The biomechanical study to evaluate tightening condition for AO lag screw depending on pull-out strength and interfragmentary compressive force_Journal of Biomedical Engineering

Authors：

SUN Peidong , JIAO Peifeng , BI Zhenyu ,  OUYANG Jun

Guangdong Provincial Medical Biomechanical Key Laboratory, Department of Anatomy, Basic Medical College, Southern Medical University, Guangzhou 510515, P.R.China;

Corresponding author：

OUYANG Jun, Email: jouyang@126.com

Keywords：

pull-out strength; interfragmentary compressive force; AO cancellous lag screw; tightening condition; synthetic cancellous bone

DOI：

10.7507/1001-5515.201609073

Video：

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Abstract Full text Figures/Tables Video References Cited by

The aim of this experimental study focused on the relationship between pull-out strength (POS) and interfragmentary compressive force (IFCF) of AO cancellous lag screw during tightening procedure. The 6.5 mm AO cancellous lag screw and synthetic cancellous bone were used for this research. The test contains rotation tests and the subsequent pull-out tests, to record the IFCF and POS under different tightening angle groups. The results of this study demonstrated the specific relationship between IFCF and POS and showed that they didn’t reach the peak at the very same time. This study revealed the change of mechanical environment surrounding AO lag screw during tightening procedure and found the effective method to determine the optimum terminating time of AO lag screw inserting.

Citation： SUN Peidong, JIAO Peifeng, BI Zhenyu, OUYANG Jun. The biomechanical study to evaluate tightening condition for AO lag screw depending on pull-out strength and interfragmentary compressive force. Journal of Biomedical Engineering, 2017, 34(6): 863-868. doi: 10.7507/1001-5515.201609073 Copy

1.	Asnis S E, Ernberg J J, Bostrom M P, et al. Cancellous bone screw thread design and holding power. J Orthop Trauma, 1996, 10(7): 462-469.
2.	Kim M B, Lee Y H, Kim J H, et al. Biomechanical comparison of three 2.7-mm screws and two 3.5-mm screws for fixation of simple oblique fractures in human distal fibulae. Clin Biomech (Bristol, Avon), 2013, 28(2): 225-231.
3.	Ricci W M, Tornetta P, Borrelli J Jr. Lag screw fixation of medial malleolar fractures: a biomechanical, radiographic, and clinical comparison of unicortical partially threaded lag screws and bicortical fully threaded lag screws. J Orthop Trauma, 2012, 26(10): 602-606.
4.	Aziz M S, Nicayenzi B, Crookshank M C, et al. Biomechanical measurements of cortical screw purchase in five types of human and artificial humeri. J Mech Behav Biomed Mater, 2014, 30: 159-167.
5.	Helfet D L, Haas N P, Schatzker J, et al. AO philosophy and principles of fracture management-its evolution and evaluation. J Bone Joint Surg Am, 2003, 85-A(6): 1156-1160.
6.	Xu Daqiang, Sun Peidong, Wang Jian, et al. Combined partially threaded cancellous lag screws offer advantages in terms of the optimal stopping time for screw tightening during compression. Int J Clin Exp Med, 2016, 9(2): 1200-1208.
7.	Andreassen G S, Høiness P R, Skraamm I, et al. Use of a synthetic bone void filler to augment screws in osteopenic ankle fracture fixation. Arch Orthop Trauma Surg, 2004, 124(3): 161-165.
8.	Dinah A F, Mears S C, Knight T A, et al. Inadvertent screw stripping during ankle fracture fixation in elderly bone. Geriatr Orthop Surg Rehabil, 2011, 2(3): 86-89.
9.	Tankard S E, Mears S C, Marsland D, et al. Does maximum torque mean optimal pullout strength of screws?. J Orthop Trauma, 2013, 27(4): 232-235.
10.	Cleek T M, Reynolds K J, Hearn T C. Effect of screw torque level on cortical bone pullout strength. J Orthop Trauma, 2007, 21(2): 117-123.
11.	Ricci W M, Tornetta P 3rd, Petteys T, et al. A comparison of screw insertion torque and pullout strength. J Orthop Trauma, 2010, 24(6): 374-378.
12.	Zdero R, Schemitsch E H. The effect of screw pullout rate on screw purchase in synthetic cancellous bone. J Biomech Eng, 2009, 131(2): 024501.
13.	Johnson N L, Galuppo L D, Stover S M, et al. An in vitro biomechanical comparison of the insertion variables and pullout mechanical properties of AO 6.5-mm standard cancellous and 7.3-mm self-tapping, cannulated bone screws in foal femoral bone. Vet Surg, 2005, 33(6): 681-690.
14.	Gausepohl T, Möhring R, Pennig D, et al. Fine thread versus coarse thread. A comparison of the maximum holding power. Injury, 2001, 32(Suppl 4): SD1-SD7.
15.	Brown G A, Mccarthy T, Bourgeault C A, et al. Mechanical performance of standard and cannulated 4.0-mm cancellous bone screws. J Orthop Res, 2000, 18(2): 307-312.
16.	Xu D Q, Sun P D, Wang J, et al. A combined partially threaded cancellous lag screw for achieving maximum compressive force without compromising pullout strength. Eur Rev Med Pharmacol Sci, 2016, 20(2): 208-213.
17.	徐达强, 孙培栋, 王健, 等. AO 松质骨拉力螺钉和组合松质骨拉力螺钉加压固定的生物力学. 中国医学物理学杂志, 2016, 33(1): 103-105.
18.	Reynolds K, Cleek T, Mohtar A, et al. Predicting cancellous bone failure during screw insertion. J Biomech, 2013, 46(6): 1207-1210.
19.	刘斌, 吴长福, 赵卫东, 等. 变牙厚椎弓根螺钉的生物力学测试. 中国临床解剖学杂志, 2011, 29(6): 698-701.
20.	Parker L, Garlick N, Mccarthy I, et al. Screw fixation of medial malleolar fractures: a cadaveric biomechanical study challenging the current AO philosophy. Bone Joint J, 2013, 95-B(12): 1662-1666.
21.	Hausmann J T, Mayr W, Unger E, et al. Interfragmentary compression forces of scaphoid screws in a sawbone cylinder model. Injury, 2007, 38(7): 763-768.
22.	Johnson K A, Smith F W. Axial compression generated by cortical and cancellous lag screws in the equine distal phalanx. Vet J, 2003, 166(2): 159-163.
23.	Xu D Q, Sun P D, Wang J, et al. The new shank construct of lag screw improves the maximum compression force for internal fixations: preliminary results. Eur Rev Med Pharmacol Sci, 2015, 19(12): 2195-2201.
24.	Wähnert D, Hofmann-Fliri L, Schwieger K, et al. Cement augmentation of lag screws: an investigation on biomechanical advantages. Arch Orthop Trauma Surg, 2013, 133(3): 373-379.

1. Asnis S E, Ernberg J J, Bostrom M P, et al. Cancellous bone screw thread design and holding power. J Orthop Trauma, 1996, 10(7): 462-469.
2. Kim M B, Lee Y H, Kim J H, et al. Biomechanical comparison of three 2.7-mm screws and two 3.5-mm screws for fixation of simple oblique fractures in human distal fibulae. Clin Biomech (Bristol, Avon), 2013, 28(2): 225-231.
3. Ricci W M, Tornetta P, Borrelli J Jr. Lag screw fixation of medial malleolar fractures: a biomechanical, radiographic, and clinical comparison of unicortical partially threaded lag screws and bicortical fully threaded lag screws. J Orthop Trauma, 2012, 26(10): 602-606.
4. Aziz M S, Nicayenzi B, Crookshank M C, et al. Biomechanical measurements of cortical screw purchase in five types of human and artificial humeri. J Mech Behav Biomed Mater, 2014, 30: 159-167.
5. Helfet D L, Haas N P, Schatzker J, et al. AO philosophy and principles of fracture management-its evolution and evaluation. J Bone Joint Surg Am, 2003, 85-A(6): 1156-1160.
6. Xu Daqiang, Sun Peidong, Wang Jian, et al. Combined partially threaded cancellous lag screws offer advantages in terms of the optimal stopping time for screw tightening during compression. Int J Clin Exp Med, 2016, 9(2): 1200-1208.
7. Andreassen G S, Høiness P R, Skraamm I, et al. Use of a synthetic bone void filler to augment screws in osteopenic ankle fracture fixation. Arch Orthop Trauma Surg, 2004, 124(3): 161-165.
8. Dinah A F, Mears S C, Knight T A, et al. Inadvertent screw stripping during ankle fracture fixation in elderly bone. Geriatr Orthop Surg Rehabil, 2011, 2(3): 86-89.
9. Tankard S E, Mears S C, Marsland D, et al. Does maximum torque mean optimal pullout strength of screws?. J Orthop Trauma, 2013, 27(4): 232-235.
10. Cleek T M, Reynolds K J, Hearn T C. Effect of screw torque level on cortical bone pullout strength. J Orthop Trauma, 2007, 21(2): 117-123.
11. Ricci W M, Tornetta P 3rd, Petteys T, et al. A comparison of screw insertion torque and pullout strength. J Orthop Trauma, 2010, 24(6): 374-378.
12. Zdero R, Schemitsch E H. The effect of screw pullout rate on screw purchase in synthetic cancellous bone. J Biomech Eng, 2009, 131(2): 024501.
13. Johnson N L, Galuppo L D, Stover S M, et al. An in vitro biomechanical comparison of the insertion variables and pullout mechanical properties of AO 6.5-mm standard cancellous and 7.3-mm self-tapping, cannulated bone screws in foal femoral bone. Vet Surg, 2005, 33(6): 681-690.
14. Gausepohl T, Möhring R, Pennig D, et al. Fine thread versus coarse thread. A comparison of the maximum holding power. Injury, 2001, 32(Suppl 4): SD1-SD7.
15. Brown G A, Mccarthy T, Bourgeault C A, et al. Mechanical performance of standard and cannulated 4.0-mm cancellous bone screws. J Orthop Res, 2000, 18(2): 307-312.
16. Xu D Q, Sun P D, Wang J, et al. A combined partially threaded cancellous lag screw for achieving maximum compressive force without compromising pullout strength. Eur Rev Med Pharmacol Sci, 2016, 20(2): 208-213.
17. 徐达强, 孙培栋, 王健, 等. AO 松质骨拉力螺钉和组合松质骨拉力螺钉加压固定的生物力学. 中国医学物理学杂志, 2016, 33(1): 103-105.
18. Reynolds K, Cleek T, Mohtar A, et al. Predicting cancellous bone failure during screw insertion. J Biomech, 2013, 46(6): 1207-1210.
19. 刘斌, 吴长福, 赵卫东, 等. 变牙厚椎弓根螺钉的生物力学测试. 中国临床解剖学杂志, 2011, 29(6): 698-701.
20. Parker L, Garlick N, Mccarthy I, et al. Screw fixation of medial malleolar fractures: a cadaveric biomechanical study challenging the current AO philosophy. Bone Joint J, 2013, 95-B(12): 1662-1666.
21. Hausmann J T, Mayr W, Unger E, et al. Interfragmentary compression forces of scaphoid screws in a sawbone cylinder model. Injury, 2007, 38(7): 763-768.
22. Johnson K A, Smith F W. Axial compression generated by cortical and cancellous lag screws in the equine distal phalanx. Vet J, 2003, 166(2): 159-163.
23. Xu D Q, Sun P D, Wang J, et al. The new shank construct of lag screw improves the maximum compression force for internal fixations: preliminary results. Eur Rev Med Pharmacol Sci, 2015, 19(12): 2195-2201.
24. Wähnert D, Hofmann-Fliri L, Schwieger K, et al. Cement augmentation of lag screws: an investigation on biomechanical advantages. Arch Orthop Trauma Surg, 2013, 133(3): 373-379.

Journal of Biomedical Engineering

The biomechanical study to evaluate tightening condition for AO lag screw depending on pull-out strength and interfragmentary compressive force

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