Biomechanische Untersuchungen zur Fixationsfestigkeit von Fadenankern aus boviner Kompakta (CB-Anker) in porciner Tibiakopfspongiosa im Ausreißversuch

Jöckel, Jens Arne; Strehl, Raimund; Götzen, L.

doi:10.1055/s-2006-942236

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…Yet, the axial forces used in this experiment meet the current standards for the biomechanical evaluation of pull-out forces [ 16 , 17 ] and allow a standardized reproducibility and exact measurement of the data.…”

Section: Discussionmentioning

confidence: 99%

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Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study

Kußmaul¹,

Schwaabe²,

Becker³

et al. 2022

Eur J Trauma Emerg Surg

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Purpose Open reduction and internal fixation using anterior plate osteosynthesis currently represents the gold standard for the treatment of symphyseal disruptions. Since postoperative screw loosening with consequent implant failure is frequently observed, this study aims to evaluate if and to what extent augmentation can increase the pull-out force of symphyseal screws to improve the constructs stability. Methods Twelve human cadaveric anterior pelvic rings were separated at the symphyseal joint for bilateral testing, consequently achieving comparable sites. First, one non-augmented screw was drilled into the superior pubic ramus, whereas the contralateral side was primarily augmented. The screws were then withdrawn with a constant speed of 10 mm/min and the fixation strengths determined by the force (N) displacement (mm) curve. Finally, the primary non-augmented site was secondary augmented, representing revision surgery after initial implant failure, and the corresponding fixation strength was measured again. Results Augmentation compared to non-augmented screws displayed significantly higher pull-out forces with an increase in pull-out force by 377% for primary and 353% for secondary augmentation (p < 0.01). There was no significant difference in the pull-out force comparing primary and secondary augmentation (p = 0.74). Conclusions Primary and secondary augmentation significantly increases the stability of symphyseal screws and, therefore, potentially decreases rates of implant failure.

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Section: Discussionmentioning

confidence: 99%

“…Following previous studies, the screw was withdrawn with a constant speed of 10 mm/min [ 17 , 18 ]. In accordance with other studies, the pull-out strength was defined by the maximum force before a decrease in load was recorded [ 18 – 20 ].…”

Section: Methodsmentioning

confidence: 99%

Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study

Kußmaul¹,

Schwaabe²,

Becker³

et al. 2022

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

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How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study

Schwaabe¹,

Gleich²,

Linhart³

et al. 2021

Eur J Trauma Emerg Surg

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Purpose Osteoporotic bone tissue appears to be an important risk factor for implant loosening, compromising the stability of surgical implants. However, it is unclear whether lumbar measured bone mineral density (BMD) is of any predictive value for stability of surgical implants at the pubic symphysis. This study examines the fixation strength of cortical screws in human cadaver specimens with different BMDs. Methods The lumbar BMD of ten human specimens was measured using quantitative computed tomography (qCT). A cut-off BMD was set at 120 mg Ca-Ha/mL, dividing the specimens into two groups. One cortical screw was drilled into each superior pubic ramus. The screw was withdrawn in an axial direction with a steady speed and considered failed when a force decrease was detected. Required force (N) and pull-out distance (mm) were constantly tracked. Results The median peak force of group 1 was 231.88 N and 228.08 N in group 2. While BMD values differed significantly (p < 0.01), a comparison of peak forces between both groups showed no significant difference (p = 0.481). Conclusion Higher lumbar BMD did not result in significantly higher pull-out forces at the symphysis. The high proportion of cortical bone near the symphyseal joint allows an increased contact of pubic screws and could explain sufficient fixation. This condition is not reflected by a compromised lumbar BMD in a qCT scan. Therefore, site-specific BMD measurement could improve individual fracture management.

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Biomechanische Untersuchungen zur Fixationsfestigkeit von Fadenankern aus boviner Kompakta (CB-Anker) in porciner Tibiakopfspongiosa im Ausreißversuch

Cited by 2 publications

References 12 publications

Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study

Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study

How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study

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