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Adjustable Stiffness, External Fixator for the Rat Femur Osteotomy and Segmental Bone Defect Models
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Pullout Strength After Multiple Reinsertions in Radial Bone Fixation.

Alfonso Mejia1, Giovanni Solitro1, Elena Gonzalez1

  • 1University of Illinois at Chicago, USA.

Hand (New York, N.Y.)
|September 7, 2018
PubMed
Summary
This summary is machine-generated.

Reinserting self-tapping screws (STS) into bone shows a significant drop in fixation after the second insertion. Beyond two uses, pullout strength remains consistent up to five insertions in radial bone.

Keywords:
biomechanicsinsertional torquemultiple insertionspullout strengthreinsertionself-tapping screws

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Area of Science:

  • Orthopedic surgery
  • Biomechanical engineering
  • Bone healing research

Background:

  • Self-tapping screws (STS) can cause bone damage with repeated insertions, raising concerns for procedures requiring multiple screw placements.
  • Previous studies on the impact of multiple STS reinsertions on bone fixation have yielded conflicting results.
  • Understanding the biomechanical consequences of repeated screw use is crucial for surgical planning and implant longevity.

Purpose of the Study:

  • To evaluate the effect of multiple reinsertions of self-tapping screws (STS) on insertional torque and pullout strength in radial bone.
  • To determine if bone density and insertion location influence the mechanical stability of repeatedly inserted STS.
  • To provide data guiding the clinical practice of screw reinsertion in orthopedic surgery.

Main Methods:

  • Experimental measurement of insertional torque and pullout strength for STS in radial sawbone shafts.
  • Testing up to five total insertions per screw site, across varying bone densities and radial shaft locations.
  • Statistical analysis, including Pearson correlation, to assess relationships between torque, pullout strength, and insertion parameters.

Main Results:

  • Insertional torque and pullout strength were highest in the middle segments of the radial shaft.
  • A significant decrease in fixation was observed between the first and second screw insertions.
  • No significant difference in pullout strength was found for 3 to 5 insertions across different bone densities and locations.
  • A moderate to high correlation (Pearson r = 0.663) was noted between insertional torque and pullout strength.

Conclusions:

  • While the first reinsertion of STS significantly impacts pullout strength, subsequent reinsertions (3-5) do not show a significant decline in stability in radial bone.
  • The middle segments of the radial shaft offer greater initial fixation.
  • Surgeons may consider further reinsertions beyond two with caution, as stability does not significantly decrease but initial fixation is compromised.