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Interfragmentary Compression Forces Vary Based on Scaphoid Bone Screw Type and Fracture Location

机译：基于舟骨骨螺钉类型和骨折部位的不同，股间压缩力变化

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Background: The objective of this study was to determine the interfragmentary compression forces generated in a foam model as a function of headless compression screw type (fully threaded and central threadless) and fracture location. Methods: Eighty-eight polyurethane foam models were fixed across a simulated transverse fracture with either a fully threaded screw or a central threadless screw. The location of the transverse fracture varied along the length of the foam model in 2 mm increments for 11 fracture locations. The force generated at the fracture site upon fixation was utilized to determine the interfragmentary compression. Interfragmentary compression was compared using a paired t test and 2-way analysis of variance, with significance set at P < .05. Results: Interfragmentary compression was found to vary based on fracture location and screw type. The fully threaded screw generated significantly greater compression for fracture locations at 12 mm and 18 mm from the top edge of the foam model, while the central threadless screw generated significantly greater compression for fractures located 2 mm from the top edge of the foam model. Conclusions: The central threadless screw and the fully threaded screw had different fracture locations where maximum compression force occurred. The fully threaded screw generated greater compression force toward the screw center due to greater thread purchase. However, the central threadless screw generated greater compression at the most proximal fracture location due to its greater thread pitch toward the screw head. Maximizing interfragmentary compression may aid in reducing nonunion rates associated with the internal fixation of proximal scaphoid fractures.
机译：背景：这项研究的目的是确定泡沫模型中产生的片段间压缩力与无头压缩螺钉类型（全螺纹和中心无螺纹）和骨折位置的关系。方法：使用全螺纹螺钉或中心无螺纹螺钉将88个聚氨酯泡沫模型固定在模拟的横向裂缝上。横向裂缝的位置沿着泡沫模型的长度以11 mm的裂缝位置以2 mm的增量变化。固定时在骨折部位产生的力被用来确定股间压缩。使用配对t检验和方差的2-way分析比较片段间压缩，显着性设置为P <.05。结果：发现片段间压迫因骨折部位和螺钉类型而异。对于距泡沫模型顶部边缘12 mm和18 mm处的裂缝位置，全螺纹螺钉产生明显更大的压缩力，而距泡沫模型顶部边缘2 mm处的裂缝产生的中心无螺纹螺钉产生明显更大的压力。结论：中央无螺纹螺钉和全螺纹螺钉具有不同的断裂位置，从而产生最大的压缩力。由于购买了更多的螺纹，全螺纹螺钉向螺钉中心产生了更大的压缩力。但是，由于中央无螺纹螺钉朝向螺钉头的螺距更大，因此在最近端的骨折位置产生了更大的压缩力。最大化片段间压迫可能有助于降低与近端舟骨骨折内固定相关的骨不连率。

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