The Effect of Cement Mixing Time on the Biomechanics of Cement Augmented Plated Fractures in Canine Femora

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Objective:The goal of this study was to determine the effect of cement mixing time and, hence, cement viscosity on the biomechanical behavior of femoral fracture fixation.Design:Cadaveric plated canine femoral fracture model, comparing treatments in matched pairs.Setting:Orthopaedic biomechanics laboratory.Intervention:Cement was inserted both as a liquid and as a paste in standard and oversized screw holes to augment fixation with plates and screws.Main Outcome Measurements:Standard 4-point bending tests were performed to obtain stiffness and failure load values.Results:Liquid cement had a 1.38 times increase in stiffness and a failure load 1.84 times greater compared with paste cement, regardless of hole size with a gap at the fracture site (P < 0.05). Liquid cement had a force to failure of 1.77 and 1.91 times in the standard-sized and oversized holes, respectively, when compared with paste cement (P < 0.05).Conclusions:When the cement was inserted in a liquid state in a plated femoral diaphyseal fracture with a gap, screw purchase augmentation achieved greater bending stiffness and resisted a greater failure load.

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