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European Journal of Trauma and Emergency Surgery

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Open Access 01-04-2022 | Pelvic Ring Fractures | Original Article

Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study

Authors: Adrian Cavalcanti Kußmaul, Fanny Schwaabe, Christopher Alexander Becker, Christian Kleber, Christoph Linhart, Christoph Thorwächter, Bianka Rubenbauer, Wolfgang Böcker, Axel Greiner

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2022

Abstract

Purpose

Open reduction and internal fixation using anterior plate osteosynthesis currently represents the gold standard for the treatment of symphyseal disruptions. Since postoperative screw loosening with consequent implant failure is frequently observed, this study aims to evaluate if and to what extent augmentation can increase the pull-out force of symphyseal screws to improve the constructs stability.

Methods

Twelve human cadaveric anterior pelvic rings were separated at the symphyseal joint for bilateral testing, consequently achieving comparable sites. First, one non-augmented screw was drilled into the superior pubic ramus, whereas the contralateral side was primarily augmented. The screws were then withdrawn with a constant speed of 10 mm/min and the fixation strengths determined by the force (N) displacement (mm) curve. Finally, the primary non-augmented site was secondary augmented, representing revision surgery after initial implant failure, and the corresponding fixation strength was measured again.

Results

Augmentation compared to non-augmented screws displayed significantly higher pull-out forces with an increase in pull-out force by 377% for primary and 353% for secondary augmentation (p < 0.01). There was no significant difference in the pull-out force comparing primary and secondary augmentation (p = 0.74).

Conclusions

Primary and secondary augmentation significantly increases the stability of symphyseal screws and, therefore, potentially decreases rates of implant failure.

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Title: Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study
Authors: Adrian Cavalcanti Kußmaul
Fanny Schwaabe
Christopher Alexander Becker
Christian Kleber
Christoph Linhart
Christoph Thorwächter
Bianka Rubenbauer
Wolfgang Böcker
Axel Greiner
Publication date: 01-04-2022
Publisher: Springer Berlin Heidelberg
Keyword: Pelvic Ring Fractures
Published in: European Journal of Trauma and Emergency Surgery / Issue 5/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-022-01963-6

At a glance: The STEP trials

Springer Medicine

Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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