Background

Osteoporosis is associated with the risk of fractures near the hip. Age and comorbidities increase the perioperative risk. Due to the ageing population, fracture of the proximal femur also proves to be a socio-economic problem. Preventive surgical measures have hardly been used so far.

Methods

10 pairs of human femora from fresh cadavers were divided into control and low-volume femoroplasty groups and subjected to a Hayes fall-loading fracture test. The results of the respective localization and classification of the fracture site, the Singh index determined by computed tomography (CT) examination and the parameters in terms of fracture force, work to fracture and stiffness were evaluated statistically and with the finite element method. In addition, a finite element parametric study with different position angles and variants of the tubular geometry of the femoroplasty was performed.

Findings

Compared to the control group, the work to fracture could be increased by 33.2%. The fracture force increased by 19.9%. The used technique and instrumentation proved to be standardized and reproducible with an average poly(methyl methacrylate) volume of 10.5 ml. The parametric study showed the best results for the selected angle and geometry.

Interpretation

The cadaver studies demonstrated the biomechanical efficacy of the low-volume tubular femoroplasty. The numerical calculations confirmed the optimal choice of positioning as well as the inner and outer diameter of the tube in this setting. The standardized minimally invasive technique with the instruments developed for it could be used in further comparative studies to confirm the measured biomechanical results.

中文翻译：

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标准化的小容量管状股骨成形术的生物力学体外检查。

背景

骨质疏松症与髋部附近骨折的风险有关。年龄和合并症会增加围手术期的风险。由于人口老龄化，股骨近端骨折也被证明是一个社会经济问题。到目前为止，几乎没有采取预防性的手术措施。

方法

将来自新鲜尸体的10对人类股骨分为对照组和小体积股骨成形术组，并进行Hayes跌落负荷骨折试验。分别用有限元法对断裂部位的定位和分类，通过计算机断层扫描（CT）检查确定的辛格指数以及断裂力，断裂功和刚度方面的参数进行统计评估。此外，进行了具有不同位置角度和股骨成形术的管状几何形状变化的有限元参数研究。

发现

与对照组相比，断裂功可提高33.2％。断裂力增加了19.9％。事实证明，所使用的技术和仪器是标准化的并且可重现的，平均聚甲基丙烯酸甲酯的体积为10.5 ml。参数研究显示了所选角度和几何形状的最佳结果。

解释

尸体研究证明了小容量管状股骨成形术的生物力学功效。数值计算证实了在这种情况下定位的最佳选择以及管的内径和外径。具有开发的仪器的标准化微创技术可用于进一步的比较研究中，以确认测得的生物力学结果。