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PubMedDate not supplied

Use of the cannulated bone screw in rearfoot surgery.

There are many types of rigid internal fixation devices available for podiatric surgery. The cannulated screw system is an easy and effective way to decrease surgical time. These screws are being used with great success for several rearfoot procedures, such as the triple arthrodesis, Dwyer calcaneal osteotomy, and posterior malleolar ankle fractures.

Ankle Injuries↗
PubMed1992

[Immobilization and early mobilization of malleolar fractures after osteosynthesis with resorbable bone screws].

71 patients with displaced ankle fracture were treated by using absorbable screws in the fixation of fractures. The follow-up time was 17 (13 to 33) months in average. The fixation devices were SR-PLLA (self-reinforced poly-L-lactide) and SR-PGA (self-reinforced polyglycolide) screws. 38 of the ankle fractures were immobilized with plaster cast and 33 ankle joints were mobilized immediately with a brace. An exact radiological result was achieved in 66 cases, insignificant displacement was observed in four cases and the result was poor in one patient. The result was classified as excellent in 62 patients, as good in eight patients and as poor in one patient. The patients treated postoperatively without plaster healed in a somewhat shorter time, but at one year check-up the differences in the clinical results were almost eliminated. Selected ankle fractures fixed with absorbable screws can be treated postoperatively with early mobilization without plaster.

Adolescent↗
PubMedDate not supplied

[Factors influencing the anchoring stability of spinal bone screws--an experimental study].

INTRODUCTION AND AIM OF THE STUDY: The primary assumption for successful internal fixation of the spine is a stable screws fixation. Aim of this experimental examination was to point out the influences on axial pull-out strength of screws and to suggest improvements for its increase. METHODS: Eight specifically manufactured screw-prototypes were tested in standardized pull-out tests in comparison by pairs. An isotropic, synthetic hard-foam was used as test material. It resembled to the spongiose bone and reduced the deviation of the results. To show the transferability of the results on bone there were made pull-out tests out off calf vertebra. RESULTS: A significant increase of axial pull-out strength can be achieved by a wide external diameter, a big insertion depth, a flat angel of tooth profile and a small thread pitch. This examination could not prove a significant advantageous influence on axial pull-out strength by fast pull-out, asymmetrical "Butress-thread" or proportion of core- and external diameter difference. CONCLUSIONS: Referring to the aim of this examination a wide outside-diameter can be recommended. Likewise the depth of insertion should be as deep as the anatomic conditions permit. The influence of these two factors are considerable. In contrast to other author's statements the maximum axial stability increases significantly by a small thread pitch and a flat angel of tooth profile.

Animals↗
PubMed2001

[Bone screw osteosynthesis of medial femoral neck fracture in elderly patients].

This study evaluated the complication rate and surgical outcome following cannulated screw fixation of femoral neck fractures in elderly patients. Between 1.6.97 and 31.12.98 we operated on 110 patients with 112 fractures. The mean age was 78.4 years (range 25-96 years). Mean follow up was 6.8 months (range 3-16 months). The mortality rate was 22.7% (25/110). 60 patients with 61 fractures could be evaluated for complications, reoperations, pain and walking ability. 68.9% of the fractures healed. Avascular necrosis developed in 18%. Non-union rate was 8.2% and redislocation rate 4.9%. 18 patients needed a second operation, two thirds received an arthroplasty and one third had implant removal or replacement. In 81.6% of the patients (the patients with secondary arthroplasty excluded) pain relief was good. Insufficient reduction and malposition of the screws are the most common causes for failure of cannulated screw fixation of femoral neck fractures in the elderly.

Adult↗
PubMed2005

Mechanical strength and optimal site of placement of a threaded bone screw assessed on the basis of the screw breakage for non-union of the scaphoid: a biomechanical study.

We have performed the surgical procedure on the patients with the fracture of the scaphoid using mini-acutrak screws (ACUMED, Inc.). A 25-year-old man was injured in a fall. Surgical treatment for non-union of the scaphoid using a mini-acutrak screw was performed. However, this screw was broken, despite the absence of any obvious trauma mechanism. A structural examination was performed with a metal microscope and a hardness test was performed. A hardness evaluation was conducted on this broken screw and similar screws. Cannulated screws having diameters of 2.7 and 3.5 mm were also evaluated in the strength test as controls for comparison. The breakage of screw occurred due to fatigue. The screw provides the strength equivalent to that of a 3.5 mm cannulated screw but the bending strength of the head end portion in which the breakage occurred was assumed to be the strength of about one-third that of the intermediate portion.

Adult↗
PubMed1999

[Lengemann suture versus bone screw osteosynthesis in treatment of ulnar osseous collateral ligament rupture of the thumb metacarpophalangeal joint].

Out of 95 ligamentous lesions of the thumb metacarpophalangeal joint, those with an isolated bony rupture of the ulnar collateral ligament were chosen. Of these, 15 patients treated with Lengemann suture and 16 with screw fixation were followed-up on average 27.3 and 26.4 months, respectively, after operative treatment. Under only "good" and "very good" clinical results, the statistical analysis of the objective and subjective parameters showed no significant difference, except for the measurement of the soft-tissue circumference (p < 0.01) between either procedure. Although both procedures have a low rate of complications, screw fixation is preferable since implant removal is not necessary.

Adult↗