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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(02): 231-239
DOI: 10.1055/s-0042-1750828
Artigo Original
Trauma

Is there a Difference in Interfragmentary Compression Strength Between Fully or Partially Threaded Screws? Results of an Experimental Biomechanical Pilot Study

Article in several languages: português | English
Tosan Okoro 
1   Departamento de Artroplastia, Fundação Ortopédica Robert Jones e Agnes Hunt Hospital NHS Trust, Gobowen, Oswestry SY10 7AG, Reino Unido
,
Marcus Landgren 
2   Departamento de Cirurgia Ortopédica, Unidade de Cirurgia de Mão, Hospital Universitário de Copenhague - Herlev e Gentofte, Gentofte, Dinamarca
3   Departamento de Clínica Médica, Universidade de Copenhague, Copenhagen, Dinamarca
,
Edem Afenu 
4   Universidade de Toronto, Faculdade de Medicina, 1 Kings College Circle, Toronto M4Y 2V6, Ontario, Canadá
,
Gabriele Russow 
5   Charité – Universidade de Medicina de Berlim, Centro de Cirurgia Musculoesquelética, Berlim, Alemanha
6   Instituto de Saúde de Berlim em Charité - Universidade de Medicina de Berlim, Instituto Julius Wolff de Biomecânica e Regeneração Musculoesquelética, Berlim, Alemanha
,
Dag Wulsten 
6   Instituto de Saúde de Berlim em Charité - Universidade de Medicina de Berlim, Instituto Julius Wolff de Biomecânica e Regeneração Musculoesquelética, Berlim, Alemanha
,
Mark Heyland 
6   Instituto de Saúde de Berlim em Charité - Universidade de Medicina de Berlim, Instituto Julius Wolff de Biomecânica e Regeneração Musculoesquelética, Berlim, Alemanha
› Author Affiliations Financial Support This work was carried out as part of the Stephan Perren AO Trauma Research Traveling Fellowship awarded to Tosan Okoro, and Marcus Landgren.
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Abstract

Objective This study assessed differences between fully- and partially-threaded screws in the initial interfragmentary compression strength. Our hypothesis was that there would be an increased loss in initial compression strength with the partially-threaded screw.

Methods A 45-degree oblique fracture line was created in artificial bone samples. The first group (FULL, n = 6) was fixed using a 3.5-mm fully-threaded lag screw, while the second group (PARTIAL, n = 6) used a 3.5-mm partially-threaded lag screw. Torsional stiffness for both rotational directions were evaluated. The groups were compared based on biomechanical parameters: angle-moment-stiffness, time-moment-stiffness, maximal torsional moment (failure load), and calibrated compression force based on pressure sensor measurement.

Results After loss of one PARTIAL sample, no statistically significant differences in calibrated compression force measurement were observed between both groups: [median (interquartile range)] FULL: 112.6 (10.5) N versus PARTIAL: 106.9 (7.1) N, Mann-Whitney U-test: p = 0.8). In addition, after exclusion of 3 samples for mechanical testing (FULL n = 5, PARTIAL n = 4), no statistically significant differences were observed between FULL and PARTIAL constructs in angle-moment-stiffness, time-moment-stiffness, nor maximum torsional moment (failure load).

Conclusion There is no apparent difference in the initial compression strength (compression force or construct stiffness or failure load) achieved using either fully- or partially-threaded screws in this biomechanical model in high-density artificial bone. Fully-threaded screws could, therefore, be more useful in diaphyseal fracture treatment. Further research on the impact in softer osteoporotic, or metaphyseal bone models, and to evaluate the clinical significance is required.

Keywords

biomechanical phenomena - bone cements - bone screws - fractures, bone

Authors Contributions

All authors contributed to the study conception and design. Material acquisition, preparation and data collection were performed by T. O., M. L., G. R., D. W., and M. H. Data analysis was performed by T. O., E. A., and M. H. The first draft of the manuscript was written by T. O., E. A., M. H. and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.


Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin, Germany.




Publication History

Received: 22 March 2022

Accepted: 28 April 2022

Article published online:
22 July 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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