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Pull-out forces of headless compression screws in variations of synthetic bone models imitating different types of scaphoid fractures in good bone quality

  • Clinical Applications of Biomaterials
  • Original Research
  • Published:
Journal of Materials Science: Materials in Medicine Aims and scope Submit manuscript

Abstract

Screw osteosynthesis using headless compression screws has become the accepted gold standard for the surgical treatment of scaphoid fractures. Optimal screw specifications remain controversially discussed. We aimed to investigate the influence of bone model composition on screw stability tests using headless compression screws in different scaphoid fracture models. We conducted pull-out tests using Acutrak2®mini, HCS®, HKS®, HBS®, Herbert/Whipple® and Twinfix® screws. To imitate cortical and cancellous bone, two-layer polyurethane (PU) models with two distinct densities were produced. The cylinders were cut at different positions to replicate fracture localisations at increasing distances. The maximum pull-out force required to achieve up to 1 mm of pull-out distance (Nto 1 mm) was measured. Acutrak2®mini and HCS® followed by Twinfix® showed the greatest average pull-out forces. Nto 1 mm was, on average, greater in the cortico-cancellous model than in the cancellous cylinder with the Acutrak2®mini and the Herbert/Whipple® screws, while it was the least with the HBS® and the Twinfix® screws; there were also differences between the HCS® and HKS®. There were no differences between the different fracture simulations in the synthesis strength using either the HKS® or HBS®. The pull-out forces of the HCS® and Twinfix® remained high also in simulations with the smaller screw base fragments. Varying imitations of cancellous and cortico-cancellous bone and fracture localisation reveal important information about the ex vivo strength of screw syntheses. The grip of the cortical structure should be used with the screws that fit more firmly in cortico-cancellous bone.

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Data availability

All relevant data were included to provided tables. The raw datasets generated and/or analysed during the current study are not publicly available due to authors’ decision but are available from the corresponding author on reasonable request.

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Funding

This study was financed by the Austrian state funding programme Funds to Promote Scientific Research [FWF]) as part of a programme to promote translational studies.

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Authors and Affiliations

  1. Department of Trauma Surgery, General Hospital of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Jochen Erhart, Inga Trulson, Stefan Hajdu, Philip Schefzig & Anna Gormasz

  2. Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria

    Ewald Unger & Winfried Mayr

  3. Section of Medical Statistics at the Core Unit of Medical Statistics and Informatics, University of Vienna, Spitalgasse 23, A-1090, Wien, Austria

    Michael Hagmann & Robin Ristl

  4. BG Clinic Tuebingen, Schnarrenbergstr. 95, D-72076, Tuebingen, Germany

    Alexander Trulson

Authors
  1. Jochen Erhart
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  2. Ewald Unger
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  3. Inga Trulson
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  4. Michael Hagmann
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  5. Robin Ristl
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  6. Alexander Trulson
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  7. Stefan Hajdu
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  8. Philip Schefzig
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  9. Anna Gormasz
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  10. Winfried Mayr
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Contributions

JE, EU and WM conceptualised and planned the study. JE, EU, IT, AT, PS and AG conducted the experiments. JE, EU, SH and PS analyzed and interpreted the results. MH performed statistical analysis. JE, EU and PS wrote the paper. All authors proof read and approved the paper prior submission.

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Correspondence to Jochen Erhart.

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Erhart, J., Unger, E., Trulson, I. et al. Pull-out forces of headless compression screws in variations of synthetic bone models imitating different types of scaphoid fractures in good bone quality. J Mater Sci: Mater Med 31, 92 (2020). https://doi.org/10.1007/s10856-020-06445-y

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  • DOI: https://doi.org/10.1007/s10856-020-06445-y

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