Effect of Screw Insertion Torque on Mechanical Properties of Four Locking Systems

Boudreau, B.; Benamou, Jérôme; Pfeil, Dirsko J F von; Guillou, Reunan P.; Beckett, Clifford; Déjardin, Loïc M.

doi:10.1111/j.1532-950x.2013.12023.x

Cited by 13 publications

(13 citation statements)

References 17 publications

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“…It is known that the strength of bone tissue reduces as the size of the screw increases; therefore, it is recommended that the screw diameter does not exceed 40% of the diameter of the bone that it is applied to (KOCH, 2005;BOUDREAU et al, 2013). Screws can be self-tapping or not, according to the manufacture's needs.…”

Section: Bone Implants That Promote Absolute Stabilitymentioning

confidence: 99%

Physics behind the implants used for high strain fractures: literature review

Macedo

Marinho

Dal‐Bó

et al. 2018

Braz. J. Vet. Res. Anim. Sci.

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Quando fraturas ósseas ocorrem, forças externas produzem movimentação interfragmentária continuamente e um método de estabilização se faz necessário. É sabido que as condições mecânicas no local de fratura influenciam a formação de calo durante o processo de cicatrização óssea e para que cicatrização óssea primária seja obtida é necessária estabilidade absoluta no foco de fratura. O conceito de strain de Perren determina que a deformação relativa no foco de fratura estabilizado depende do tamanho da lacuna de fratura original. Fraturas redutíveis (sem cominuição) são consideradas de alto strain, pois uma pequena força aplicada a linha de fratura resulta em grande movimentação com efeito deletério ao processo de consolidação. O presente trabalho revisa a literatura disponível a respeito de fatores que influenciam a mecânica de fraturas de alto strain em medicina veterinária, seus métodos de tratamento e a física por trás dos implantes disponíveis. Cada configuração de fratura requer atenção especial e cuidado crítico na escolha do método de osteossíntese e no tipo de estabilidade necessária para que a consolidação ocorra no tempo esperado. Conhecimento da teoria do strain é mandatório para a formação de cirurgiões ortopédicos.

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Section: Bone Implants That Promote Absolute Stabilitymentioning

confidence: 99%

Physics behind the implants used for high strain fractures: literature review

Macedo

Marinho

Dal‐Bó

et al. 2018

Braz. J. Vet. Res. Anim. Sci.

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“…The stability of the angle-stable plates depends mostly on their design, accurate screw insertion and the strength of the interlock between screw head and the plate hole. [2][3][4][5][6] When compared to conventional plates, locking plate systems offer many mechanical and biological advantages such as decreased need for anatomical plate contouring, preservation of periosteal blood supply under the plate and increased resistance to screw pullout. As a result, the angle-stable implants offer faster healing and lower complication rates.…”

Section: Introductionmentioning

confidence: 99%

“…In these studies, the connection between the screw head and the plate hole was investigated using destructive mechanical tests. 2,4,[13][14][15] In this study, we introduce micro-CT as a novel nondestructive quantitative method investigating locking systems. In this experiment, 3.5 mono-and 3.5 polyaxial locking plates were used.…”

Section: Introductionmentioning

confidence: 99%

How Do the Locking Screws Lock? A Micro-CT Study of 3.5-mm Locking Screw Mechanism

Kaczmarek¹,

Bartkowiak

Paczos

et al. 2020

Vet Comp Orthop Traumatol

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Objective To quantify the amount of the screw head thread and the plate hole thread connection in two 3.5 mm locking plates: Locking Compression Plate (LCP) and Polyaxial Locking System (PLS). Materials and Methods A micro - CT scan of a screw head - plate hole connection was performed pre- and post destructive tests. Tests were performed on bone surrogates in a fracture gap model. The 3.5 LCP and 3.5 PLS plates, with 3 perpendicular screws per segment were used in a destructive static test. The 3.5 PLS plates with mono- and polyaxial screws were compared in a cyclic fatigue tests in two orthogonal directions. Pre - and post - test scan datasets were compared. Each dataset was converted into serial images depicting sections cut orthogonally to locking screw axis. The amount of engagement was detected through automated image postprocessing. Results The mean amount of the thread connection for the LCP was 28.85% before and 18.55% after destructive static test. The mean amount of the connection for the PLS was 16.20% before and 14.55% after destructive static test. When inserted monoaxially, the mean amount of the connection for the PLS screws was 14.4% before and 19.24% after destructive cyclic test. The mean amount of the connection for the polyaxial inserted PLS screws when loaded against plate thickness was 2.99% before and 2.08% after destructive cyclic test. The mean amount of the connection for the polyaxial inserted PLS screws when loaded against plate width was 3.36% before and 3.93% after destructive cyclic test. The 3D visualization of the thread connection showed that the initial interface points between screw head and plate hole are different for both LCP and PLS after the destructive testing. Depending on the type of applied force, there was either loss or increase of the contact. Clinical Relevance Micro-CT offers news possibilities in locking implant investigation. It might be helpful in better understanding the nature of locking mechanism and prediction of possible mode of failure in different systems.

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“…When a torque was applied over the limit, implant failure occurred. [18][19][20] Consequently, several studies suggest the implementation of torque-limiting drivers when using locking screws fixation devices. 16,[21][22][23] Another newly introduced polyaxial locking plate system (ARIX Atraumatic Rigid Fixation, Jeil Medical Co., Seoul, South Korea) is similar to PAX but has some different mechanical characteristics.…”

Section: Introductionmentioning

confidence: 99%

Effect of Screw Insertion Torque on Mechanical Properties of a Hybrid Polyaxial Locking System

Jung

Jang

Yim

et al. 2020

Vet Comp Orthop Traumatol

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Objective The aim of this study was to determine the effect of insertion torque and angulation on the push-out strength of screws in Atraumatic Rigid Fixation (ARIX) system. Materials and Methods In vitro mechanical tests of the ARIX system were conducted. Screw plate constructs (n = 120) were tested using five different insertion torques at four different angles relative to the perpendicular axis of the plate. Before the push-out test, screws were locked into the plates, and the push-out force of the screw was measured by applying a load parallel to the screw axis. Results Implant failure was observed at 0.8 Nm at an insertion angle of 15 degrees, and at 1 Nm at 0 degree, 5 degrees and 10 degrees. Two types of failures were observed: cold welding and plate deformation. An insertion torque of 0.8 Nm produced a significantly higher push-out force compared with 0.2 Nm. Non-angled specimens with 0.8 Nm insertion torque exhibited significantly higher screw push-out forces compared with other tested specimens and insertion angles. Insertion angle did not affect screw push-out force at insertion torques of 0, 0.2, 0.4 and 0.6 Nm. Conclusion The ARIX locking system is much more sensitive to insertion torque than angle. An effect of insertion angle was observed only at an insertion torque of 0.8 Nm, under which all angles significantly decreased push-out force relative to zero degrees of angulation. In addition, low insertion torques can result in screws loosening over time, while greater insertion torques than 1 Nm can result in screw head stripping and plate hole deformation.

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Effect of Screw Insertion Torque on Mechanical Properties of Four Locking Systems

Cited by 13 publications

References 17 publications

Physics behind the implants used for high strain fractures: literature review

Physics behind the implants used for high strain fractures: literature review

How Do the Locking Screws Lock? A Micro-CT Study of 3.5-mm Locking Screw Mechanism

Effect of Screw Insertion Torque on Mechanical Properties of a Hybrid Polyaxial Locking System

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