University Hospital Muenster, Department of Trauma, Hand and Reconstructive Surgery, Albert-Schweitzer-Campus 1, Building W 1, 48149 Muenster, Germany.
Bone Joint J. 2013 Oct;95-B(10):1406-9. doi: 10.1302/0301-620X.95B10.31220.
The augmentation of fixation with bone cement is increasingly being used in the treatment of severe osteoporotic fractures. We investigated the influence of bone quality on the mechanics of augmentation of plate fixation in a distal femoral fracture model (AO 33 A3 type). Eight osteoporotic and eight non-osteoporotic femoral models were randomly assigned to either an augmented or a non-augmented group. Fixation was performed using a locking compression plate. In the augmented group additionally 1 ml of bone cement was injected into the screw hole before insertion of the screw. Biomechanical testing was performed in axial sinusoidal loading. Augmentation significantly reduced the cut-out distance in the osteoporotic models by about 67% (non-augmented mean 0.30 mm (sd 0.08) vs augmented 0.13 mm (sd 0.06); p = 0.017). There was no statistical reduction in this distance following augmentation in the non-osteoporotic models (non-augmented mean 0.15 mm (sd 0.02) vs augmented 0.15 mm (sd 0.07); p = 0.915). In the osteoporotic models, augmentation significantly increased stability (p = 0.017).
骨水泥固定增强术越来越多地用于治疗严重骨质疏松性骨折。我们研究了骨质量对股骨远端骨折模型（AO 33 A3 型）中板固定增强力学的影响。将 8 个骨质疏松和 8 个非骨质疏松的股骨模型随机分配到增强组或非增强组。使用锁定加压钢板进行固定。在增强组中，在插入螺钉之前，将 1 毫升骨水泥注入螺钉孔中。生物力学测试采用轴向正弦加载。增强显著减少了骨质疏松模型的切出距离，约减少 67%（未增强组平均为 0.30 毫米（标准差 0.08），增强组为 0.13 毫米（标准差 0.06）；p = 0.017）。在非骨质疏松模型中，增强后该距离没有统计学上的减少（未增强组平均为 0.15 毫米（标准差 0.02），增强组为 0.15 毫米（标准差 0.07）；p = 0.915）。在骨质疏松模型中，增强显著增加了稳定性（p = 0.017）。
