Screw insertion in osteoporotic bone: Turn-of-The-nut and torque-based techniques provide similar resistance to bone plate slippage

Simon C. Mears, Evan R. Langdale, Stephen M. Belkoff

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES:: To measure the resistance to plate slippage provided by a screw inserted to various torsional and rotational endpoints. MATERIALS AND METHODS:: A 7-hole, 3.5-mm narrow dynamic compression plate was affixed to an osteoporotic humeral shafts using screws inserted: (1) to 90 degrees after plate contact, (2) to 180 degrees after plate contact, (3) by the 1.4-N·m torque limit method, and (4) by the "2-fingers tight" method. The resistance of the plate to sliding against the bone was measured using a materials testing machine. We checked for an effect of screw insertion method on bone-plate slippage with a general linearized latent and mixed model, controlling for bone mineral density, sex, and specimen clustering. Significance was set at P < 0.05. RESULTS:: The force required to slip the plate for 180 degrees of screw rotation was not significantly greater than that of the other insertion groups. CONCLUSIONS:: Inserting screws 180 degrees after seating can be expected to yield plate contact to bone similar to that of the "2-fingers tight" standard.

Original languageEnglish (US)
Pages (from-to)e65-e68
JournalJournal of orthopaedic trauma
Volume29
Issue number2
DOIs
StatePublished - Feb 6 2015

Keywords

  • Loss of fixation
  • Osteoporosis
  • Plating
  • Screw insertion
  • Stripping

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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