Evaluation of calcium phosphate bone cement in augmenting screw hole defects in the ulna: A biomechanical study

IF 1.8 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2026-01-01 Epub Date: 2025-11-21 DOI:10.1016/j.clinbiomech.2025.106717

Wasim Awal , Randy Bindra , Giuseppe Pastore , Lawrence Baartz , Alastair Quinn , David Saxby

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引用次数: 0

Abstract

Background

Following ulnar shortening osteotomies, plates are often removed due to discomfort or irritation. The screw holes left after plate removal act as stress risers and predispose the bone to fracture. To our knowledge, calcium phosphate cement (CPC) is yet to be investigated for its use in reinforcing screw holes. The aim of this study was to determine if filling screw holes with CPC in a synthetic anatomical ulna model will improve its immediate mechanical strength compared to leaving screw holes unfilled.

Methods

Eighteen synthetic anatomical ulna models were randomly divided into three equal groups. The control group was left unaltered, the drilled group received six 3.5 mm screw holes, and the CPC group had the six 3.5 mm screw holes filled with CPC. All bones were subjected to torsional loading until failure. Peak torque at failure, stiffness, and energy absorption were measured.

Findings

Compared to the drilled group, the CPC group had greater peak torque, stiffness, and energy absorption. Group effects on peak torque and stiffness were moderate (eta squared = 0.12 for both) but did not reach statistical significance (p = 0.37 and 0.38, respectively). A statistically significant group effect was found for energy absorption (p < 0.001); but post-hoc analysis revealed no difference between the drilled and CPC groups.

Interpretation

Effect sizes suggest CPC may improve mechanical performance, albeit modestly. Clinicians may consider using CPC for reinforcing screw holes after plate removal in bones like the ulna when refracture is of concern.

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磷酸钙骨水泥加固尺骨螺钉孔缺损的生物力学研究。

背景：尺侧截骨术后，由于不适或刺激，钢板常被移除。取下钢板后留下的螺钉孔充当应力发生器，使骨头容易骨折。据我们所知，磷酸钙水泥（CPC）在螺钉孔加固中的应用还有待研究。本研究的目的是确定在合成尺骨解剖模型中，与不填充螺钉孔相比，用CPC填充螺钉孔是否会提高其即时机械强度。方法：合成尺骨解剖模型18只，随机分为3组。对照组保持不变，钻孔组置入6个3.5 mm螺钉孔，CPC组置入6个3.5 mm螺钉孔。所有骨骼均承受扭转载荷直至破坏。测量了失效时的峰值扭矩、刚度和能量吸收。结果表明：与钻孔组相比，CPC组具有更高的峰值扭矩、刚度和能量吸收。组对峰值扭矩和刚度的影响中等（两者的eta平方均= 0.12），但未达到统计学意义（p分别= 0.37和0.38）。在能量吸收方面发现了统计学上显著的群体效应(p)解释：效应大小表明CPC可能改善机械性能，尽管幅度不大。当担心再骨折时，临床医生可能会考虑使用CPC在骨（如尺骨）取出钢板后加固螺钉孔。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.