facingsuperiorly

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C A S E R E P O R TF E M O R A L N E C K F R A C T U R E

X - R A Y C A S E S

Fig.1

Displaced cervical hip fracture

Garden IV

Fig.3


after reposition and operation

with hook-pin osteosynthesis

Fig.4

Healed cervical hip fracture

2 years after operation withhook-pins

Fig.5

Healed cervical hip fracture

2 years after operation withhook-pins

Fig.2


after reposition and operation

with hook-pin osteosynthesis

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P I N R E M O V A L

A 10-20mm skin incision is made for pin removal.

The end of the pin can be identified manually or

using image intensification. The fibrous tissue

which often surrounds the end of the pin is

incised.The outer introducer is placed over the extractor

and the extractor is screwed clockwise. Engage the

lugs of the outer introducer into the pin. Continue

to turn the extractor. This withdraws the hook back

into the body of the pin, which can then be

removed.

Occasionally, it may happen that the hook is

removed on its own, leaving behind the body of

the pin. In that case, the body of the pin can beremoved by using the inner introducer.

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H A N S S O N P I N S Y S T E M O R D E R I N G I N F O R M A T I O N

H A N S S O N P IN S

S t a in le s s S t e e l P in T i t a n iu m

R e f L e n g t h R e f

m m

394070S 70mm 694070S

394075S 75mm 694075S394080S 80mm 694080S

394085S 85mm 694085S

394090S 90mm 694090S

394095S 95mm 694095S

394100S 100mm 694100S

394105S 105mm 694105S

394110S 110mm 694110S

394115S 115mm 694115S

394120S 120mm 694120S

394125S 125mm 694125S

394130S 130mm 694130S

394135S 135mm 694135S

394140S 140mm 694140S

IN S T R U M E N T S

R e f . N o . D e s c r ip t i o n

704501 Short Cannulated Drill 6.7mm x 246mmwith Jacobs fitting

704522 Long Solid Drill 6.7mm x 276mmwith Jacobs fitting

704510 Protective Measuring Sleeve

704537 Drill Guide 6mm

with Elastosil handle

704538 Drill Guide 8mmwith Elastosil handle

704539 Drill Guide 10mm

with Elastosil handle

704511 Guide-wire Bush

704515 Outer Introducer

704516 Inner Introducer

704517 Introducer Handle

704518 Extractor

704505S Threaded Guide-wire 2.4mm x 300mm(Single Use - Sterile Packed)

901703 Sterilisation Tray for Instruments(Lid and Insert)

Special Order NOTE: All implants are sterile packed.

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R E F E R E N C E SS l i p p e d C a p i t a l F e m o r a l E p i p y s i s

C l i n i c a l S t u d i e s :

1. Osteosynthesis with the Hook-Pin in Slipped Capital Femoral Epiphysis. Hansson L.I. (1982):

Acta Orthop. Scand. 53: 87-96

2. Epidemiology of Slipped Capital Femoral Epiphysis in Southern Sweden. Hgglund G., Hansson L.I., and Ordeberg G. (1984):

Clinic. Orthop. 191: 82-94

3. Slipped Capital Femoral Epiphysis in Southern Sweden. Long-term Results after Femoral neck Osteotomy. Hgglund G., Hansson L.I., Ordeberg G., and

Sandstrm S. (1986):


4. Vitality of the Slipped Capital Femoral Epiphysis. Preoperative evaluation by tetracycline labeling.

Hgglund G., Hansson L.I., and Ordeberg G. (1985):


5. Familial Slipped Capital Femoral Epiphysis. Hgglund G., Hansson L.I., and Sandstrm S. (1986):


6. Slipped Capital Femoral Epiphysis in Southern Sweden. Long-term Results after Nailing/Pinning. Hgglund G., Hansson L.I., and Sandstrm S. (1987):


7. Bone Growth after Fixing Slipped Femoral Epiphyses: Brief Report. Hgglund G., Bylander B., Hansson L.I., Selvik G. (1988):

J Bone Joint Surg (Br) 70: 845-46

8. Remodelling After Pinning for Slipped Capital Femoral Epiphysis. Jones J.R., Paterson D.C., Hillier T.M., Foster B.K. (1990):

J Bone Joint Surg (Br) 72: 568-73

T h e s i s :

1. Physiolysis of the hip.

Epidemiology, natural history and long time results after closed treatment.

Gunnar Ordeberg, 1986.

2. Physiolysis of the hip.

Epidemiology, etiology and therapy.

Gunnar Hgglund, 1986.

C l i n i c a l S t u d i e s :

1. Vitality of the femoral head after femoral neck fracture evaluated by tetracycline labelling.

Strmqvist B, Ceder L, Hansson LI, Thorngren KG

Arch Orthop Trauma Surg 99:1-6, 1981

2. 85Sr-scintimetry in femoral neck fracture.

Brummer R, Hansson LI, Sjstrand LO

Arch Orthop Trauma Surg 1982:101(1):47-51

3. Scintimetric evaluation of nailed femoral neck fractures with special reference to type of osteosynthesis.

Strmquist B, Hansson LI, Palmer J

Acta Orthop Scand 1983 Jun:54(3):340-7

4. Femoral head vitality after intracapsular hip fracture, 490 cases studied by intravital tetracycline labelling and Tc-MDP radionuclide imaging.

Strmqvist B

Acta Orthop Scand Suppl 200:1-71,1983

5. Emission tomography in femoral neck fracture for evaluation of avascular necrosis.

Strmqvist B, Brismar J, Hansson LI

Acta Orthop Scand 54:872-7, 1983

6. Technetium-99m-methylendiphosphonate scintimetry after femoral neck fracture.

A three-year follow-up study.


Clin Orthop 1984 Jan-Feb:(182):177-89

7. Femoral head vitality in femoral neck fracture after hook-pin internal fixation.

Strmquist B, Hansson LI

Clin Orthop 1984 Dec:(191):105-9

8. Two-year follow-up of femoral neck fractures. Comparison of osteosynthesis methods.

Strmqvist B, Hansson LI, Nilsson LTActa Orthop Scand 1984 Oct:55(5):521-5

9. Femoral head vitality at reoperation for femoral neck fracture complications.

Strmqvist B, Hansson LI, Palmer J

Arch Orthop Trauma Surg 1984:103(4):235-40

R E F E R E N C E SF e m o r a l N e c k F r a c t u r e s

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R E F E R E N C E SF e m o r a l N e c k F r a c t u r e s ( c o n t . )

10. Hip fracture in rheumatoid arthritis.

Strmqvist B

Acta Orthop Scand 1984 Dec:55(6):624-8

11. External and biopsy determination of peroperative Tc-99m MDP femoral-head labbeling in fracture of the femoral neck.


J Nucl Med 1984 Aug:25(8):854-8

12. Hook-pin fixation in femoral neck fractures. A two-year follow-up study of 300 cases.

Strmqvist B, Hansson LI, Nilsson LT

Clin Orthop 218:58-62, 1987

13. Effects of strategy changes in the treatment of femoral neck fractures during a 17-year period.

Ceder L, Strmqvist B, Hansson LI

Clin Orthop 1987 218:53-7

14. Prognostic precision in postoperative, 99Tc-MDP scintimetry after femoral neck fracture.

Strmqvist B, Hansson LI, Nilsson LT

Acta Orthop Scand 1987 58:494-8

15. Displacement in femoral neck fractures. A numerical analysis of 200 fractures.

Eliasson P, Hansson LI, Krrholm J

Acta Orthop Scand 1988 Aug:59(4):361-426.

16. Treatment of hip fractures in rheumatoid arthritis.

Strmqvist B, Kelly I, Lidgren L

Clin Orthop 1988 Mar:(228):75-8

17. Fixation of fractures of the femoral neck using screws or hook-pins. Radionuclide study and short-term results.

Strmqvist B, Hansson LI, Ross HRev Chir Orthop 1988:74(7):609-13

18. Intracapsular pressures in undisplaced fractures of the femoral neck.

Strmquist B, Nilsson LT, Egund N

J Bone Joint Surg:Br: 1988 Mar:70(2):192-4

19. Function after hook-pin fixation of femoral neck fractures. Prospective 2-year follow-up of 191 cases.

Nilsson LT, Strmqvist B, Thorngren KG

Acta Orthop Scand 1989 Oct:60(5):573-8

20. Stability of femoral neck fractures. A postoperative roentgen stereophotogrammetric analysis.

Ragnarsson JI, Hansson LI, Krrholm J

Acta Orthop Scand 1989 Jun:60(3):283-735.

21. Internal fixation of femoral neck fractures in Parkinsons disease. 32 patients followed for 2 years.

Londos E., Nilsson L.T., Strmqvist B.

Acta Orthop Scand 1989; 60(6):682-685

22. Stability of femoral neck fracture. Roentgen stereophotogrammetry of 29 hook-pinned fractures.

Ragnarsson JI, Krrholm JActa Orthop Scand 1991; 62(3):201-207.

23. Femoral neck fracture fixation with hook-pins. 2 years results and learning curve in 626 prospective cases.

Strmqvist B., Nilsson L.T., Thorngren K.G.


24. Bone mineral content and fixation strength of femoral neck fractures. A cadaver study.

Sjstedt A., Zetterberg C.,Hansson T., Hult E., Elkstrm L.


25. Factors Influencing Postoperative Movement in Displaced Femoral Neck Fractures: Evaluation by Conventional Radiography and Stereography.

Ragnarsson J.I., Krrholm J.

Journal of Orthopaedic Trauma 1992; N2: 152-158.

26. Function of the hip after femoral neck fractures treated by fixation or secondary total hip replacement.

Nilsson LT, Franzen H, Strmqvist B, Wiklund I

Int Orthop 1991:(15):315-18

27. The effect of Implant design and bone density on maximum torque and holding power for femoral neck fracture devices.

Eriksson F., Mattsson P., Larsson S.

Annales Chirurgiae et Gynaecologiae 2000; 89: 119-123

28. Treatment of femoral neck fracture with Hansson Pins. A biomechanical study.

Uta S., Inoue Y., Kaneko K., Mogami A., Tobe M., Maeda M., Iwase H., Obayashi O.

Japan Clinical Biomechanics 2000; 21:377-383

29. Quality of life is better after osteosynthesis than after hemioarthroplasty in femoral neck fractures.

Nilsson LT, Jaalovara P, Franzen H, Virkkunen H, Strmqvist B

Submitted.

T h e s i s :

1. Femoral head vitality after intracapsular hip fracture.

Bjrn Strmqvist, 1983.

2. Primary osteosynthesis for femoral neck fracture.

Lars T Nilsson, 1989.

3. Femoral neck fracture stability. Evaluation with roentgen stereophotogrammetric analysis, magnetic resonance imaging, scintimetry, radiography and

histopatology.

Jon Ragnarsson, 1991.

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Stryker Trauma

Selzach AGBohnackerweg 12545 SelzachSwitzerland

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PIN SYSTEM

The Trochanteric Gamma Nail is the latest development in

Orthinox, the continuing evolution of the Gamma LockingNail family designed for rapid and secure fixation of intertrochanteric and

pertrochanteric fractures. Combining strength and biomechanical advantages of the

existing Gamma family it is the Golden standard for proximal femoral fractures.

The Long Gamma Nail is a specialised development of theoriginal Gamma Locking Nail allowing surgeons to extend the

benefits of the highly successful standard implant for trochanteric fractures. It hasbeen designed to treat subtrochanteric, ipsilateral neck and shaft fractures as wellas for prophylactic use.

The OMEGA PLUS Compression Hip Screw System integrates innovative featuressuch as sideplate made of superstrong alloy material and improvedinstrumentation. OMEGA PLUS Plates and Lag Screws are available in Sterileor Non-Sterile packaging for customer preference and convenience.

This new generation of Cannulated Screws has been designed to optimise surgicaloutcomes while simplifying procedures. The ASNIS III System offers the surgeon acomplete choice of implants, material and packaging combined with a new user-friendly instrumentation.

This innovative device has been developed for Femoral Neck Fracture and SlippedCapital Femoral Epiphysis treatments. The Hansson Pin System is a simple andprecise instrumentation combined with a unique implant. This unthreaded pinwith a spreading hook allows a strong and stable fixation through a simple andshort procedure, thus preserving the blood supply and the bone integrity.

PIN SYSTEM

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