Screw loosening in an in vitro mid fibular osteotomy model under dynamic loading conditions

The purpose of this study was to evaluate the effect of cyclic loading on screw fixation in an experimental bone plating model. The test specimens consist of plated porcine fibulae subjected to cyclic compressive, bending and torsional loading. Breakaway torque measurements of orthopedic screws are found to be significantly less than the screws tightening torque. The breakaway torque for a given screw and tapped bone hole is found to be consistent after repeated tightening, and is proposed as a viable approach to quantify bone screw loosening. After cyclic loading at moderate levels no screw loosening was identified, but instead an apparent paradoxical tightening, as observed in breakaway torque measurements of the screws. Cyclic loading of a plated fibular fracture was not found to cause screw loosening unless accompanied by gross failure as found under excessive load levels.