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Resorbable fillers reduce stress risers from empty screw holes.

J Winslow Alford¹, Michael P Bradley, Paul D Fadale

¹Department of Orthopaedic Surgery, Rhode Island Hospital, Brown Medical School, Providence, Rhode Island, USA.

The Journal of Trauma

|December 13, 2007

Summary

Resorbable screws used as bone defect fillers immediately increase bone strength after hardware removal. These resorbable screws maintain bone integrity during healing, reducing refracture risk in active individuals.

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Area of Science:

Orthopedic surgery
Biomaterials science
Bone healing research

Background:

Post-surgical empty screw holes act as stress concentrators, compromising bone integrity.
This weakening increases the risk of refracture, particularly in active patients.
Novel methods are needed to mitigate stress risers and enhance bone stability after hardware removal.

Purpose of the Study:

To evaluate the efficacy of resorbable screws as bone defect fillers.
To determine if resorbable screws provide immediate mechanical support.
To assess if resorbable screws maintain bone strength during their resorption phase.

Main Methods:

A randomized, prospective controlled animal study was conducted using 75 New Zealand white rabbits.
Paired femurs were used, with defects filled by either metal or resorbable screws, or left as empty controls.
Mechanical testing (torsion to failure, peak torque, energy to failure, stiffness) and histologic analysis were performed at baseline, 1 week, and 13 weeks.

Main Results:

Resorbable fillers significantly increased peak torque (30%) and energy to failure (73%) at baseline.
Both metal and resorbable screws increased bone energy to failure at 1 week compared to controls.
Histology confirmed partial resorption and new bone formation without lysis; bone strength at 13 weeks was comparable to healed contralateral femurs.

Conclusions:

Resorbable screw fillers effectively restore bone strength immediately after insertion.
These fillers mitigate the weakening effect of empty screw holes, reducing refracture potential.
Resorbable screws offer a promising solution for bone defect management post-hardware removal.