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Fractures: Bone Repair

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...

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A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique

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Off With the Head: Decreasing Complications With Headless Compression Screws for Tibial Tubercle Fracture Fixation.

Bryan Menapace^1,2, Brett A Shannon², Kevin Neal³

¹Shriners Children's Hospital, Portland, OR.

Journal of Pediatric Orthopedics

|August 7, 2025

Summary

Headless compression screws (HCS) show promise for treating tibial tubercle fractures (TTF). This study found HCS significantly reduced pain and hardware removal reoperations compared to traditional headed screws, with similar healing outcomes.

Keywords:

complication headless compression screw pain removal of hardware tibial tubercle fracture

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Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device

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Published on: November 8, 2024

Area of Science:

Orthopedic surgery
Pediatric orthopedics
Trauma surgery

Background:

Tibial tubercle fractures (TTF) often require surgical repair.
Traditional headed cannulated screws lead to high reoperation rates for hardware removal (50-60%).
Headless compression screws (HCS) represent a newer fixation option.

Purpose of the Study:

To evaluate if lower-profile HCS reduce pain and reoperation for hardware removal in pediatric TTF.
To compare fracture healing and functional outcomes between HCS and headed screws.

Main Methods:

Multicenter, retrospective, case-control study (2014-2024).
Included 148 pediatric TTF patients (121 headed screws, 27 HCS).
Analyzed reoperation for hardware removal (ROH), pain, complications, and healing outcomes.

Main Results:

HCS group showed significantly less pain (11% vs. 38%) and lower ROH rates (7.4% vs. 40%) compared to headed screws with washers.
No significant differences in hardware failure, nonunion, or postoperative management.
Slightly lower, though not statistically significant, rates of wound complications and infections with HCS.

Conclusions:

HCS offer comparable surgical, healing, and management outcomes to headed screws for pediatric TTF.
HCS significantly reduce pain and the need for reoperation for hardware removal.
HCS may lead to fewer wound complications and infections.