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European Journal of Trauma and Emergency Surgery

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Open Access 08-12-2021 | Osteoporosis | Original Article

How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study

Authors: Fanny Schwaabe, Johannes Gleich, Christoph Linhart, Alexander Martin Keppler, Matthias Woiczinski, Christian Kammerlander, Axel Greiner, Wolfgang Böcker, Adrian Cavalcanti Kußmaul

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2022

Abstract

Purpose

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.

Methods

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 The screw was withdrawn in an axial direction with a steady speed and considered failed when a force decrease was detected.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.

Results

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).

Conclusion

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.

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Title: How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study
Authors: Fanny Schwaabe
Johannes Gleich
Christoph Linhart
Alexander Martin Keppler
Matthias Woiczinski
Christian Kammerlander
Axel Greiner
Wolfgang Böcker
Adrian Cavalcanti Kußmaul
Publication date: 08-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: Osteoporosis
Osteoporosis
Published in: European Journal of Trauma and Emergency Surgery / Issue 4/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-021-01850-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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