The aim of this study was to analyze biomechanically the impact of bone cement augmentation on the fixation strength and cut-out resistance of Proximal Femoral Nail Antirotation (PFNA) and Trochanteric Fixation Nail Advanced (TFNA) head elements within the femoral head in a human cadaveric model with poor bone quality. Methodology: Fifteen pairs of fresh-frozen human cadaveric femoral heads were randomized to three sets of five pairs each for center-center implantation of either TFNA blade, TFNA screw, or PFNA blade. By splitting the specimens of each pair for treatment with or without bone cement augmentation, six study groups were created. All specimens were biomechanically tested under progressively increasing cyclic loading featuring a physiologic loading trajectory in a setup simulating a reduced intertrochanteric fracture with lack of posteromedial support. Number of cycles to 5° varus collapse was evaluated together with the corresponding load at failure. Results: Compared to the non-augmented state, all types of implants demonstrated significantly higher numbers of cycles to failure and load at failure following augmentation, p ≤ 0.03. Augmented TFNA blades resulted in highest numbers of cycles to failure and loads at failure (30492; 4049 N) followed by augmented PFNA blades (30033; 4003 N) and augmented TFNA screws (19307; 2930 N), p = 0.11. Augmented TFNA screws showed similar numbers of cycles to failure and loads at failure compared to both non-augmented TFNA and PFNA blades, P = 0.98.

From a biomechanical perspective, bone cement augmentation significantly increases the cut-out resistance of instrumented TFNA and PFNA head elements and is a valid supplementary treatment option to these nailing procedures in poor bone quality.

这项研究的目的是生物力学分析骨水泥填充对人尸体股骨头内股骨近端防旋转（PFNA）和股骨转子粗隆固定钉（TFNA）固定元件的固定强度和抗剪切力的影响。骨骼质量差的模型。方法：将15对新鲜冷冻的人体尸体股骨头随机分为三对，每对五对，用于TFNA刀片，TFNA螺钉或PFNA刀片的中心-中心植入。通过将每对样本分开进行有无骨水泥增强治疗，创建了六个研究组。所有样本均在逐渐增加的循环负荷下进行生物力学测试，循环负荷具有生理负荷轨迹，其设置模拟了缺乏后内侧支撑的减少的股骨转子间骨折。评估了5°内翻塌陷的循环次数以及相应的失效载荷。结果：与非增强状态相比，所有类型的植入物均显示出更高的破坏循环次数和增强后的破坏载荷，p≤0.03。增强的TFNA刀片导致最大的故障循环次数和失败时的负载（30492; 4049 N），其次是增强的PFNA刀片（30033; 4003 N）和增强的TFNA螺钉（19307; 2930 N），p = 0.11。

从生物力学的角度来看，骨水泥增强显着增加了器械化的TFNA和PFNA头部元件的抗切割能力，并且对于这些不良骨质的钉扎手术是一种有效的补充治疗选择。