Background

Osteoplasty has been discouraged in long bones. However, despite a substantial lack of pre-clinical biomechanical tests, multiple clinical studies have implemented a wide range of techniques to optimise long bone osteoplasty. The aim of the present study is to evaluate the biomechanical properties of osteoplasty alone and in combination with Kirschner wires (K-wires) in a cadaveric human diaphyseal model undergoing 3-point bending stress.

Methods

Thirty unpaired human cadaveric hemi-tibia specimens were randomly assigned to receive no consolidation (group 1, n = 10), osteoplasty alone (group 2, n = 10), or K-wires augmented osteoplasty (group 3, n = 10). Specimens were tested on a dedicated servo-hydraulic machine using a 3-point bending test. Fracture load was calculated for each specimen; two-sample Wilcoxon rank-sum tests were used to assess differences between groups.

Results

Median volume of polymethyl methacrylate injected was 18 mL for group 2 (25th–50th percentile 15–21 mL) and 19 mL for group 3 (25th–50th percentile 17–21). There were no significant differences in fracture load between groups 1 and 2 (z = − 0.793; p = 0.430), between groups 1 and 3 (z = − 0.944; p = 0.347), and between groups 2 and 3 (z = − 0.454; p = 0.650). Fractures through the cement occurred in 4 of 30 cases (13.3%); there were no K-wires fractures.

Conclusions

Osteoplasty with or without K-wires augmentation does not improve the resistance of diaphyseal bone to bending stresses.

中文翻译：

---

带或不带Kirschner线增强术的骨成形术对经历弯曲应力的长骨骨干的生物力学影响：对癌症患者经皮成像引导固结的影响。

背景

不鼓励长骨进行骨成形术。然而，尽管基本上缺乏临床前的生物力学测试，但多项临床研究已经实施了广泛的技术来优化长骨成形术。本研究的目的是评估在接受3点弯曲应力的尸体人体骨干模型中，单独的骨成形术以及与Kirschner线（K线）联合使用的骨成形术的生物力学特性。

方法

随机分配30例未成对的人体尸体半胫骨标本，以不进行巩固（第1组，n  = 10），仅进行骨成形术（第2组，n  = 10）或使用K线增强骨成形术（第3组，n  = 10）。样品在专用伺服液压机上使用三点弯曲测试进行了测试。计算每个样品的断裂载荷。两次样本Wilcoxon秩和检验用于评估组之间的差异。

结果

第2组注射的中位聚甲基丙烯酸甲酯的体积为18 mL（第25-50％的15-21 mL），第3组注射的中位数为19 mL（第25-50％的17-21）。有在断裂载荷组1和2之间没有显著差异（ž  = - 0.793; p  = 0.430），组1和3之间（ž  = - 0.944; p  = 0.347），和组2和3之间（ž  = - 0.454；p  = 0.650）。30例中有4例（13.3％）发生了通过水泥的骨折；没有K线断裂。

结论

带或不带K线增强的骨成形术都不会提高骨干骨骼对弯曲应力的抵抗力。