Injury | International Journal of the Care of the Injured - Volume 47 - Supplement 2 - June 2016

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compared to 14 control screws in the contralateral humerus.
Additionally, frozen cut sections along the screw axes were carried
out to macroscopically assess the integrity of the cement bone
interface. Extraction torque for augmented screws was not increased
compared to the control group and macroscopically there was no
damage to the trabeculae within the humeral head due to screw
removal. Therefore it was concluded that the removal of in situ PMMA
augmented screws from an angular stable plate can be accomplished
without additional damage to the bone-cement interface. These results
are in accordance with clinical observations of implant removal in
other anatomic locations following augmented screw fixation.
Conclusion and future directions
In summary, various treatment options for the use of augmenta-
tion in osteoporotic fracture fixation are currently available [54–59].
Different composites can be used for reconstruction of osseous defects
in fragility fractures in different anatomic locations. Strengthening
implant fixation through theuse ofmaterials suchas PMMAhave shown
promising mechanical and clinical results, with a majority of these
materials showing remarkable biocompatibility. Given the demo-
graphic changes of our aging population, the need for early weight-
bearing andmobilization toavoid complications and the loss of function
and independence in older patients is of great importance. Therefore,
the need to develop biomaterials that improve fixation in osteoporotic
bone is of great importance. Additional studies are necessary toevaluate
the mechanical, clinical, and biomedical aspects of augmentation using
different composites and in different injuries.
Conflict of interest
Dr. Christian Kammerlander has been involved in educational
activities with DePuy Synthes. All other authors declare no conflict of
interest.
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