Partially threaded headless screw may benefit adequate interfragmentary compression and reduced driving torque for small bone fixation

Journal of Orthopaedic Surgery
Chen-Chiang LinKun-Jhih Lin

Abstract

Headless compression screws (HCSs) are commonly used to fixate small bones and articular fractures. Understanding the biomechanical efficacy of different HCS designs can help surgeons make proper interfragmentary compression when a specific implant is chosen. HCSs with three different central shaft designs (unthreaded, fully threaded, and partially threaded) were studied: the Herbert-Whipple, Mini-Acutrak 2, and headless reduction (HLR). Polyurethane foam blocks were machined with a simulated fracture gap of 0.5 mm and set onto a custom-made jig to simultaneously measure compression force and driving torque during screw insertion. The maximal achievable compression forces and driving torques recorded were 47.4 ± 0.9 N and 145.11 ± 1.65 N mm for the HLR, 50.98 ± 1.29 N and 152.62 ± 2.83 N mm for the Mini-Acutrak 2, and 19.33 ± 1.0 N and 33.4 ± 2.2 N mm for the Herbert-Whipple. Overall, the compression force of the Mini-Acutrak 2 and HLR increased with the torque. Unlike the other screws, the Herbert-Whipple's driving torque increased while the compression force decreased after peak compression force was achieved. The partially threaded shaft design (HLR) demonstrated equivalent biomechanical advantage with the Mini-Acutrak 2 in ...Continue Reading

References

Jan 1, 1984·The Journal of Bone and Joint Surgery. British Volume·T J Herbert, W E Fisher
Aug 1, 1996·Journal of Biomechanical Engineering·J R ChapmanD Kowalski
Dec 20, 2005·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·C A BaileyC P Kelly
Nov 17, 2009·Archives of Orthopaedic and Trauma Surgery·Onder BaranHasan Havitcioglu
Jul 31, 2010·Hand Clinics·John R Fowler, Asif M Ilyas
Apr 10, 2012·Injury·Soroush AssariAsif M Ilyas
Jul 3, 2013·The Journal of Hand Surgery·Adam HartPaul A Martineau

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