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Fully Threaded Versus Partially Threaded Screws: Determining Shear in Cancellous Bone Fixation.

Michael W Downey1, Victor Kosmopoulos2, Brian B Carpenter3

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The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|July 27, 2015
PubMed
Summary

Fully threaded screws offer superior shear strength and stiffness in bone fixation compared to partially threaded screws. This study suggests a potential shift away from partially threaded screws for cancellous bone fixation.

Keywords:
biomechanicscancellous bone screwholding strengthlag techniquescrew failureshear strength

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Area of Science:

  • Orthopedic biomechanics
  • Biomaterials engineering
  • Surgical fixation techniques

Background:

  • Intraosseous fixation is crucial in orthopedic surgery.
  • Previous studies have compared various fixation methods.
  • The comparative shear strength of fully versus partially threaded screws remains understudied.

Purpose of the Study:

  • To investigate the shear strength and stiffness of fully threaded versus partially threaded cancellous bone screws.
  • To test the hypothesis that fully threaded screws provide greater shear resistance.

Main Methods:

  • Thirty-six synthetic bone blocks were used.
  • Group 1: Fixed with fully threaded 4.0-mm cancellous screws using the lag technique.
  • Group 2: Fixed with partially threaded 4.0-mm cancellous screws using the standard method.
  • Mechanical testing under shear load at 0.5 mm/s until failure.

Main Results:

  • Fully threaded screws demonstrated significantly greater initial stiffness (106.4 N/mm vs. 80.1 N/mm, p=.026).
  • Yield load and displacement were 64% and 67% higher for fully threaded screws, respectively.
  • Fully threaded screws exhibited superior resistance to shear failure.

Conclusions:

  • A fully threaded screw construct is important for preventing shear and reducing fracture strain.
  • The findings question the continued use of partially threaded screws in cancellous bone fixation.
  • This study supports the use of fully threaded screws for enhanced orthopedic fixation stability.