Can High-friction Intraannular Material Increase Screw Pullout Strength in Osteoporotic Bone?

Bronsnick, Daniel; Harold, Ryan E.; Youderian, Ari R.; Solitro, Giovanni F.; Amirouche, Farid; Goldberg, Benjamin A.

doi:10.1007/s11999-014-3975-1

Cited by 7 publications

(6 citation statements)

References 7 publications

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“…Different thread shapes allow for modifications in the contact surface area and shear force development at the screw-bone interface, thereby affecting the fixation stability of the device. Previously, the fixation stability of bone screws has been consistently evaluated by a pure axial pullout test [34][35][36][37]. It is well known that the application of pullout tests in the axial direction is not clinically realistic, since it rarely simulates most of the physiological loading conditions [38,39].…”

Section: Discussionmentioning

confidence: 99%

Fixation stability comparison of bone screws based on thread design: buttress thread, triangle thread, and square thread

Feng

Luo

et al. 2022

BMC Musculoskelet Disord

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Background The influence of thread profile on the fixation stability of bone screws remains unclear. This study aimed to compare the fixation stability of screws with different thread profiles under several loading conditions. Methods Bone screws that differed in thread profile (buttress, triangle, and square thread) only were made of stainless steel. Their fixation stabilities were evaluated individually by the axial pullout test and lateral migration test, besides, they were also evaluated in pairs together with a dynamic compression plate and a locking plate in polyurethane foam blocks under cyclic craniocaudal and torsional loadings. Results The triangle-threaded and square-threaded screws had the highest pullout forces and lateral migration resistance. When being applied to a dynamic compression plate, higher forces and more cycles were required for both triangle- and square-threaded screws to reach the same displacement under cyclic craniocaudal loading. On the other hand, the triangle-threaded screws required a higher torque and more cycles to reach the same angular displacement under cyclic torsional loading. When being applied to a locking plate, the square-threaded screws needed higher load, torque, and more cycles to reach the same displacement under both cyclic craniocaudal and torsion loadings. Conclusions The triangle-threaded screws had superior pullout strength, while square-threaded screws demonstrated the highest lateral migration resistance. Moreover, dynamic compression plate fixation with triangle- and square-threaded screws achieved more favorable fixation stability under craniocaudal loading, while triangle-threaded screws demonstrated superior fixation stability under torsional loading. Locking plate fixation with a square-threaded screw achieved better fixation stability under both loading types.

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Section: Discussionmentioning

confidence: 99%

Fixation stability comparison of bone screws based on thread design: buttress thread, triangle thread, and square thread

Feng

Luo

et al. 2022

BMC Musculoskelet Disord

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“…Likewise, there exist many reports of the effects of screw design, insertion technique, and variation in natural and synthetic bone substrates on pullout strength, but none are specific to the proximal humerus nor included consideration of cross elements. 8,12,13,20,36,38,41 As such, our study is unique in both implant design and application.…”

Section: Discussionmentioning

confidence: 99%

Cross-elements to enhance fixation in osteoporotic bone with application to proximal humeral locking plates: a biomechanical study

González-Hernández¹,

Pietrzak

Jain³

et al. 2020

Journal of Shoulder and Elbow Surgery

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Additionally, the study did not explore the relationship between screw characteristics, insertion torque, and stability (Addevico et al, 2020). Other factors impacting stability such as intrannular materials (Bronsnick et al, 2015), insertion torque (Addevico et al, 2021), porous media for bone (Travascio et al, 2015), bone mechanobiology (Volz et al, 2021) were not conferred in our study.…”

Section: Limitations and Prospectsmentioning

confidence: 92%

Biomechanics and finite element analysis comparing posterior T-plates with LCP for fixation of posterolateral tibial plate fractures

Hu,

Ren,

Peng

et al. 2023

Front. Bioeng. Biotechnol.

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Objective: The treatment for posterolateral tibial plateau fractures (PTPF) have been subjects of controversy. We conducted a study to improve the fixation of PTPF through a lateral approach.Methods: We utilized 40 synthetic tibias and categorized the fracture models into five groups based on the locking compression plate (LCP) and T-distal radius plate (TPP) via various forms of fixation with screws through the posterolateral (PL) fracture fragments. I: Two-screw fixation using two locking screws (LPTL). Ⅱ: Two-screw fixation with both variable angle locking screws (LPTV). Ⅲ: One-screw fixation with one locking screw (LPOL). Ⅳ: One-screw fixation with one locking screw and two anteroposterior lag screws (LPOLTL). Ⅴ: a distal radius plate with three locking screws (TPP). Biomechanical tests were conducted to observe the axial compression displacement of the PL fracture fragments at force levels of 250 N, 500 N, and 750 N, as well as to determine the failure load and the axial stiffness for each respective group.Results: Under a 750 N load condition, the displacements within the five experimental groups exhibited the following trend: Ⅴ < Ⅱ < Ⅰ< Ⅳ < Ⅲ. However, there were no significant differences between Group V and Group II, Group I and Group IV (p > 0.05), and only Group Ⅲ demonstrated a displacement exceeding 3 mm. The failure load and the axial stiffness exhibited the same trend. Conversely, statistical significance was identified among the remaining group compared with Group Ⅲ (p < 0.05). Regarding the finite element analysis, the maximum displacements for the five models under the load of 750 N exhibited the following trend: Ⅴ < Ⅱ < Ⅰ< Ⅳ < Ⅲ. The following trends were observed in maximum von Mises stresses for these models under the load of 750 N: Ⅴ < Ⅱ < Ⅳ< Ⅰ < Ⅲ.Conclusion: It is crucial to address the inadequate mechanical strength associated with single screw fixation of LCP for fixing PL fractures in a clinical setting. The biomechanical strength of two-screw fixation surpasses that of single-screw fixation. Introducing variable-angle screws can further enhance the fixation range. Furthermore, the addition of two lag screws threaded from anterior to posterior can compensate the mechanical stability, when PL fracture is fixed with single screw in clinic.

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Can High-friction Intraannular Material Increase Screw Pullout Strength in Osteoporotic Bone?

Cited by 7 publications

References 7 publications

Fixation stability comparison of bone screws based on thread design: buttress thread, triangle thread, and square thread

Fixation stability comparison of bone screws based on thread design: buttress thread, triangle thread, and square thread

Cross-elements to enhance fixation in osteoporotic bone with application to proximal humeral locking plates: a biomechanical study

Biomechanics and finite element analysis comparing posterior T-plates with LCP for fixation of posterolateral tibial plate fractures

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