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An in vitro biomechanical evaluation of an expansive double-threaded bi-directional compression screw for fixation of type II odontoid process fractures: A SQUIRE-compliant article.

Abstract Odontoid process fracture accounts for 5% to 15% of all cervical spine injuries, and the rate is higher among elderly people. The anterior cannulated screw fixation has been widely used in odontoid process fracture, but the fixation strength may still be limited under some circumstances. This study aims to investigate the biomechanical fixation strength of expansive double-threaded bi-directional compression screw (EDBCS) compared with cannulated lag screw (CLS) and improved Herbert screw (IHS) for fixation of type II odontoid process fracture.Thirty fresh cadaveric C2 vertebrae specimens were harvested and randomly divided into groups A, B, and C. A type II fracture model was simulated by osteotomy. Then the specimens of the 3 groups were stabilized with a single CLS, IHS, or EDBCS, respectively. Each specimen was tested in torsion from 0° to 1.25° for 75 s in each of 5 cycles clockwise and 5 cycles anticlockwise. Shear and tensile forces were applied at the anterior-to-posterior and proximal-to-distal directions, respectively, both to a maximum load of 45 N and at a speed of 1 mm/min.The mean torsional stiffness was 0.309 N m/deg for IHS and 0.389 N m/deg for EDBCS, which were significantly greater compared with CLS, respectively (0.169 N m/deg) (P < .05 and P < .05). The mean shear stiffness for the EDBCS was 238 N/mm, which was significantly greater than CLS (150 N/mm) and IHS (132 N/mm) (P < .05 and P < .05). All 3 screws only partly restored tensile stiffness, but not significantly.Fixation with the EDBCS can improve the biomechanical strength for odontoid process fracture compared with CLS and IHS, especially in terms of torsional and shear stiffness.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28422889
OWN - NLM
STAT- In-Process
DA  - 20170419
LR  - 20170419
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 16
DP  - 2017 Apr
TI  - An in vitro biomechanical evaluation of an expansive double-threaded
      bi-directional compression screw for fixation of type II odontoid process
      fractures: A SQUIRE-compliant article.
PG  - e6720
LID - 10.1097/MD.0000000000006720 [doi]
AB  - Odontoid process fracture accounts for 5% to 15% of all cervical spine injuries, 
      and the rate is higher among elderly people. The anterior cannulated screw
      fixation has been widely used in odontoid process fracture, but the fixation
      strength may still be limited under some circumstances. This study aims to
      investigate the biomechanical fixation strength of expansive double-threaded
      bi-directional compression screw (EDBCS) compared with cannulated lag screw (CLS)
      and improved Herbert screw (IHS) for fixation of type II odontoid process
      fracture.Thirty fresh cadaveric C2 vertebrae specimens were harvested and
      randomly divided into groups A, B, and C. A type II fracture model was simulated 
      by osteotomy. Then the specimens of the 3 groups were stabilized with a single
      CLS, IHS, or EDBCS, respectively. Each specimen was tested in torsion from 0
      degrees to 1.25 degrees for 75 s in each of 5 cycles clockwise and 5 cycles
      anticlockwise. Shear and tensile forces were applied at the anterior-to-posterior
      and proximal-to-distal directions, respectively, both to a maximum load of 45 N
      and at a speed of 1 mm/min.The mean torsional stiffness was 0.309 N m/deg for IHS
      and 0.389 N m/deg for EDBCS, which were significantly greater compared with CLS, 
      respectively (0.169 N m/deg) (P &lt; .05 and P &lt; .05). The mean shear stiffness for 
      the EDBCS was 238 N/mm, which was significantly greater than CLS (150 N/mm) and
      IHS (132 N/mm) (P &lt; .05 and P &lt; .05). All 3 screws only partly restored tensile
      stiffness, but not significantly.Fixation with the EDBCS can improve the
      biomechanical strength for odontoid process fracture compared with CLS and IHS,
      especially in terms of torsional and shear stiffness.
FAU - Liu, Ning
AU  - Liu N
AD  - aDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical
      University bDepartment of Anesthesiology, Xijing Hospital, The Fourth Military
      Medical University, Xi'an cDepartment of Orthopedics, 62th Hospital of PLA, Puer,
      China.
FAU - Tian, Li
AU  - Tian L
FAU - Jiang, Rong-Xian
AU  - Jiang RX
FAU - Xu, Chao
AU  - Xu C
FAU - Shi, Lei
AU  - Shi L
FAU - Lei, Wei
AU  - Lei W
FAU - Zhang, Yang
AU  - Zhang Y
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2017/04/20 06:00
MHDA- 2017/04/20 06:00
CRDT- 2017/04/20 06:00
AID - 10.1097/MD.0000000000006720 [doi]
AID - 00005792-201704210-00071 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Apr;96(16):e6720. doi: 10.1097/MD.0000000000006720.

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