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

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...

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Autores principales: Cavalcanti Kußmaul, Adrian, Schwaabe, Fanny, Becker, Christopher Alexander, Kleber, Christian, Linhart, Christoph, Thorwächter, Christoph, Rubenbauer, Bianka, Böcker, Wolfgang, Greiner, Axel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9532288/
https://www.ncbi.nlm.nih.gov/pubmed/35364692
http://dx.doi.org/10.1007/s00068-022-01963-6
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author Cavalcanti Kußmaul, Adrian
Schwaabe, Fanny
Becker, Christopher Alexander
Kleber, Christian
Linhart, Christoph
Thorwächter, Christoph
Rubenbauer, Bianka
Böcker, Wolfgang
Greiner, Axel
author_facet Cavalcanti Kußmaul, Adrian
Schwaabe, Fanny
Becker, Christopher Alexander
Kleber, Christian
Linhart, Christoph
Thorwächter, Christoph
Rubenbauer, Bianka
Böcker, Wolfgang
Greiner, Axel
author_sort Cavalcanti Kußmaul, Adrian
collection PubMed
description 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 The screws were then withdrawn with a constant speed of 10 mm/min and the fixation strengths determined by the force (N) displacement (mm) curve.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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00068-022-01963-6.
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spelling pubmed-95322882022-10-06 Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study Cavalcanti Kußmaul, Adrian Schwaabe, Fanny Becker, Christopher Alexander Kleber, Christian Linhart, Christoph Thorwächter, Christoph Rubenbauer, Bianka Böcker, Wolfgang Greiner, Axel Eur J Trauma Emerg Surg Original Article 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00068-022-01963-6. Springer Berlin Heidelberg 2022-04-01 2022 /pmc/articles/PMC9532288/ /pubmed/35364692 http://dx.doi.org/10.1007/s00068-022-01963-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Cavalcanti Kußmaul, Adrian
Schwaabe, Fanny
Becker, Christopher Alexander
Kleber, Christian
Linhart, Christoph
Thorwächter, Christoph
Rubenbauer, Bianka
Böcker, Wolfgang
Greiner, Axel
Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study
title Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study
title_full Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study
title_fullStr Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study
title_full_unstemmed Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study
title_short Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study
title_sort does augmentation increase the pull-out force of symphyseal screws? a biomechanical cadaver study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9532288/
https://www.ncbi.nlm.nih.gov/pubmed/35364692
http://dx.doi.org/10.1007/s00068-022-01963-6
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