Fixation strength of anteriorly inserted headless screws for talar neck fractures

Jonathan H. Capelle, Cory G. Couch, Kevin M. Wells, Randal P. Morris, William L. Buford, David J. Merriman, Vinod Panchbhavi

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: For noncomminuted talar neck fractures, traditional fixation is with small fragment screws or cannulated screws. Newer screw systems on the market allow placement of cannulated headless screws, which provide compression by virtue of a variable-pitch thread. The headless construct has an inherent advantage, particularly for the talus, when the screws must be countersunk to prevent wear of the joint articular surfaces. This study tested the biomechanical fixation strength of cannulated headless variable-pitch screws compared with conventional cannulated screws, both placed in an anterior to posterior direction. Methods: A reproducible talar neck fracture was created in nine paired, preserved, cadaver talar necks using a materials testing machine. Talar head fixation was then performed with two cannulated headless variable-pitch 4/5 screws or two 4.0-mm conventional cannulated screws. The specimens were tested to failure and the fixations were normalized to their intact pairs and compared. Results: The headless variable-pitch screw fixation had significantly lower failure displacement than the conventional screw fixation. No significant differences were found between the two fixations for failure stiffness, load at failure or energy absorbed. Conclusions: Cannulated headless variable-pitch screws significantly improved failure displacement when compared to conventional cannulated screws in a cadaveric model, and may be a viable option for talus fracture fixation. Clinical Relevance: Headless, fully threaded, variable-pitch screws have inherent advantages over conventional screws in that they may be less damaging to the articular surface and can compress the fracture for improved reduction. This study demonstrates these screws are also biomechanically similar to conventional screws.

Original languageEnglish (US)
Pages (from-to)1012-1016
Number of pages5
JournalFoot and Ankle International
Volume34
Issue number7
DOIs
StatePublished - Jul 2013

Fingerprint

Fracture Fixation
Talus
Neck
Joints
Materials Testing
Cadaver
Head

Keywords

  • Ankle
  • Biomechanics
  • Fracture fixation
  • Talus
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Capelle, J. H., Couch, C. G., Wells, K. M., Morris, R. P., Buford, W. L., Merriman, D. J., & Panchbhavi, V. (2013). Fixation strength of anteriorly inserted headless screws for talar neck fractures. Foot and Ankle International, 34(7), 1012-1016. https://doi.org/10.1177/1071100713479586

Fixation strength of anteriorly inserted headless screws for talar neck fractures. / Capelle, Jonathan H.; Couch, Cory G.; Wells, Kevin M.; Morris, Randal P.; Buford, William L.; Merriman, David J.; Panchbhavi, Vinod.

In: Foot and Ankle International, Vol. 34, No. 7, 07.2013, p. 1012-1016.

Research output: Contribution to journalArticle

Capelle, JH, Couch, CG, Wells, KM, Morris, RP, Buford, WL, Merriman, DJ & Panchbhavi, V 2013, 'Fixation strength of anteriorly inserted headless screws for talar neck fractures', Foot and Ankle International, vol. 34, no. 7, pp. 1012-1016. https://doi.org/10.1177/1071100713479586
Capelle JH, Couch CG, Wells KM, Morris RP, Buford WL, Merriman DJ et al. Fixation strength of anteriorly inserted headless screws for talar neck fractures. Foot and Ankle International. 2013 Jul;34(7):1012-1016. https://doi.org/10.1177/1071100713479586
Capelle, Jonathan H. ; Couch, Cory G. ; Wells, Kevin M. ; Morris, Randal P. ; Buford, William L. ; Merriman, David J. ; Panchbhavi, Vinod. / Fixation strength of anteriorly inserted headless screws for talar neck fractures. In: Foot and Ankle International. 2013 ; Vol. 34, No. 7. pp. 1012-1016.
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abstract = "Background: For noncomminuted talar neck fractures, traditional fixation is with small fragment screws or cannulated screws. Newer screw systems on the market allow placement of cannulated headless screws, which provide compression by virtue of a variable-pitch thread. The headless construct has an inherent advantage, particularly for the talus, when the screws must be countersunk to prevent wear of the joint articular surfaces. This study tested the biomechanical fixation strength of cannulated headless variable-pitch screws compared with conventional cannulated screws, both placed in an anterior to posterior direction. Methods: A reproducible talar neck fracture was created in nine paired, preserved, cadaver talar necks using a materials testing machine. Talar head fixation was then performed with two cannulated headless variable-pitch 4/5 screws or two 4.0-mm conventional cannulated screws. The specimens were tested to failure and the fixations were normalized to their intact pairs and compared. Results: The headless variable-pitch screw fixation had significantly lower failure displacement than the conventional screw fixation. No significant differences were found between the two fixations for failure stiffness, load at failure or energy absorbed. Conclusions: Cannulated headless variable-pitch screws significantly improved failure displacement when compared to conventional cannulated screws in a cadaveric model, and may be a viable option for talus fracture fixation. Clinical Relevance: Headless, fully threaded, variable-pitch screws have inherent advantages over conventional screws in that they may be less damaging to the articular surface and can compress the fracture for improved reduction. This study demonstrates these screws are also biomechanically similar to conventional screws.",
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AU - Buford, William L.

AU - Merriman, David J.

AU - Panchbhavi, Vinod

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N2 - Background: For noncomminuted talar neck fractures, traditional fixation is with small fragment screws or cannulated screws. Newer screw systems on the market allow placement of cannulated headless screws, which provide compression by virtue of a variable-pitch thread. The headless construct has an inherent advantage, particularly for the talus, when the screws must be countersunk to prevent wear of the joint articular surfaces. This study tested the biomechanical fixation strength of cannulated headless variable-pitch screws compared with conventional cannulated screws, both placed in an anterior to posterior direction. Methods: A reproducible talar neck fracture was created in nine paired, preserved, cadaver talar necks using a materials testing machine. Talar head fixation was then performed with two cannulated headless variable-pitch 4/5 screws or two 4.0-mm conventional cannulated screws. The specimens were tested to failure and the fixations were normalized to their intact pairs and compared. Results: The headless variable-pitch screw fixation had significantly lower failure displacement than the conventional screw fixation. No significant differences were found between the two fixations for failure stiffness, load at failure or energy absorbed. Conclusions: Cannulated headless variable-pitch screws significantly improved failure displacement when compared to conventional cannulated screws in a cadaveric model, and may be a viable option for talus fracture fixation. Clinical Relevance: Headless, fully threaded, variable-pitch screws have inherent advantages over conventional screws in that they may be less damaging to the articular surface and can compress the fracture for improved reduction. This study demonstrates these screws are also biomechanically similar to conventional screws.

AB - Background: For noncomminuted talar neck fractures, traditional fixation is with small fragment screws or cannulated screws. Newer screw systems on the market allow placement of cannulated headless screws, which provide compression by virtue of a variable-pitch thread. The headless construct has an inherent advantage, particularly for the talus, when the screws must be countersunk to prevent wear of the joint articular surfaces. This study tested the biomechanical fixation strength of cannulated headless variable-pitch screws compared with conventional cannulated screws, both placed in an anterior to posterior direction. Methods: A reproducible talar neck fracture was created in nine paired, preserved, cadaver talar necks using a materials testing machine. Talar head fixation was then performed with two cannulated headless variable-pitch 4/5 screws or two 4.0-mm conventional cannulated screws. The specimens were tested to failure and the fixations were normalized to their intact pairs and compared. Results: The headless variable-pitch screw fixation had significantly lower failure displacement than the conventional screw fixation. No significant differences were found between the two fixations for failure stiffness, load at failure or energy absorbed. Conclusions: Cannulated headless variable-pitch screws significantly improved failure displacement when compared to conventional cannulated screws in a cadaveric model, and may be a viable option for talus fracture fixation. Clinical Relevance: Headless, fully threaded, variable-pitch screws have inherent advantages over conventional screws in that they may be less damaging to the articular surface and can compress the fracture for improved reduction. This study demonstrates these screws are also biomechanically similar to conventional screws.

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