Bone 47 (2010) 1048–1053

Contents lists available at ScienceDirect

Bone
j o u r n a l h o m e p a g e : w w w. e l s e v i e r. c o m / l o c a t e / b o n e

Effects of three different preservation methods on the mechanical properties of

human and bovine cortical bone
Unger Stefan, Blauth Michael, Schmoelz Werner ⁎
Department for Trauma Surgery, Medical University Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
AO-Trauma Clinical Priority Program “Fracture Fixation in Osteoporotic Bone” (CPP FFOB), AO Foundation, AO-Trauma, Stettbachstraße 6, CH-8600 Duebendorf, Switzerland

a r t i c l e i n f o a b s t r a c t

Article history: Background and purpose: In the development of new strategies for fracture fixation, new methods have to be
Received 2 July 2010 tested biomechanically under in vitro conditions before clinical trials can be performed. The gold standard for
Revised 17 August 2010 laboratory evaluations is fresh-frozen specimen. As the availability of fresh-frozen specimens is limited and since
Accepted 17 August 2010 their use bears infectious risks, specimens treated with various chemical embalming fluids are also used. These
Available online 21 August 2010
preservation methods may alter the mechanical properties of the specimens used. Therefore, the aims of the
present study were to determine the effects of three different preservation methods (formalin fixation (FO),
Edited by: Thomas Einhorn
Thiel-fixation (TH), and alcohol–glycerine fixation (AG)) on the elastic and postyield mechanical properties of
Keywords: cortical bone and to compare these properties to those of fresh-frozen (FF) specimens.
Cortical bone Materials and methods: Cylindrical cortical specimens (diameter 3 mm, length 60 mm) were obtained from
Preservation human femurs (n = 48) and bovine tibiae (n = 40). Before specimen immersion in different fixation fluids, bone
Mechanical property mineral density (BMD) as well as the initial Young's modulus was determined. The Young's modulus was
Three-point bending determined in a nondestructive bending test, and measurements were repeated after 6 months of immersion in
Young's modulus fixative solution. Subsequent to the nondestructive test, a destructive 3-point bending test was conducted to
Energy absorption
assess the postyield and fracture properties.
Results: The BMD as well as the initial Young's modulus showed no significant differences between the four test
groups. After 6 months in fixative solution, the Young's modulus was significantly lowered in human Thiel
specimens and only showed minor changes in formalin- and alcohol–glycerine-treated specimens. The plastic
energy absorption of human and bovine specimens was altered significantly. Formalin as well as alcohol–
glycerine fixation yielded a significant decrease in plastic energy absorption, whereas Thiel fixation significantly
increased the plastic energy absorption.
Discussion/conclusion: Because of the significantly altered plastic mechanical properties of cortical bone, the use
fresh-frozen bone specimens is recommended in biomechanical studies investigating failure loads of orthopaedic
implants. The use of embalmed specimens should be restricted to pilot tests.
© 2010 Elsevier Inc. All rights reserved.

Introduction nonembalmed specimen [6]. In addition, most human tissue available

In recent years, new concepts and implants for the treatment of
fractures in osteoprotic bone have been developed. Before clinical
trials, laboratory evaluation of these new concepts and implants by
means of biomechanical in vitro experiments is required. The in vitro
experiments should mimic in vivo conditions as closely as possible.
Therefore, the gold standard is the use of fresh-frozen human
specimens, as the mechanical properties of bone are not altered
significantly by freezing [1–5]. However, one disadvantage of fresh-
frozen specimens is the remaining risk of contamination with
pathogenic germs. Furthermore, long-duration tests at room temper-
ature are hardly possible because of the rapid deterioration of
⁎ Corresponding author. Fax: + 43 512 504 25743.
E-mail address: werner.schmoelz@uki.at (W. Schmoelz).
for biomechanical in vitro testing is derived from anatomical
departments and is stored in various preservation solutions. This
leads to a limited availability of fresh-frozen specimens, as fresh-
frozen storage is more costly.
For these reasons, biomechanical in vitro tests are frequently
conducted using specimens treated with different chemical preser-
vation methods. However, it is controversially discussed in the
literature whether and how different preservation methods affect
the mechanical properties of bone.
One of the most common methods is formalin fixation.
Formalin, the aqueous solution of formaldehyde, is an excellent
preservation solution. It rapidly stops all bacterial and nonbacterial
degradation processes, as formalin acts as a strong disinfectant [7].
A disadvantage of formalin is the chemical reaction of aldehydes
with the primary amine groups of the collagen chains, leading to
an increased number of inter- and intrafibrillar cross-links and

8756-3282/$ – see front matter © 2010 Elsevier Inc. All rights reserved.
doi:10.1016/j.bone.2010.08.012
 S. Unger et al. / Bone 47 (2010) 1048–1053
therefore altering the mechanical properties of bone [8]. Although
the effects of formaldehyde on the mechanical properties of bone
have been under investigation since the 1960s [1,2,9], there is still
no general consent.
In 2008, two studies investigating the effects of formalin
fixation on the mechanical properties of bone were published,
drawing opposite conclusions. Ohman et al. [6] investigated the
effect of formalin on cylindrical cortical bone specimens from
human femurs and stated that human bone tissue should be tested
nonfixed whenever possible. In contrast, van Haaren et al. [10],
who conducted a study on formalin effects on whole goat bones,
concluded that, for biomechanical studies investigating orthopae-
dic implants, bones treated with formaldehyde can be used when
preserved up to 1 year.
Another widely used preservation method is the use of ethyl-
alcohol. Because of its denaturing, bactericidal and hygroscopic effects
ethyl-alcohol yields excellent preservation results and inhibits the
transmission of infectious diseases. However, the hygroscopic effect of
ethyl-alcohol leads to a certain shrinking of soft tissue and may also
alter the mechanical properties of bone.
The effects of ethyl-alcohol on bone tissue were examined by
Sedlin [1], who reported a 2.5–4% decrease in Young's modulus.
Linde and Sorensen [4] investigated the effects of 70% ethanol
fixation and reported a trend, but no statistical significance, towards
an increase of stiffness and elastic energy.
A further more recently developed embalming method is the Thiel
fixation. It was developed by W. Thiel in 1992, with the intention of
avoiding unnatural discolorations and hardening induced by embalm-
ing whole corpses with formaldehyde/formalin [7,11]. In addition,
Thiel fixation has a strong disinfective effect.
There is no literature available investigating the effects of Thiel
fixation on the mechanical properties of bone. As the Thiel-fixative
contains a certain amount of formalin and ethyl-alcohol, it may alter
the mechanical properties of bone in a similar way to formalin and
ethyl-alcohol fixation.
The aim of the present study was to determine the effects of
three different preservation fluids (formalin, ethyl-alcohol, and
Thiel fixation) on the mechanical properties of cortical human and
bovine bone specimens. The results were compared to the gold
standard of fresh-frozen specimens. The mechanical properties
were assessed by a nondestructive cyclic and a destructive 3-point
bending test.
Materials and methods
Specimens
Seven bovine tibiae, cleaned from all soft tissue and aged between
20 and 24 months, were obtained from a local abattoir.
Three pairs of fresh-frozen human femurs were obtained from the
local anatomical department (2 females and 1 male, mean age
69.3 years; SD 5.13). The femurs were cleaned from all soft tissue,
double-sealed in plastic bags, and kept frozen at −20 °C until specimen
preparation.
Specimen preparation
Cylindrical cortical specimens with a length of 60 mm and a
diameter of 3 mm were used according to the literature [12,13].
For human specimens, the femoral shaft segment was cut 20 mm
distally of the lesser trochanter and subdivided in a proximal and
distal segment. These segments were sectioned into eight radial
segments by using a water-cooled circular saw. For the bovine
specimens, the mid shaft section of the bovine tibiae was prepared,
and the cortical bone was again cut into 10 radial segments.
1049
The obtained radial pieces were then mounted on a bench lathe
and machined into the above-mentioned geometry. All specimens
were constantly kept moist with saline solution during the prepara-
tion procedure.
For the human specimens, a total number of 48 samples (n = 12
per fixation method) were machined. For the bovine specimens, a
total number of 40 samples (n = 10 per fixation method) were
obtained.
Bone mineral density measurements
Bone mineral density (BMD) was assessed by qCT, including EFP
calibration (GE Lightspeed VCT 16, Milwaukee, USA; EFP-Phantom,
QRM GmbH, Möhrendorf, Deutschland). CT analysis and BMD
measurements were accomplished with the J-Vision 3.3.16 Diagnost.
Software (Version 3.3.16, Agfa, Belgium). BMD was measured using
circular ROIs (region of interest) with a diameter of 2.5 mm at the
midsection of the specimens.
Preservation protocol
The cortical bone specimens were assigned to four different
treatment groups with an equally distributed BMD and initially
measured Young's modulus (measured as described below).
a.) Fresh-frozen specimen (FF)
The specimens were wrapped in saline soaked gauze and
frozen at −20 °C. Before testing, the specimens were thawed
overnight at 6 °C.
b.) Formalin (FO)
The formalin solution used in this study consisted of 2%
formalin, 5% phenol, and 93% distilled water and is the standard
solution used at the local anatomical department.
c.) Thiel preservation (TH)
For the Thiel preservation, the “Leicheninfusionslösung” as
described and published in 2002 by W. Thiel [11] was used. The
solution was mixed and obtained from the local anatomical
department according to the composition described in the
literature [11].
d.) Alcohol–glycerine fixation (AG)
The alcohol–glycerine fixative used in the present study was
composed of 96% ethyl-alcohol (96% undiluted alcohol), 3%
glycerine, and 1% phenol.
The specimens of the formalin, Thiel, and alcohol–glycerine
groups were immersed in the preservation solution and stored at
6 °C. All specimens were left at room temperature 2 hours before
testing.
Testing protocol
All 3-point bending tests were conducted in an electromechanical
material testing machine (Zwick Z2.5/TS1S, Zwick GmbH & Co. KG,
Ulm, Germany). The width between supports was set to 48 mm
resulting in a width between supports-to-specimen thickness ratio of
16:1 as recommended in the literature [12–14]. The obtained data
were analysed using the testXpert software (testXpert V11.02, Zwick
GmbH & Co. KG, Ulm, Germany).
In the nondestructive 3-point bending test (Fig. 1), the cortical
specimens were loaded for five cycles with a testing speed of 2 mm/
min, after a preload of 2 N was applied. Human specimens were loaded
from 0.15% to 0.5% strain, whereas bovine specimens were loaded from
0.15% to 1% strain.
After the initial test for group assignment, the specimens were
deposited in the different preservation solution and retested after
6 months in solution. The initial Young's modulus (Einit) as well as the
Young's modulus after 6 months in solution (E6 months) were
1050 S. Unger et al. / Bone 47 (2010) 1048–1053
Fig. 1. Test setup of the non destructive and destructive 3-point bending tests.
calculated from the obtained force and displacement data of the fifth
loading cycle, using following formula:
4⋅l3v ⋅ðxh −xl Þ E = Young's modulus (GPa)
E= 3⋅π⋅d40 ⋅ΔL lv = width between supports (mm)
xh = force at 1% strain (kN)/force at 0.5% strain (kN)
xl = force at 0.15% strain (kN)
d0 = specimen diameter (mm)
ΔL = deflexion between xh and xl (mm)
Subsequent to the nondestructive test after 6 months, the speci-
mens were loaded until failure to assess the postyield and fracture
properties. The test setup was the same as for the nondestructive test
setup (width between supports = 48 mm; test speed = 2 mm/min;
preload = 2 N). The following mechanical properties were calculated:
– Ultimate stress and ultimate strain (σultimate and εultimate)
– Energy absorption: The specimen's energy absorption was deter-
mined by calculating the area under the stress–strain curve. The
elastic (Eelast) as well as the plastic energy (Eplast) absorptions were
calculated (Fig. 2). The yield point (Rp 0.1), separating the elastic
and plastic region was defined with the 0.1% strain offset method.
Statistical analysis was performed with SPSS Statistics 17.0 (SPSS
Inc. Chicago, IL, USA). Data were tested for normal distribution using a
Kolmogorov–Smirnov test. An analysis of variance (ANOVA) followed
Fig. 2. Schematic drawing of the elastic and plastic energy calculation.
by a Bonferroni post-hoc test was performed to detect differences
between the groups. The level of significance was set at p b 0.05.
Results
All results are reported as mean values and standard deviation
(SD) and are summarised in Tables 1–3.
BMD and Young's modulus
Statistical analysis revealed no significant differences in BMD
between the four treatment groups before biomechanical testing,
neither for human (p = 0.739) nor for the bovine specimens
(p = 0.878; Table 1).
For the initial Young's modulus, no significant differences between
the four investigated preservation methods were found, neither in
human (p = 0.994) nor in bovine specimens (p = 0.823; Table 1).
After a preservation time of 6 months, TH specimens showed a
significant decrease in the Young's modulus when compared to FF
specimens (p = 0.023). The Young's modulus of the FO and the AG
group were not altered significantly when compared to the FF
specimens (Table 1).
The bovine specimens showed similar changes in the Young's
modulus as the human specimens, with the lowest Young's modulus
found in the TH group. Compared to FF specimens, statistical analysis
revealed no significant differences (Table 1).
Ultimate stress and ultimate strain
Compared to human FF specimens, FO and TH specimens did not
show a difference in ultimate stress, but FO had at a significantly lower
ultimate strain (p = 0.035), while TH specimens showed a signifi-
cantly higher ultimate strain (p = 0.002). In contrast to the FO and TH
specimens, the AG specimens had a significantly higher ultimate
stress (p ≤ 0.001) while failing at a similar ultimate strain to FF
specimens (Table 2 and Fig. 3).
Similar results for ultimate strain and ultimate stress were found
for bovine cortical specimens (Table 2 and Fig. 4). AG specimens had a
significantly increased ultimate stress (p ≤ 0.001) and no changes in
ultimate strain when compared to FF specimens, while TH specimens
had a significantly increased ultimate strain (p = 0.006).
Elastic and plastic energy absorption
Comparing the elastic energy absorption in human specimens, no
changes were found for FO and TH, while AG specimens showed a
significantly higher elastic energy absorption (p ≤ 0.001) (Table 3 and
Fig. 5).
The plastic energy absorption was significantly increased in
human TH specimens (p = 0.003). In contrast to that, compared to
the FF, the AG and FO specimens had a decreased plastic energy
absorption with the latter being significant (p = 0.05) (Table 3 and
Fig. 5).
None of the investigated preservation methods significantly
altered the elastic energy absorption for bovine specimens (Table 3
and Fig. 6).
Plastic energy absorption (Table 3 and Fig. 6) of bovine specimens
was significantly increased in the TH group (p = 0.036). In analogy to
the human specimens, the bovine FO and AG specimens showed a
decrease in plastic energy absorption, with the latter being significant
(p = 0.030).
Discussion
Determining the mechanical properties of bone is a difficult and
demanding issue, mainly due to the complex and hierarchical
 S. Unger et al. / Bone 47 (2010) 1048–1053 1051

Table 1
BMD and Young's modulus (mean values ± SD).

BMD (mg/cm3) Young's modulus (GPa)

Human specimens Bovine specimens Human Human Bovine Bovine

specimens—initial specimens—6 months specimens—initial specimens—6 months

Fresh-frozen (FF) 1091.25 1094.05 17.85 18.42 22.35 21.05

± 157.40 ± 210.67 ±1.01 ± 0.97 ±1.38 ± 1.39
Formalin (FO) 1071.46 1025.37 17.75 18.65 22.78 21.44
± 137.08 ± 187.36 ±0.81 ± 0.82 ±1.60 ± 1.43
Thiel (TH) 1065.30 1036.24 17.83 17.25a 22.87 20.06
± 119.91 ± 200.28 ±1.12 ± 1.11 ±1.20 ± 0.95
Alcohol–glycerine (AG) 1031.56 1081.29 17.79 19.15 22.38 22.19
± 111.01 ± 218.23 ±0.97 ± 0.80 ±1.77 ± 1.69
a
Significant difference from fresh-frozen specimens; (pb0.05).

structure of bone [15]. Mechanical properties are additionally specimens showed the same (but insignificant) trends. Formalin
influenced by a variety of factors, such as anatomical location, specimens had a significantly lower ultimate strain and plastic energy
specimen size and shape, loading mechanism, and strain rate. absorption.
Comparison of studies investigating the effects of preservation These findings are in line with Goh et al. [16] who investigated the
methods on the mechanical properties of bone is not easy. effects of formalin fixation on whole cat femurs and humeri and
Standardized testing protocols are not available and bone samples reported a 40–50% decrease in energy absorption in torsion and
derived from different species with different specimen geometries/ bending tests. The findings are also in line with Currey et al. [8] who
types (whole bones vs. machined specimens, cortical vs. trabecular investigated the effects of formalin fixation on bovine cortical bone
specimens), as well as different preservation fluids in different specimens loaded in 3-point bending and tension. Although the
concentrations are used. differences in energy absorption were insignificant, Currey et al.
In the present study, the mechanical properties of pin-shaped concluded that a large difference in energy absorption could be
(cylindrical) bone specimens were determined in a nondestructive covered by the wide confidence intervals. In contrast, van Haaren et al.
and a destructive 3-point bending test to investigate the influence of [10] found no significant differences in energy absorption testing
three different preservation methods (formalin fixation, Thiel fixa- formalin embalmed and fresh-frozen goat femurs and humeri in
tion, and alcohol–glycerine fixation) and to compare them to the gold torsion and 4-point bending. However, this study did not report
standard of fresh-frozen specimens. numerical values or a standard deviation of their measurements. As
All biomechanical tests were conducted on bovine and human they assessed the apparent structural properties of whole bones and
cortical bone specimens to confirm the obtained human results as the not tissue level properties, other factors such as bone geometry and
naturally given variations due to age, gender, and osteoporosis status in positioning of the bone in the test setup are likely to have a larger
human bone specimens which were not present in bovine specimens. effect on the results than the investigated preservation method.
In formalin-treated specimens, the postyield properties were In the present study, the effects of formalin on the elastic
affected significantly in human bone specimens, whereas the bovine mechanical properties were minor. Human as well as bovine speci-
mens showed no significant differences in Young's modulus when
Table 2
compared to fresh-frozen specimens after a preservation time of
Ultimate stress and strain. 6 months. In addition, no significant differences were found in the
elastic energy absorption. McElhaney et al. [9] reported an insignif-
Human specimens Bovine specimens
icant decrease in Young's modulus investigating bovine bone speci-
σultimate εultimate σultimate εultimate mens loaded in compression and tension. Sedlin [1] investigated the
(N/mm2) (%) (N/mm2) (%)
effects of formalin on tension specimens from human femurs and
Fresh-frozen (FF) 183.76 1.79 231.35 1.95 reported a suggestive but insignificant increase in Young's modulus.
±15.11 ±0.26 ±33.94 ± 0.36
The results of Currey et al. [8] showed an insignificant increase in
Formalin (FO) 195.07 1.50a 241.60 1.79
±16.02 ±0.20 ±42.89 ± 0.31
Young's modulus, but in conclusion, however, he stated a “very small
Thiel (TH) 200.15 2.19a 255.97 2.51a but real effect on Young's modulus which seems to be enlarged by
±20.73 ±0.32 ±23.41 ± 0.44 formalin fixation.”
Alcohol–glycerine (AG) 227.30a 1.63 301.18a 1.66 In contrast to the current findings in 3-point bending, Ohman et al.
±17.71 ±0.20 ±27.77 ± 0.24
[6] reported a significant decrease of 24% in Young's modulus when
a
Significant difference from fresh-frozen specimens; (pb0.05).

Table 3
Elastic and plastic energy absorption (mJ/mm3).

Human specimens Bovine specimens

Elastic energy p value Plastic energy p value Elastic energy p value Plastic energy p value

Fresh-frozen (FF) 86.71 148.70 197.38 186.81

± 7.68 ±48.32 ± 55.47 ±79.92
Formalin (FO) 93.35 0.297 94.21a 0.05 186.78 1.0 115.67 0.436
± 5.85 ±37.21 ± 10.87 ±79.19
Thiel (TH) 89.71 1.0 223.24a 0.003 182.64 1.0 299.20a 0.036
± 7.45 ±61.73 ± 8.51 ± 115.36
Alcohol–glycerine (AG) 114.98a b0.001 114.98 0.565 221.03 0.545 71.79a 0.030
±10.53 ±41.77 ± 20.90 ±60.16
a
Indicates a significant difference to fresh-frozen specimens.
1052 S. Unger et al. / Bone 47 (2010) 1048–1053
Fig. 3. Mean stress–strain graph of human cortical specimens in the load to failure test
after 6 months of fixation time.
investigating the effects of formalin fixation on cylindrical human
femoral specimens loaded in compression.
In summary, the authors of the present study are in line with
Currey et al. [8] who stated that it is unlikely that formalin fixation has
no effect at all on the mechanical properties of bone. Especially the
plastic energy absorption was significantly reduced when compared
to fresh-frozen specimens. Therefore, formalin-embalmed specimens
are not recommended when load to failure tests are conducted.
Although an extensive literature research was conducted, no
studies investigating the effects of Thiel fixation on the mechanical
properties of cortical bone were found. In the presented study, human
as well as bovine Thiel specimens were affected significantly. The
elastic mechanical properties were affected to a lesser extent than the
post yield properties. The Young's modulus after 6 months of fixation
time was only decreased significantly in human specimens, when
compared to fresh-frozen specimens.
In the load to failure test, human and bovine Thiel-fixated
specimens had a significantly higher ultimate strain and significantly
increased plastic energy absorption compared to fresh-frozen
specimens.
Therefore, Thiel specimens cannot be recommended for biome-
chanical load to failure test because of a significantly altered failure
strain and plastic energy absorption.
Alcohol–glycerine fixation also affected the mechanical properties
of cortical bone specimens.
In the Young's modulus measurements, human as well as bovine
alcohol–glycerine specimens showed the highest Young's modulus
Fig. 4. Mean stress–strain graph of bovine cortical specimens in the load to failure test
after 6 months of fixation time.
Fig. 5. Elastic and plastic energy absorption of human cortical bone specimens after
6 months of preservation time. ⁎Significant differences compared to FF specimens.
after 6 months. This was statistically not significant when compared
to fresh-frozen specimens. These findings are in line with Beaupied
et al. [17], who investigated the effects of 70% ethanol on whole rat
femurs loaded in tension and reported an insignificant increase in
Young's modulus. Also, Linde and Sorensen [4] reported a statistically
not significant trend towards an increase in stiffness and elastic
energy, investigating the storage effects of 70% ethanol on cylindrical
trabecular human bone specimens loaded in compression. In contrast,
Sedlin investigated the effects of storage in 40% ethanol for 5–10 days
on cortical bone specimens derived from human femurs and reported
a decrease of 2.5–4.0% in Young's modulus [1,3,14].
The static destructive 3-point bending test revealed a significantly
higher ultimate stress and no significant differences in ultimate strain
when compared to fresh-frozen specimens. Regarding the elastic
energy, human as well as bovine alcohol–glycerine specimens showed
the highest elastic energy absorption, which was significantly different
from the fresh-frozen group in human specimens. The plastic energy
absorption was lowered significantly in bovine specimens when
compared to fresh-frozen specimens. Human specimens showed the
same trends as bovine specimens. However, the difference was not
significant.
A contributing factor to these results might be that specimens
stored in ethanol are dehydrated due to a loss of residual water. Evans
[3] as well as Turner and Burr [14] reported that dehydrated or dried
bone will become more brittle, with the Young' modulus generally
increasing and the toughness (total energy absorption) decreasing.
This is in line with the findings of the present study as after
6 months in solution alcohol–glycerine specimens showed the high-
est Young's modulus and a lowered (significantly in bovine speci-
mens) plastic energy absorption. Furthermore, ultimate stress was
Fig. 6. Elastic and plastic energy absorption of the bovine cortical specimens after
6 months of preservation time. ⁎Significant differences compared to FF specimens.
 S. Unger et al. / Bone 47 (2010) 1048–1053
significantly higher in alcohol–glycerine specimens compared to
fresh-frozen samples.
These results indicate that preservation with an alcohol–glycerine
solution is not appropriate for specimens subjected to load to failure
tests in biomechanical studies.
The present study investigated the changes in the mechanical
properties on the tissue level (standardized test specimens) and not
on the apparent structural level (whole bone). As the majority of
fracture implants in preclinical in vitro testing are fixed to the bone by
screws, this is of importance because screw purchase is more
dependent on the mechanical properties of the surrounding tissue
and less on the apparent structure of the whole bone.
Conclusion
In the present study, the effects of three different preservation
methods on cortical bone specimens were investigated and compared
to fresh-frozen specimens. The elastic as well as the plastic
mechanical properties were affected by the preservation methods.
The results of the present study suggest that in biomechanical studies
investigating failure loads of orthopaedic implants, fresh-frozen
specimens should be used. The use of “embalmed” specimens should
be restricted to pilot test.
Acknowledgments
This work was financially supported by the AO-Foundation, within
the Clinical Priority Project “Fracture Fixation in Osteoporotic Bone”
(CPP-FFOB). Furthermore, the authors would like to thank Dr. Volker
Kuhn for his discussions in the early phase of the project planning and
Dr. Peter Struve for proofreading of the manuscript.
1053
References
[1] Sedlin ED. A rheologic model for cortical bone. A study of the physical properties of
human femoral samples. Acta Orthop Scand Suppl 1965;Suppl 83:1–77.
[2] Sedlin ED, Hirsch C. Factors affecting the determination of the physical properties
of femoral cortical bone. Acta Orthop Scand 1966;37:29–48.
[3] Evans GF. Mechanical Properties of Bone. Springfield, IL, USA: Charles C. Thomas
Publisher; 1973.
[4] Linde F, Sorensen HC. The effect of different storage methods on the mechanical
properties of trabecular bone. J Biomech 1993;26:1249–52.
[5] Panjabi MM, Krag M, Summers D, Videman T. Biomechanical time-tolerance of
fresh cadaveric human spine specimens. J Orthop Res 1985;3:292–300.
[6] Ohman C, Dall'Ara E, Baleani M, Van Sint Jan S, Viceconti M. The effects of
embalming using a 4% formalin solution on the compressive mechanical
properties of human cortical bone. Clin Biomech (Bristol, Avon) 2008;23:1294–8.
[7] Thiel W. The preservation of the whole corpse with natural color. Ann Anat
1992;174:185–95.
[8] Currey JD, Brear K, Zioupos P, Reilly GC. Effect of formaldehyde fixation on some
mechanical properties of bovine bone. Biomaterials 1995;16:1267–71.
[9] McElhaney J, Fogle J, Byars E, Weaver G. Effect of embalming on the mechanical
properties of beef bone. J Appl Physiol 1964;19:1234–6.
[10] van Haaren EH, van der Zwaard BC, van der Veen AJ, Heyligers IC, Wuisman PI,
Smit TH. Effect of long-term preservation on the mechanical properties of cortical
bone in goats. Acta Orthop 2008;79:708–16.
[11] Thiel W. Supplement to the conservation of an entire cadaver according to W.
Thiel. Ann Anat 2002;184:267–9.
[12] Berns T, Hofmann C, Gotzen L. Strength testing of pins made of human femur
cortical bone. Unfallchirurg 2001;104:64–8.
[13] Hofmann C, Schadel-Hopfner M, Berns T, Sitter H, Gotzen L. Influence of
processing and sterilization on the mechanical properties of pins made from
bovine cortical bone. Unfallchirurg 2003;106:478–82.
[14] Turner CH, Burr DB. Basic biomechanical measurements of bone: a tutorial. Bone
1993;14:595–608.
[15] Currey J. Measurement of the mechanical properties of bone: a recent history. Clin
Orthop Relat Res 2009;467:1948–54.
[16] Goh JC, Ang EJ, Bose K. Effect of preservation medium on the mechanical
properties of cat bones. Acta Orthop Scand 1989;60:465–7.
[17] Beaupied H, Dupuis A, Arlettaz A, Brunet-Imbault B, Bonnet N, Jaffre C, et al. The
mode of bone conservation does not affect the architecture and the tensile
properties of rat femurs. Biomed Mater Eng 2006;16:253–9.