The effect of screw thread length on initial stability of Schatzker type 1 tibial plateau fracture fixation: a biomechan
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RESEARCH ARTICLE
Open Access
The effect of screw thread length on initial stability of Schatzker type 1 tibial plateau fracture fixation: a biomechanical study Ahmet Salduz1* , Fevzi Birisik1, Gokhan Polat1, Bugra Bekler2, Ergun Bozdag2 and Onder Kilicoglu1
Abstract Background: This study compares the cyclic loading properties and failure loads of two screw combinations on a synthetic Schatzker type 1 tibia fracture model. Our hypothesis was that after adequate compression with first a partially threaded screw, addition of a fully threaded screw would provide more stability than an addition of a second partially threaded screw. Methods: The Schatzker type 1 tibial plateau fracture model was created. Fixation was obtained in group A (n = 10) with two partially threaded screws and in group B (n = 10) with one fully threaded screw and one partially threaded screw. Load-displacement evaluation was made at each 1000-cycle interval up to 10,000 cycles. Failure load was identified as the load creating a 2-mm displacement. Two-factor (groups and periods) repeated measurement analysis of variance and independent sample t tests were used. Results: According to the two-factor repeated analysis, there was no significant difference for periods (p = 0.29) and time-period interaction (p = 0.59) (Wilk’s Lambda F value, 1.507 and 0.871, respectively). In the test of betweensubject effects, there was no significant difference between groups in terms of cyclic loadings (p = 0.06, F = 4.065). However, in the t test for each 1000-cycle interval, the value of mean displacement in group B was significantly lower than that in group A in the initial, 1000-, 2000-, and 3000-cycle intervals (p = 0.023, 0.031, 0.025, 0.043, respectively). The mean displacement and standard deviations increased with the number of cycles. The mean range of displacement initially was 0.66 mm for group A and 0.36 mm for group B. The mean range of displacement after 10,000 cycles was 0.79 mm for group A and 0.44 mm for group B. The mean failure load value was 682 ± 234 N for group A and 835 ± 245 N for group B. In independent sample t tests, there were no significant differences between the two groups in terms of failure load (p > 0.05). Conclusions: Obtaining fixation with one partially and one fully threaded screw can minimize displacement at the fracture site at early cyclic loadings. Keywords: Tibial plateau fractures, Cancellous screw, Thread length, Cyclic loading, Biomechanical test
Background The treatment goal for tibial plateau fractures is anatomic reduction and rigid fixation to allow early mobilization. Several fixation methods have been described for rigid osteosynthesis. Percutaneous fixation using a partially threaded cannulated screw is one of the methods, which is reported by some authors with a high * Correspondence: [email protected] 1 Department of Orthopedic and Traumatology, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey Full list of author information is available at the end of the article
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