ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022
How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 3 citations in OpenAlex.
- Development and evaluation of a multi-axis loading simulator for the spine, pelvis, and lumbosacral region.Scientific reports · 2026Article
- Evaluating the contact anatomy and contact bone volume of spinal screws using a novel drilled surface image.PloS one · 2023Article
- Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
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Authors and funding
9 authors at 2 institutions in 1 country.
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Abstract
purposeOsteoporotic 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.
methodsThe 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 The screw was withdrawn in an axial direction with a steady speed and considered failed when a force decrease was detected.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.
resultsThe 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).
conclusionHigher 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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