Influence of osteoporosis on fracture fixation - a systematic literature review

Abstract

In contrast to biomechanical evidence that local osteoporosis affects anchorage of implants, this could not be reproduced in clinical studies, due to the lack of accurate osteoporosis assessment, missing complication definitions and heterogeneous inclusion criteria in these studies. Prospective studies are required that address specifically the correlation between local bone status and the risk of fixation failure.

Internal fixation of fragility fracturesof the femoral neck

“…The lack of correlation between the stability of the head fragment and BMD contradicts findings in other reported biomechanical studies (Goldhahn et al 2008). A possible explanation for this is our application of donor-specific loads exclusively in the physiological range.…”

“…In biomechanical experiments it has been shown that the holding-power of screws correlates with bone quality and there are indications, yet no final scientific evidence, for this correlation in vivo (Goldhahn et al 2008). In fact, a recent cohort study including 140 patients with femoral neck fractures did not find an association between BMD and failure rate following internal fixation (Viberg et al 2014).…”

“…A possible explanation for this is our application of donor-specific loads exclusively in the physiological range. At present, there seems to be little scientific evidence of a clinical association between BMD and the outcome in operated hip fractures (Goldhahn et al 2008, Viberg et al 2014). Either there is no association between bone quality and surgical outcome, or maybe BMD is not a good measure to predict the bone's ability to make a stable osteosynthesis possible.…”

Efficacy of compression application in instable intraarticular distal radius fractures, treated with external fixator

“…In IADRF, following treatment, median nerve compression findings may be seen (Goldhahn et al, 2008). With the used compression technique, no damage finding in the median nerve was found and even, the number of patients, showing compression findings was less than the control group.…”

Osteoporotic sheep mandibular model for comparative alveolar bone healing research

“…The long-bones of sheep and the maxillofacial sites in the sheep have been used to model the healing of implants, however, very little work has been done on the use of the Osteoporotic Sheep Model. However, the literature supports the contention that the sheep are suitable animal species for both bone defect and for intra-oral dental implant research and furthermore, sheep are an important species for biomedical research in the Euroasian region [4,9,10,13]. Duncan [3] refers to noncritical size defects in the posterior mandible, and the use of the posterior mandible for implant placement following extraction of premolar teeth.…”