How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study.
Biomechanics
Bone mineral density
Fracture
Osteoporosis
Osteosynthesis
Pubic symphysis
Pull-out force
Journal
European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
received:
14
09
2021
accepted:
26
11
2021
pubmed:
10
12
2021
medline:
11
8
2022
entrez:
9
12
2021
Statut:
ppublish
Résumé
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. 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 The screw was withdrawn in an axial direction with a steady speed and considered failed when a force decrease was detected.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. 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). 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.
Identifiants
pubmed: 34881391
doi: 10.1007/s00068-021-01850-6
pii: 10.1007/s00068-021-01850-6
pmc: PMC9360150
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3101-3108Subventions
Organisme : Medizinischen Fakultät, Ludwig-Maximilians-Universität München
ID : WiFoMed Grant Nr: 80946025
Informations de copyright
© 2021. The Author(s).
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