Kennedy Jim, Molony Diarmuid, Burke Neil G, FitzPatrick David, Mullett Hannan
Department of Orthopaedic Research, Royal College of Surgeons, Dublin, Ireland.
J Orthop Surg (Hong Kong). 2013 Aug;21(2):173-7. doi: 10.1177/230949901302100211.
PURPOSE. To evaluate the effect of filling a central humeral bone void with calcium triphosphate cement on the strength and stability of an osteosynthesis in elderly cadavers. METHODS. 14 fresh cadaveric shoulder specimens obtained from 11 donors (mean age, 91.5 years; mean body weight, 61 kg) were divided into 2 age- and sex-matched groups. A standardised 3-part proximal humeral fracture with a central bone void was created in each specimen. Each specimen was reduced and fixed with a locking plate. In half the specimens the central bone void was packed with calcium triphosphate cement. The intra-fragmentary motion and the load and mode of failure were recorded. RESULTS. Respectively in the test group and controls, the intra-fragmentary motion was 1.0 and 6.4 mm, and the peak displacement at the 500 N load was 1.8 and 9.1 mm. The Cohen's d was 1.6 to 2.7 for all load steps, indicating a large effect of the calcium triphosphate cement on strength and stability. The mean difference in the failure load was 300 N (p<0.05). CONCLUSION. Construct stability and failure load improved significantly when the central humeral bone void was filled with calcium triphosphate cement.
目的。评估用磷酸三钙骨水泥填充肱骨干中央骨缺损对老年尸体骨折固定强度和稳定性的影响。方法。从11名捐赠者（平均年龄91.5岁；平均体重61千克）获取的14个新鲜尸体肩部标本被分为2个年龄和性别匹配的组。在每个标本上制造一个标准化的伴有中央骨缺损的三部分肱骨近端骨折。每个标本均用锁定钢板进行复位和固定。在一半的标本中，中央骨缺损用磷酸三钙骨水泥填充。记录骨折块间运动以及载荷和失效模式。结果。在试验组和对照组中，骨折块间运动分别为1.0和6.4毫米，在500牛载荷下的峰值位移分别为1.8和9.1毫米。在所有载荷步骤中，科恩d值为1.6至2.7，表明磷酸三钙骨水泥对强度和稳定性有很大影响。失效载荷的平均差异为300牛（p<0.05）。结论。当用磷酸三钙骨水泥填充肱骨干中央骨缺损时，结构稳定性和失效载荷显著改善。
