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Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study
Adrian Cavalcanti Kußmaul1, Fanny Schwaabe2, Christopher Alexander Becker2
1Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany. adrian.kussmaul@med.uni-muenchen.de.
Summary
Augmenting symphyseal screws significantly increases their pull-out force, enhancing construct stability and potentially reducing implant failure in pelvic fracture treatment.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Trauma Management
Background:
- Open reduction and internal fixation with anterior plate osteosynthesis is standard for symphyseal disruptions.
- Postoperative screw loosening and implant failure are common complications.
Purpose of the Study:
- To evaluate if augmentation increases the pull-out force of symphyseal screws.
- To determine the extent to which augmentation improves construct stability.
Main Methods:
- Twelve human cadaveric pelvic rings were used for bilateral testing.
- Screws were tested in non-augmented, primarily augmented, and secondarily augmented (revision) conditions.
- Screw pull-out forces were measured using a standardized testing protocol.
Main Results:
- Augmented screws showed significantly higher pull-out forces than non-augmented screws (377% increase for primary, 353% for secondary augmentation).
- No significant difference in pull-out force was observed between primary and secondary augmentation.
- P-values were < 0.01 for augmentation vs. non-augmentation and = 0.74 for primary vs. secondary augmentation.
Conclusions:
- Both primary and secondary augmentation substantially enhance symphyseal screw stability.
- Augmentation may decrease the incidence of implant failure in symphyseal disruptions.
