The aim of this study was to test a novel method for intra-operative assessment of osteoporotic bone fracture strength using a surgical tool instrumented with a strain gauge and compare the device with cortical width (CW) measurements in the distal radius. The force needed to puncture the cortex (FNP) was quantified with the device and found to strongly correlate with bone mineral density (BMD) in the diaphysis (adj. R2= 0.66, p < 0.001). Screw pullout studies were performed and correlation between FNP and screw pullout strength (SPS) was modest (adj. R2= 0.34 with p < 0.05). CW correlated well with BMD (adj. R2= 0.7, p < 0.0001) and SPS (adj. R2= 0.5, p = 0.002) in the diaphysis. This technology may allow objective intra-operative assessment of bone strength to provide surgeons another tool for decision making on fixation strategies appropriate to the area of bone treated.

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