A comparative study of the effect of drilling depth on generation of compressive force by headless compression screws us
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(2019) 14:5
RESEARCH ARTICLE
Open Access
A comparative study of the effect of drilling depth on generation of compressive force by headless compression screws using conical and cylindrical type of drill bit Hyung-Sik Kim, Ho-Jung Kang, Yun-Rak Choi, Won-Taek Oh and Il-Hyun Koh*
Abstract Background: This study was conducted to measure the effect of different drilling depths on compression forces generated by two commonly used headless compression screws using the two different types of drill bit, the Acutrak® mini (conical type drill bit) and the Synthes 3.0 HCS® (cylindrical type drill bit). Methods: A load cell was placed between two Sawbone blocks, which were 12 mm and 40 mm in thickness, respectively. After placing the guide pin into the center of the block, the drilling depth of the Acutrak® mini and Synthes HCS® screws ranged from 16 to 28 mm and 22 to 28 mm, respectively. The 24-mm screws were inserted and the compression force was measured immediately and at 30 min post-insertion. Results: The Acutrak® mini generated greater compression force compared to the Synthes 3.0 HCS® when drilled to a depth of less than 24 mm. The compression force of the Acutrak® mini showed a strong inverse correlation with the drilling depth. There was no significant inverse correlation observed between the compression force of the Synthes HCS® and the drilling depth. Conclusions: If the screw length and the drill depth are the same, the Synthes 3.0 HCS® (cylindrical type drill bit) is safer and easier to use as it has no change in the compression force even when over-drilling because the compression force of the two screws is similar. As for the Acutrak® mini (conical type drill bit), while it is technically demanding due to varying compression force according to the drill depth, it can be used in certain cases because it can give stronger compression force through under-drilling. Keywords: Biomechanics, Compression force, Drill bit type, Drilling depth, Headless compression screw
Introduction Headless compression screws, designed to maintain compression force when the head is inserted into the bone, are commonly used because of minimal risk of tissue irritation and damage to the surrounding articular cartilage [1, 2]. Headless compression screws generate compression force through different pitches and diameters between the leading and the trailing threads [3]. Generally, the leading thread has a wider thread pitch with a smaller diameter, while the trailing thread has a narrower pitch and a larger diameter [4]. The type of the * Correspondence: [email protected] Department of Orthopaedic Surgery, Yonsei University College of Medicine, 50 Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
drill bit may vary depending on the diameter difference between the leading thread and the tailing thread, as well as the design of the screw itself. Threadless central shaft screws such as the Synthes 3.0 HCS® (Synthes Inc.®, Westchester, PA, USA), which have threads at both ends and a sparing central shaft, use a cylindrical type drill bit wit
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