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Related Concept Videos

Frictional Forces on Screws01:17

Frictional Forces on Screws

Screws are characterized by a helical ridge known as a thread wrapped around a cylindrical shaft. They are commonly used as fasteners to hold objects together or to transmit power and motion in machines. One type of screw that is particularly useful for transmitting power is the square-threaded screw.
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Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
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Do locking screws work in plates bent at holes?

Christina L Boulton1, Hyunchul Kim, Swapnil B Shah

  • 1*Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD; †Fischell Department of Bioengineering, Orthopaedics Mechanobiology Laboratory, University of Maryland, College Park, MD; ‡Alameda County Medical Center, Oakland, CA; and §San Francisco Orthopaedic Residency Program, San Francisco, CA.

Journal of Orthopaedic Trauma
|August 17, 2013
PubMed
Summary
This summary is machine-generated.

Bending a 3.5-mm locking compression plate at a screw hole by more than 5 degrees significantly reduces locked screw survival. Pre-bending screw head inserts do not improve survival rates in these biomechanical tests.

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Area of Science:

  • Orthopedic biomechanics
  • Surgical implant technology

Background:

  • Locked compression plates are widely used in orthopedic surgery.
  • The integrity of locked screws is critical for fracture fixation stability.
  • Plate bending during surgical procedures may alter screw performance.

Purpose of the Study:

  • To evaluate the impact of plate bending at a locking hole on the biomechanical properties and survival of locked screws.
  • To determine if bending angles affect locked screw performance.

Main Methods:

  • 3.5-mm locking compression plates were subjected to coronal plane bends of 5, 15, and 45 degrees at a locking hole.
  • A separate 45-degree group included a threaded screw head insert before bending.
  • Ten plates per group underwent cyclic loading, compared to non-bent controls.

Main Results:

  • Significant reductions in protocol survival were observed for 15-degree (P=0.006) and 45-degree (P=0.0007) bends compared to controls.
  • Mean cycles survived significantly decreased with 15-degree (P=0.027) and 45-degree (P=0.0002) bends.
  • The 5-degree bend group showed a non-significant decrease in survival (P=0.17).
  • A threaded screw head insert did not alter survival in the 45-degree group.

Conclusions:

  • Bending a 3.5-mm locking compression plate >5 degrees at a locking hole significantly compromises locked screw survival.
  • The observed decrease in screw survival is statistically significant and potentially impacts clinical outcomes.
  • Using a threaded screw head insert prior to bending does not mitigate the negative biomechanical effects.