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1.
Objective—To determine and compare the in vitro pullout strength of 5.5-mm cortical versus 6.5-mm cancellous bone screws inserted in the diaphysis and metaphysis of adult equine third metacarpal (MCIII) bones, in threaded 4.5-mm cortical bone screw insertion holes that were then overdrilled with a 4.5-mm drill bit to provide information relevant to the selection of a replacement screw if a 4.5-mm cortical screw is stripped. Study Design—In vitro pullout tests of 5.5-mm cortical and 6.5-mm cancellous screws in equine MCIII bones. Sample Population—Two independent cadaver studies each consisting of 14 adult equine MCIII bones. Methods—Two 4.5-mm cortical screws were placed either in the middiaphysis (study 1) or distal metaphysis (study 2) of MCIII bones. The holes were then overdrilled with a 4.5-mm drill bit and had either a 5.5-mm cortical or a 6.5-mm cancellous screw inserted; screw pullout tests were performed at a rate of 0.04 mm/second until screw or bone failure occurred. Results—In diaphyseal bone, the screws failed in all tests. Tensile breaking strength for 5.5-mm cortical screws (997.5 ± 49.3 kg) and 6.5-mm cancellous screws (931.6 ± 19.5 kg) was not significantly different. In metaphyseal bone, the bone failed in all tests. The holding power for 6.5-mm cancellous screws (39.1 ± 4.9 kg/mm) was significantly greater than 5.5-mm cortical screws (23.5 ± 3.5 kg/mm) in the metaphysis. There was no difference in the tensile breaking strength of screws in the diaphysis between proximal and distal screw holes; however, the holding power was significantly greater in the distal, compared with the proximal, metaphyseal holes. Conclusions—Although tensile breaking strength was not different between 5.5-mm cortical and 6.5-mm cancellous screws in middiaphyseal cortical bone, holding power of 6.5-mm cancellous screws was greater than 5.5-mm cortical screws in metaphyseal bone of adult horses. Clinical Relevance—If a 4.5-mm cortical bone screw strips in MCIII diaphyseal bone of adult horses, either a 5.5-mm cortical or 6.5-mm cancellous screw, however, would have equivalent pullout strengths. A 6.5-mm cancellous screw, however, would provide greater holding power than a 5.5-mm cortical screw in metaphyseal bone.  相似文献   

2.
The holding power of orthopedic screws in the third metacarpal and metatarsal cadaver bones of foals that were aged from 1 to 14 days was tested. Comparative trials between screws inserted at the same site in contralateral bones from the same foal were performed to compare the holding power of 5.5 mm cortical and 6.5 mm cancellous screws in the metaphysis, and the holding power of 5.5 and 4.5 mm cortical screws in the diaphysis. A MTS servohydraulic tensile testing machine was used to perform screw pullouts at a displacement rate of 19 mm/sec. There was no significant difference between maximum holding power of 5.5 mm cortical screws and 6.5 mm cancellous screws in the metaphysis when expressed as kg per mm of bone width at the screw insertion site (p = 0.097) or as kg per mm of screw thread engaged in the bone (p = 0.17). There was no significant difference in holding power of 5.5 and 6.5 mm screws in the proximal versus distal metaphysis (p = 0.10). The 5.5 mm screws had significantly greater holding power than the 4.5 mm screws in the diaphysis (p = 0.0097). Fixation failure at screw pullout was always due to bone shear. In internal fixation in foal bone, the 5.5 mm screws may be a suitable alternative to 6.5 mm screws in the metaphysis. Use of 5.5 mm rather than 4.5 mm screws is recommended in the diaphysis because of greater holding power.  相似文献   

3.
OBJECTIVES: To compare bone fragment compression and the mechanical pushout strength and stiffness of 6.5-mm Acutrak Plus (AP) and 4.5-mm AO cortical (AO) bone screws after stabilization of a simulated equine third metacarpal (MC3) bone complete lateral condylar fracture. STUDY DESIGN: In vitro biomechanical paired study of screw insertion variables, bone fragment compression, and screw pushout tests using a bone screw stabilized simulated lateral condylar fracture model. SAMPLE POPULATION: Six pairs of cadaveric equine MC3s. METHODS: Metacarpi were placed in a fixture and centered on a biaxial load cell in a materials testing system to measure torque, compressive force, and time for drilling, tapping, and screw insertion. Fragment compression was measured with a pressure-sensing device placed between the simulated fracture fragments during screw insertion for fragment stabilization. Subsequently, screws were pushed out of the stabilized bone fragments in a single cycle to failure. A paired t test was used to assess differences between site preparation, screw insertion, fragment compression, and screw pushout variables, with significance set at P <.05. RESULTS: Measured drilling variables were comparable for AO and AP specimens. However, the AP tap had significantly greater insertion torque and force. Mean maximum screw insertion torque was significantly greater for AO screws. For fragment compression, AP screws generated 65% and 44% of the compressive pressure and force, respectively, of AO screws. AP screws tended to have higher overall pushout strength. Pushout stiffness was similar between both screw types. CONCLUSION: The 6.5-mm tapered AP screw generated less interfragmentary compressive pressure and force but had similar pushout stiffness. Evaluation of failure patterns demonstrated that AP screws had greater pushout strength compared with 4.5-mm AO screws for fixation of a simulated complete lateral condylar fracture. CLINICAL RELEVANCE: The 6.5-mm tapered AP screw should provide ample holding strength but would provide less interfragmentary compression than 4.5-mm AO screws for repair of complete lateral condylar fractures in horses.  相似文献   

4.
OBJECTIVE: To compare drilling, tapping, and screw-insertion torque, force, and time for the 4.5-mm AO and 6.5-mm Acutrak Plus (AP) bone screws, and to compare the mechanical shear strength and stiffness of a simulated complete lateral condylar fracture of the equine third metacarpal bone (MC3) stabilized with either an AO or AP screw. STUDY DESIGN: In vitro biomechanical assessment of screw-insertion variables, and shear failure tests of a bone-screw-stabilized simulated lateral condylar fracture. SAMPLE POPULATION: Eight pairs of cadaveric equine MC3s METHODS: Metacarpi were placed in a fixture and centered on a biaxial load cell in a materials-testing system to measure torque, compressive force, and time for drilling, tapping, and screw insertion. Standardized simulated lateral condylar fractures were stabilized by either an AO or AP screw and tested in shear until failure. A paired t test was used to assess differences between screws, with significance set at P < .05. RESULTS: Insertion and mechanical shear testing variables were comparable for AO and AP insertion equipment and screws. CONCLUSION: The 6.5-mm tapered AP screw can be inserted in equine third metacarpal condyles and is mechanically comparable with the 4.5-mm AO screw for fixation of a simulated lateral condylar fracture. CLINICAL RELEVANCE: Considering the comparable mechanical behavior, the potential for less-persistent soft-tissue irritation with the headless design, and the ability to achieve interfragmentary compression by inserting the screw in one hole drilled perpendicular to the fracture plane, the 6.5-mm tapered AP screw may be an attractive alternative for repair of incomplete lateral condylar fractures in horses.  相似文献   

5.
Comparison was made of the holding power of orthopedic screws inserted self-tapped or after pre-tapping in foal bone. Third metacarpal and metatarsal bones were used. Comparative trials were made between screws inserted at the same site in the corresponding bones from the contralateral limbs of the same foal. A MTS servohydraulic tensile testing machine was used to perform screw pullouts at a displacement rate of 19 mm/sec. The 5.5 mm cortical screws had significantly greater holding power than 6.5 mm cancellous screws when both were inserted self-tapped (p = 0.0056). Pre-tapped insertion of 5.5 mm screws produced a significantly greater holding power than self-tapped insertion of 5.5 mm screws (p = 0.018). Pre-tapped insertion of 6.5 mm screws produced a significantly greater holding power than self-tapped insertion of 6.5 mm screws (p = 0.0000). In internal fixation of fractures in foals, insertion of 5.5 mm and 6.5 mm screws pre-tapped in metaphyseal bone is recommended because it produces greater holding power than self-tapped insertion.  相似文献   

6.
Comparison was made of the holding power of 5.5 and 4.5 mm cortical orthopedic screws inserted into third metacarpal and metatarsal cadaver bones from 3- and 8-year-old horses. The tensile strength of these screws was tested mechanically. In nine comparative trials of these screws, 5.5 mm screws pulled out of bone in five trials at an average of 116.0 kg tensile force and broke in four trials at an average of 1383.2 kg. A 4.5 mm screw pulled out of bone at 834.5 kg in one trial, and screws broke at an average of 849.2 kg in eight trials. The larger 5.5 mm screw required a significantly greater (p = 0.022) pullout force than the mean force at 4.5 mm screw breakage. Fixation failure was due to screw breakage or bone shear, with 5.5 mm screws occasionally creating bone fragmentation during pullout. The average tensile breaking strengths of the 5.5 mm screws (1391.4 kg) and 4.5 mm screws (832.7 kg) determined mechanically were similar to forces at screw breakage during pullout testing in bone. Since the 5.5 mm screws have greater holding power and tensile strength than 4.5 mm screws, the use of the 5.5 mm screw in fracture repair in adult horses is recommended.  相似文献   

7.
OBJECTIVE: To compare screw insertion variables and pullout mechanical properties between AO 6.5-mm cancellous and 7.3-mm cannulated bone screws in foal femoral bone. STUDY DESIGN: A paired, in vitro mechanical study. SAMPLE POPULATION: Seven pairs of femora from immature (1-7 months) foals. METHODS: The 6.5 cancellous and 7.3-mm cannulated screws were inserted at standardized proximal and distal metaphyseal, and mid-diaphyseal locations. Insertion torque, force, and time to drill, tap (6.5-mm cancellous), guide wire insertion (7.3-mm cannulated), and screw insertion were measured. Screw pullout properties (yield and failure load, displacement, and energy, and stiffness) were determined from mechanical tests. The effects of screw type and location on insertion variables and pullout properties were assessed with repeated measures ANOVA. Pairwise comparisons were examined with post hoc contrasts. Significance was set at P<.05 for all comparisons. RESULTS: Insertion torques for the 7.3-mm cannulated screws were significantly greater than for the 6.5-mm tap, but significantly lower than for the 6.5-mm cancellous screws. Total screw insertion times were similar. Pullout properties of both screws were similar at each femoral location. The holding power of both screws was significantly greater in the mid-diaphysis than in either metaphyseal location. Pullout failure occurred by bone shearing at the bone-screw interface in all specimens. CONCLUSIONS: The 6.5-mm cancellous and 7.3-mm cannulated screws vary in insertion properties, but have similar pullout properties in the mid-diaphysis, proximal, and distal metaphysis of foal femora. Both screw types have greater holding power at the mid-diaphyseal location compared with metaphyseal locations. Based on overall similar holding powers of 6.5-mm cancellous and 7.3-mm cannulated screws, it is unlikely that increasing the screw diameter beyond 6.5 mm will provide increased holding power in foal femoral bone. CLINICAL RELEVANCE: Use of the 7.3-mm cannulated screw should be considered for foal femoral fracture repair when greater accuracy is needed, or when bone threads for the 6.5-mm cancellous screw have been stripped.  相似文献   

8.
OBJECTIVE: To compare screw insertion characteristics and pullout mechanical properties between self-tapping (ST) and non-self-tapping (NST) AO 4.5-mm cortical bone screws in adult equine third metacarpal bone (MC3). STUDY DESIGN: In vitro biomechanical experiment. ANIMALS OR SAMPLE POPULATION: Seven pairs of adult equine MC3. METHODS: Bicortical holes were drilled transversely in proximal metaphyseal, diaphyseal, and distal metaphyseal locations of paired MC3. NST screws were inserted in pre-tapped holes in 3 sites of one bone pair, and ST screws were inserted in non-tapped holes of contralateral MC3. Tapping and screw insertion times and maximum torques were measured. Screw pullout mechanical properties were determined. RESULTS: Screw insertion time was longer for ST screws. Total time for tapping and insertion (total insertion time) was over twice as long for NST screws. Statistically significant differences were not observed between screws for any pullout mechanical property. From pullout tests, diaphyseal locations had significantly stiffer and stronger structure than metaphyseal locations. Pullout failure more commonly occurred because of screw breakage than bone failure. Bone failure and bone comminution were more commonly associated with ST screws. Bone failure sites had pullout failure loads that were 90% of screw failure sites. CONCLUSIONS: NST and ST 4.5-mm-diameter cortical bone screws have similar pullout mechanical properties from adult equine MC3. ST screws require less than half the total insertion time of NST screws. CLINICAL RELEVANCE: Use of ST 4.5-mm-diameter cortical bone screws should be considered for repair of adult equine MC3 fractures; however, bone failures at screw sites should be monitored.  相似文献   

9.
A simulated lateral humeral condylar fracture was created in each of the 52 humeri collected from 26 dogs. One humerus from each pair was stabilized with a 2.0 mm cortical bone screw which was inserted in lag fashion. The other humerus from each pair was stabilized with a 2.2 mm threaded diameter Orthofix pin inserted across the condyle. Prior to each repair, an antirotational K-wire was placed and then the Pressurex Sensitive film was inserted in the osteotomy site in order to determine the compressive pressure (MPa), compressive force (KN), and area of compression (cm(2)) achieved during fixation. The maximum insertional torque achieved before stripping was measured for each implant. The mean compression generated by insertion of a 2.0 mm lag screw was 20.36 +/- 1.51 MPa compared to 18.88 +/- 1.76 MPa generated by a 2.2 mm Orthofix pin (p < 0.003). The mean area of compression generated by insertion of a 2.0 mm lag screw was 2.39 +/- 1.29 cm(2), compared to 1.16 +/- 0.84 cm(2) generated by insertion of a 2.2 mm Orthofix pin (p < 0.0001). The mean compressive force (compression x area compressed) generated by insertion of a 2.0 mm lag screw was 4.96 +/- 2.90 Kn, compared to 2.20 +/- 1.65 Kn generated by insertion of a 2.2 mm Orthofix pin (p < 0.0001). The mean insertion torque to failure for the lag screws was 0.49 +/- 0.07 NM, compared to 0.91 NM +/- 0.18 NM generated by the Orthofix pins (P < 0.0001). Both repair methods are likely to be acceptable for the repair of similar fractures in small breed dogs.  相似文献   

10.
OBJECTIVE: To compare the mechanical shear strengths and stiffnesses obtained from in vitro testing of a simulated complete third carpal bone (C3) frontal plane radial facet slab fracture (osteotomy) stabilized with either a 4/5 Acutrak (AT) compression screw or a 4.5-mm AO cortical bone (AO) screw inserted in lag fashion. Drilling, tapping, and screw insertion torques, forces, and times also were compared between AT and AO implants. STUDY DESIGN: In vitro biomechanical assessment of site preparation, screw insertion, and shear failure test variables of bone screw stabilized simulated C3 slab fracture in paired cadaveric equine carpi. SAMPLE POPULATION: Eight pairs of cadaveric equine C3 without orthopedic abnormalities. METHODS: Standardized simulated C3 slab fractures were repaired with either AO or AT screws (AO/C3 and AT/C3 groups, respectively). Drilling, tapping, and screw insertion torques, forces, and times were measured with a materials testing machine for each screw type. Repaired specimens were tested in axially oriented shear until failure. Paired Students t-tests were used to assess differences between site preparation, screw insertion, and shear testing variables. Significance was set at P <.05. RESULTS: There were no significant differences in bone fragment measurements of the standardized simulated C3 slab fractures created for AO or AT screws. There were no significant differences for mean and maximum drilling torques; however, the tapered AT drill had greater maximum drilling force compared with the 3.2-mm and 4.5-mm AO drill bits. Mean insertion torque and force measured from the self-tapping AT screw were not significantly different compared with the 4.5-mm AO tap. There were no significant differences in maximum screw torque among constructs. Total procedure time was significantly longer for the AT group (5.8 +/- 1.6 minutes) compared with the AO group (2.9 +/- 1.1 minutes; P =.001). AT stabilized specimens had significantly greater mean +/- SD initial shear stiffness (3.64 +/- 1.08 kN/mm) than AO specimens (1.64 +/- 0.73 kN/mm; P =.005). All other shear mechanical testing variables were not statistically different among screw types. CONCLUSION: The 4/5 Acutrak insertion technique was accurate and safe, and the AT screw effectively stabilized simulated equine C3 frontal plane slab fractures. When tested in shear, this screw type was mechanically comparable to the 4.5-mm AO screw; however, AT constructs had greater initial shear stiffness. Initial shear stiffness was likely an indirect measure of interfragmentary compression, and thus may indicate that the AT screw provides a more rigid fixation for frontal plane C3 slab fractures in horses. CLINICAL RELEVANCE: Considering the comparable mechanical behavior, greater initial shear stiffness for AT screw stabilized C3 slab fracture fragments, the ability to accurately insert the screw with the aid of a guide pin, and the potential for less persistent soft tissue irritation with the headless screw design, the 4/5 tapered AT screw is an attractive alternative for repair of C3 slab fractures in horses.  相似文献   

11.
The objective of this study was to compare the biomechanical properties in a single cycle axial loading test and the types of failures in two constructs (a 3-hole 4.5-mm dynamic compression plate (DCP) and 7-hole 5.5-mm Y locking compression plate (Y-LCP)) in equine proximal interphalangeal joint (PIJ) arthrodesis. One limb in each pair was randomly assigned to PIJ arthrodesis using a 3-hole 4.5-mm DCP combined with two transarticular 5.5-mm cortical screws, whereas the contralateral limb was submitted to PIJ arthrodesis using a 7-hole Y-shaped 5.0-mm LCP in conjunction with one transarticular 4.5-mm cortical screw inserted through the central plate hole. Cortical screws were inserted in lag fashion. Constructs were submitted to a single axial load cycle to failure. Construct stiffness, load, and deformation were analyzed. Dynamic compression plate and Y-LCP arthrodesis constructs did not differ significantly and were equally resistant to axial loading under the conditions studied (DCP and Y-LCP group stiffness, 5685.22 N/mm and 6591.10 N/mm, respectively). Arthrodesis of the PIJ using a DCP and two transarticular 5.5-mm cortical screws or a Y-LCP yielded biomechanically equivalent outcomes under the test conditions considered. However, Y-LCP provides less impact in the palmar/plantar bone. Application of Y-LCP with unicortical screws has equivalent biomechanical characteristics of DCP and may be a safe option for PIJ arthrodesis, where potential trauma secondary to applying bicortical screws in the palmar/plantar aspect of the pastern can be avoided.  相似文献   

12.
OBJECTIVE: To compare acute fixation stability and insertion effort of cortex bone screws with and without a shaft inserted in lag fashion in equine metacarpal (metatarsal, MC(T)III) bone. METHODS: Screw types with independent variables of screw diameter (4.5 or 5.5 mm) and shaft type (without shaft, with 20-mm shaft, or with 25-mm shaft) were studied. Bone specimens cut from distal equine MC(T)III condyles were used. After screw insertion in lag fashion into 2 bone blocks with an instrumented device, shear tests were conducted in a mechanical testing machine. Outcome variables of peak insertion torque, insertion energy, stiffness. yield strength, and displacement at 3 kN of load were compared. RESULTS: The effects of screw design were substantial. Screws with shaft were 30% to 40% stiffer and 60% to 70% stronger than screws without shaft. Screws with shaft could tolerate 80 to 95 kg more force than screws without shaft before yielding. At 3 kN load, the displacement with screws with shaft was 55% to 60% of that with screws without shaft. Screws with a long shaft tended to perform better than those with a short shaft. There was no difference in the shear stiffness, shear yield strength, or shear displacement between the 2 screw diameters. Although larger diameter screws required more insertion effort, and screws with a short shaft required the most insertion energy, these differences were small. CONCLUSIONS: Cortex screws with a long shaft of 4.5- or 5.5-mm diameter provide better stability in equine MC(T)III condyle bone with less insertion effort compared with those with a short shaft or no shaft. CLINICAL SIGNIFICANCE: Cortex bone screws with a shaft inserted in lag fashion should be considered for the fixation of equine MC(T)III condylar fractures.  相似文献   

13.
Objectives: To compare in vitro monotonic biomechanical properties of an axial 3‐hole, 4.5 mm narrow locking compression plate (ELCP) using 5.0 mm locking screws and 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion (ELCP–TLS) with an axial 3‐hole, 4.5 mm narrow dynamic compression plate (DCP) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion (DCP–TLS) for equine proximal interphalangeal (PIP) joint arthrodesis. Design: Experimental. Animal Population: Cadaveric adult equine forelimbs (n=18 pairs). Methods: For each forelimb pair, 1 PIP joint was stabilized with an axial ELCP using 5.0 mm locking screws and 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion and 1 PIP joint with an axial 3‐hole narrow DCP (4.5 mm) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion. Six matching pairs of constructs were tested in single cycle to failure under axial compression, 6 construct pairs were tested for cyclic fatigue under axial compression, and 6 construct pairs were tested in single cycle to failure under torsional loading. Mean values for each fixation method were compared using a paired t‐test within each group with statistical significance set at P<.05. Results: Mean yield load, yield stiffness, and failure load under axial compression, single cycle to failure, of the DCP–TLS fixation were significantly greater than those of the LCP–TLS fixation. There was no significant difference between the mean number of cycles to failure in axial compression of the LCP–TLS and the DCP–TLS fixations. Mean yield load, yield stiffness, and failure load under torsion, single cycle to failure, of the LCP–TLS fixation were significantly greater than those of the DCP–TLS fixation. Conclusion: The DCP–TLS construct provided significantly greater stability under axial compression in single cycle to failure than the ELCP–TLS construct, the ELCP–TLS construct provided significantly greater stability under torsional loading in single cycle to failure than the DCP–TLS construct, and there was no significant difference in stability between the 2 constructs for cyclic loading under axial compression.  相似文献   

14.
OBJECTIVE: To evaluate and compare the mechanical properties of 4.5 narrow and 3.5 broad plating systems using their respective cortical and cancellous screws in unstable, central, and eccentric gap fracture models. STUDY DESIGN: Mechanical evaluation and comparison of 2 dynamic compression plate (DCP) systems. SAMPLE POPULATION: Eighteen cortical and 30 cancellous gapped fracture models. METHODS: DCP (4.5 mm narrow, 3.5 mm broad) with their respective cortical screws were applied to cortical bone density polyurethane foam blocks to construct center gap cortical fracture models that were tested in gap closing monotonic 4-point bending. DCP (4.5 mm narrow, 3.5 mm broad) with their respective cancellous screws were applied to cancellous bone density polyurethane foam blocks to construct eccentric gap cancellous fracture models. The cancellous constructs were tested in monotonic gap opening and gap closing cantilever bending and in cyclic axial loading. Univariate and multivariate repeated measures ANOVA were used to compare the maximum loads at failure of the 4.5 mm constructs and 3.5 mm constructs. RESULTS: The 4.5 mm narrow plating system withstood significantly higher loads at failure than the 3.5 mm broad plating system in 4-point bending (P<.0001) and gap opening cantilever bending (P<.0001). The 4.5 mm system failed in gap closing cantilever bending by plastic deformation of the plate, whereas the 3.5 mm system failed by screw pullout. There was no difference between the 2 systems in cyclic axial loading. CONCLUSION: Results indicate that the 4.5 mm narrow plating system has a mechanical advantage over the 3.5 mm broad plating system for stabilization of gapped fracture models. CLINICAL RELEVANCE: The 4.5 mm narrow plating system may be mechanically advantageous compared with the 3.5 mm broad plating system for stabilizing unreconstructed comminuted long bone fractures in large dogs.  相似文献   

15.
Objectives— To compare compression pressure (CP) of 6.5 mm Acutrak Plus (AP) and 4.5 mm AO cortical screws (AO) when inserted in simulated lateral condylar fractures of equine 3rd metacarpal (MC3) bones. Study Design— Paired in vitro biomechanical testing. Sample Population— Cadaveric equine MC3 bones (n=12 pair). Methods— Complete lateral condylar osteotomies were created parallel to the midsagittal ridge at 20, 12, and 8 mm axial to the epicondylar fossa on different specimens grouped accordingly. Interfragmentary compression was measured using a pressure sensor placed in the fracture plane before screw placement for fracture fixation. CP was acquired and mean values of CP for each fixation method were compared between the 6.5 mm (AP) and 4.5 mm (AO) for each group using a paired t‐test within each fracture fragment thickness group with statistical significance set at P<.05. Results— AO screw configurations generated significantly greater compressive pressure compared with AP configurations. The ratio of mean CP for AP screws to AO screws at 20, 12, and 8 mm, were 21.6%, 26.2%, and 34.2%, respectively. Conclusion— Mean CP for AP screw fixations are weaker than those for AO screw fixations, most notably with the 20 mm fragments. The 12 and 8 mm groups have comparatively better compression characteristics than the 20 mm group; however, they are still significantly weaker than AO fixations. Clinical Relevance— Given that the primary goals of surgical repair are to achieve rigid fixation, primary bone healing, and good articular alignment, based on these results, it is recommended that caution should be used when choosing the AP screw for repair of lateral condylar fractures, especially complete fractures. Because interfragmentary compression plays a factor in the overall stability of a repair, it is recommended for use only in patients with thin lateral condyle fracture fragments, as the compression tends to decrease with an increase in thickness.  相似文献   

16.
An in vitro experimental cadaveric mechanical testing study was performed using 20 radiographically mature dogs, weighing between 18-33 kg. The aim of the study was to compare the axial pull-out strength of 3.5 mm cortical and 4.0 mm cancellous bone screws inserted in the canine proximal tibia using manual and power tapping techniques. 3.5 cortical and 4.0 cancellous bone screws were inserted in canine cadaver proximal tibiae using a manual or power tapping technique. The screws were extracted using a servohydraulic materials testing machine in order to measure axial pull-out strength. Axial pull-out strength was recorded relative to the total bone width and total cortical width of each tibia. The mean axial pull-out strength for all constructs was 717.8+/-56.5 N without any statistically significant difference among groups (p=0.4183). The groups were equal in animal body weight, cortical width and total bone width (p=0.2808). The axial pull-out strength in proportion to cortical and total bone width was not significantly different among groups (p=0.5318). Axial pull-out strengths of 3.5 mm cortical and 4.0 mm cancellous bone screws inserted in the proximal tibial metaphysis were not significantly different. Axial pull-out strength was not affected by the use of power tapping in either screw type.  相似文献   

17.
Objectives— To compare in vitro monotonic biomechanical properties of an axial 3‐hole, 4.5 mm narrow dynamic compression plate (DCP) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion (DCP‐TLS) with 3 parallel transarticular 5.5 mm cortical screws inserted in lag fashion (3‐TLS) for the equine proximal interphalangeal (PIP) joint arthrodesis. Study Design— Paired in vitro biomechanical testing of 2 methods of stabilizing cadaveric adult equine forelimb PIP joints. Sample Population— Cadaveric adult equine forelimbs (n=15 pairs). Methods— For each forelimb pair, 1 PIP joint was stabilized with an axial 3‐hole narrow DCP (4.5 mm) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion and 1 with 3 parallel transarticular 5.5 mm cortical screws inserted in lag fashion. Five matching pairs of constructs were tested in single cycle to failure under axial compression, 5 construct pairs were tested for cyclic fatigue under axial compression, and 5 construct pairs were tested in single cycle to failure under torsional loading. Mean values for each fixation method were compared using a paired t‐test within each group with statistical significance set at P<.05. Results— Mean yield load, yield stiffness, and failure load under axial compression and torsion, single cycle to failure, of the DCP‐TLS fixation were significantly greater than those of the 3‐TLS fixation. Mean cycles to failure in axial compression of the DCP‐TLS fixation was significantly greater than that of the 3‐TLS fixation. Conclusion— The DCP‐TLS was superior to the 3‐TLS in resisting the static overload forces and in resisting cyclic fatigue. Clinical Relevance— The results of this in vitro study may provide information to aid in the selection of a treatment modality for arthrodesis of the equine PIP joint.  相似文献   

18.
Objectives— To compare in vitro monotonic biomechanical properties of an equine spoon plate (ESP) with an axial 3‐hole, 4.5 mm narrow dynamic compression plate (DCP) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws (DCP‐TLS) inserted in lag fashion for equine proximal interphalangeal (PIP) joint arthrodesis. Study Design— Paired in vitro biomechanical testing of 2 methods of stabilizing cadaveric adult equine forelimb PIP joints. Animal Population— Cadaveric adult equine forelimbs (n=18 pairs). Methods— For each forelimb pair, 1 PIP joint was stabilized with an ESP (8 hole, 4.5 mm) and 1 with an axial 3‐hole narrow DCP (4.5 mm) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion. Six matching pairs of constructs were tested in single cycle to failure under axial compression with load applied under displacement control at a constant rate of 5 cm/s. Six construct pairs were tested for cyclic fatigue under axial compression with cyclic load (0–7.5 kN) applied at 6 Hz; cycles to failure were recorded. Six construct pairs were tested in single cycle to failure under torsional loading applied at a constant displacement rate (0.17 radians/s) until rotation of 0.87 radians occurred. Mean values for each fixation method were compared using a paired t‐test within each group with statistical significance set at P<.05. Results— Mean yield load, yield stiffness, and failure load for ESP fixation were significantly greater (for axial compression and torsion) than for DCP‐TLS fixation. Mean (± SD) values for the ESP and DCP‐TLS fixation techniques, respectively, in single cycle to failure under axial compression were: yield load 123.9 ± 8.96 and 28.5 ± 3.32 kN; stiffness, 13.11 ± 0.242 and 2.60 ± 0.17 kN/cm; and failure load, 144.4 ± 13.6 and 31.4 ± 3.8 kN. In single cycle to failure under torsion, mean (± SD) values for ESP and DCP‐TLS, respectively, were: stiffness 2,022 ± 26.2 and 107.9 ± 11.1 N m/rad; and failure load: 256.4 ± 39.2 and 87.1 ± 11.5 N m. Mean cycles to failure in axial compression of ESP fixation (622,529 ± 65,468) was significantly greater than DCP‐TLS (95,418 ± 11,037). Conclusion— ESP was superior to an axial 3‐hole narrow DCP with 2 abaxial transarticular screws inserted in lag fashion in resisting static overload forces and cyclic fatigue. Clinical Relevance— In vitro results support further evaluation of ESP for PIP joint arthrodesis in horses. Its specific design may provide increased stability without need for external coaptation support.  相似文献   

19.
This report describes the clinical experience with internal fixation of a sagittal and a medial parasagittal patellar fracture using lag screws. Severely displaced sagittal and medial parasagittal fractures of the patella were diagnosed in 2 horses (a 10‐year‐old Thoroughbred gelding and a 5‐year‐old Thoroughbred mare) and were repaired using internal fixation. A direct approach through the fascia latae was used. In both cases, the leg was placed in full extension and the fracture was corrected by a combination of digital manipulation and application of bone reduction forceps. Articular congruency was assured by arthrotomy and digital assessment, and radiographic skyline projection. Then, the leg was placed in flexion and two 5.5 mm cortical screws with washers were inserted in lag fashion, under radiographic guidance (skyline projection). In one case, an additional 6.5 mm cancellous screw was used. Both fractures healed without evidence of degenerative joint disease. However, the first horse's wound dehisced, then healed by second intention uneventfully. The second horse was put in a sling in order to prevent lying down. Both horses were able to be used for their intended purpose. In these clinical cases, sagittal and medial parasagittal patellar fractures were treated successfully by open reduction and internal fixation. Post‐operative management in a sling was used successfully in the second case to prevent wound dehiscence.  相似文献   

20.
OBJECTIVE: To compare the biomechanical characteristics and mode of failure of 2 techniques using parallel 5.5 mm screws for pastern joint arthrodesis in horses. STUDY DESIGN: Randomized block design, for horse (1-5), method of fixation (two 5.5 mm screws versus three 5.5 mm screws), side (right, left), and end (front, hind). Constructs were tested to failure in 3-point bending. SAMPLE POPULATION: Twenty limbs (5 cadavers). METHODS: A combined aiming device was used to facilitate screw placement. Two parallel 5.5 mm screws were inserted in lag fashion in 1 limb of a pair, and three 5.5 mm screws were inserted in the contralateral limb. Constructs were then tested in 3-point bending in a dorsal-to-palmar (plantar) direction using a materials testing machine at a loading rate of 19 mm/s. Maximal bending moment at failure and stiffness were obtained from bending moment-angular deformation curves. RESULTS: There was no significant difference between two and three 5.5 mm screw constructs for bending moment and stiffness (P<.05). All constructs ultimately failed by bone fracture or screw bending. For proximal interphalangeal (PIP) joint arthrodesis constructs loaded in 3-point bending, no significant effect of treatment, side, or end on maximal bending moment or stiffness was detected. CONCLUSIONS: Two 5.5 mm cortical screws inserted in parallel should provide a surgically simpler and equally strong PIP joint arthrodesis compared with three 5.5 mm cortical screws. CLINICAL RELEVANCE: Two 5.5 mm cortical screws inserted in parallel for PIP joint arthrodesis should perform similarly under conditions used in this study, as three 5.5 mm screws inserted in a similar manner, when loaded under bending.  相似文献   

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