[The use of DensiProbe™ in hindfoot arthrodesis. Can fusion failure be predicted by mechanical bone strength determination?]. / Zur Nutzung von DensiProbe™ bei der Rückfußarthrodese. Kann das Versagen durch eine mechanische Bestimmung der Knochenfestigkeit vorhergesagt werden?
Z Orthop Unfall
; 149(2): 206-11, 2011 Apr.
Article
in De
| MEDLINE
| ID: mdl-20936593
ABSTRACT
AIM:
Bone quality is a main factor in implant fixation. After having shown promising results, we have further investigated the use of the DensiProbe™ as an intraoperative measurement tool for evaluation of calcaneal bone quality and prediction of nailed hindfoot arthrodesis failure.METHOD:
In this add-on study 19 nail arthrodeses were performed using a conventional screw plus a locked blade (n = 6) or plus a locked screw (n = 13) in the calcaneus. A specially devised tool was inserted at the fixation sites of the screws and the cancellous break-away torque was measured. The constructs were then cyclically loaded to failure.RESULTS:
We saw a wide range of BMD (1.9-185.9 mgHA/cm³, mean 102.4 mg/cm³, SD 53.5). The peak torque was 0.47-1.78 Nm (mean 0.92 Nm, SD 0.46) at the proximal screw site (PSS) and 0.24 and 1.2 Nm (mean 0.63 Nm, SD 0.37) at the distal screw site (DSS), respectively, and 0.42 and 1.52 Nm (mean 1.00 Nm, SD 0.36) in the screw plus blade group (PSS). The number of cycles correlated with peak torque (two screws group PSS p = 0.002, r² = DSS 0.61 p = 0.001, r² = 0.90; screw plus blade group PSS p = 0.001, r² = 0.99). Peak torque also correlated with BMD in both groups (two screws group PSS p = 0.01, r² = 0.71; DSS p = 0.001; r² = 0.83; screw plus blade group PSS 0.42 and 1.52 Nm, mean 1.00 Nm, SD 0.36).CONCLUSION:
A mechanical bone measurement tool like the DensiProbe™ seems to be suitable for predicting tibiotalocalcaneal arthrodesis failure in a biomechanical test set-up. As a restriction in clinical practice failure is multifactorial and prediction cannot be based upon these measurements only.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Arthrodesis
/
Bone Density
/
Ankle Injuries
/
Densitometry
/
Fractures, Bone
Type of study:
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
De
Journal:
Z Orthop Unfall
Journal subject:
ORTOPEDIA
/
TRAUMATOLOGIA
Year:
2011
Document type:
Article
Affiliation country:
Suiza
Publication country:
ALEMANHA
/
ALEMANIA
/
DE
/
DEUSTCHLAND
/
GERMANY