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Variable Fixation Technology Provides Rigid as Well as Progressive Dynamic Fixation: A Biomechanical Investigation.

A Frank1,2, S Brianza3, M Plecko4

  • 1Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Muenster, Germany.

The Journal of Bone and Joint Surgery. American Volume
|October 21, 2020
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The Variable Fixation Locking Screw (VFLS) initially offers rigid fixation comparable to standard screws. Its resorbable sleeve enables progressive dynamic stabilization, potentially enhancing secondary fracture healing.

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Area of Science:

  • Orthopedic biomechanics
  • Biomaterials science
  • Surgical innovation

Background:

  • A novel Variable Fixation Locking Screw (VFLS) was developed to promote secondary fracture healing.
  • The VFLS incorporates a resorbable sleeve that gradually degrades, altering mechanical properties over time.
  • This study evaluates the VFLS's capacity for both rigid and progressive dynamic fixation.

Purpose of the Study:

  • To assess the interfragmentary stability of the VFLS under various loading conditions.
  • To compare the VFLS fixation with standard locking screws and combined technologies.
  • To investigate the effect of sleeve resorption on fracture gap dynamization.

Main Methods:

  • A simulated fracture-gap model was used to test VFLS stability.
  • Compression and torsional loading were applied to test constructs.
  • An optical measurement system quantified interfragmentary movements before and after sleeve dissolution.

Main Results:

  • Initial axial stiffness was similar across all tested screw configurations.
  • Sleeve resorption significantly reduced construct stiffness and increased axial displacement.
  • VFLS alone demonstrated a substantial increase in dynamic axial displacement post-resorption.

Conclusions:

  • The VFLS provides initial rigid fixation comparable to standard locking screws.
  • Sleeve degradation results in reproducible, progressive dynamization of the fracture gap.
  • This variable fixation may positively influence secondary fracture healing processes.