Hack J, Krüger A, Masaeli A, Aigner R, Ruchholtz S, Oberkircher L
Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany.
Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany.
Injury. 2018 Aug;49(8):1520-1525. doi: 10.1016/j.injury.2018.06.012. Epub 2018 Jun 9.
Cement-augmentation is a well-established way to improve the stability of sacroiliac screw fixation in osteoporosis-associated fragility fractures of the posterior pelvic ring. However, to date little is known about the influence of different techniques of cement augmentation on construct stability. The aim of this study was to evaluate the primary stability of cement-augmented sacroiliac screw fixation with cannulated versus perforated screws under cyclic loading.
A total of eight fresh-frozen human cadaveric hemipelvis specimens with osteoporosis were used. After generating ventral osteotomies on both sides of the sacrum, each specimen was treated using a cement-augmented cannulated screw on one side and a cement-augmented perforated screw on the other side. Afterwards, axial cyclic loading was performed.
No statistically significant difference was found between cannulated and perforated screws concerning maximum load (356.25 N versus 368.75 N, p = 0.749), plastic deformation (1.95 mm versus 1.43 mm, p = 0.798) and stiffness (27.04 N/mm versus 40.40 N/mm, p = 0.645).
Considering the at least equivalent results for perforated screws, cement augmentation via perforated screws might be an interesting option in clinical practice because of potential advantages, e.g. radiological control before cement application, reduced risk of cement displacement and time saving.
骨水泥强化是一种公认的提高骨质疏松性骨盆后环脆性骨折中骶髂螺钉固定稳定性的方法。然而，迄今为止，关于不同骨水泥强化技术对固定结构稳定性的影响知之甚少。本研究的目的是评估在循环加载下，使用空心螺钉与多孔螺钉进行骨水泥强化骶髂螺钉固定的初始稳定性。
共使用8个患有骨质疏松症的新鲜冷冻人体半骨盆标本。在骶骨两侧进行腹侧截骨术后，每个标本一侧使用骨水泥强化空心螺钉治疗，另一侧使用骨水泥强化多孔螺钉治疗。之后，进行轴向循环加载。
空心螺钉与多孔螺钉在最大载荷（356.25N对368.75N，p = 0.749）、塑性变形（1.95mm对1.43mm，p = 0.798）和刚度（27.04N/mm对40.40N/mm，p = 0.645）方面均未发现统计学上的显著差异。
考虑到多孔螺钉至少能取得同等效果，在临床实践中，通过多孔螺钉进行骨水泥强化可能是一个有趣的选择，因为它具有潜在优势，例如在注入骨水泥前可进行影像学控制、骨水泥移位风险降低以及节省时间。
