A biomechanical study comparing a raft of 3.5 mm cortical screws with 6.5 mm cancellous screws in depressed tibial plateau fractures

The Knee
Sunit PatilAndrew Port

Abstract

There has been a recent trend towards using a raft of small diameter 3.5mm cortical screws for supporting depressed tibial plateau fractures (Schatzker type III). Our aim was to compare the biomechanical properties of a raft of 3.5 mm cortical screws with that of 6.5 mm cancellous screws in a synthetic bone model. Ten rigid polyurethane foam (sawbone) blocks, with a density simulating osteoporotic bone and ten blocks with a density simulating normal density bone were obtained. A Schatzker type III fracture was created in each block. The fracture fragments were then elevated and supported using two 6.5 mm cancellous screws in ten blocks and four 3.5 mm cortical screws in the remaining. The fractures were loaded using a Lloyd testing machine. The mean force needed to produce a depression of 5 mm was 700.8 N with the four-screw construct and 512.4 N with the two-screw construct in the osteoporotic model. This difference was highly statistically significant (p = 0.009). The mean force required to produce the same depression was 1878.2 N with the two-screw construct and 1938.2 N with the four-screw construct in the non-osteoporotic model. Though the difference was not statistically significant (p = 0.42), an increased fragmentation ...Continue Reading

References

Mar 7, 2002·Journal of Orthopaedic Trauma·Madhav A KarunakarJames F Kellam
Mar 7, 2002·Journal of Orthopaedic Trauma·Greg L WestmorelandWilliam C Hutton
Mar 23, 2012·Journal of Orthopaedic Trauma·Richelle C TakemotoKenneth A Egol

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Citations

Oct 22, 2011·Archives of Orthopaedic and Trauma Surgery·Yong-Cheol YoonJae-Woo Cho
Sep 5, 2013·BMC Sports Science, Medicine and Rehabilitation·Caroline M BlakeyPaul M Sutton
Jul 8, 2009·The Journal of Oral Implantology·Linus ChongJohn Gaughan
Mar 25, 2011·Indian Journal of Orthopaedics·Gunasekaran KumarBadri Narayan
Mar 21, 2012·Journal of Orthopaedic Trauma·Antonius PizanisMarkus Burkhardt
Aug 6, 2013·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·F Alan Barber
Jan 26, 2013·Orthopaedics & Traumatology, Surgery & Research : OTSR·G Burdin
Apr 30, 2013·Orthopaedics & Traumatology, Surgery & Research : OTSR·T VendeuvreL E Gayet

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