J Korean Foot Ankle Soc.  2020 Jun;24(2):94-97. 10.14193/jkfas.2020.24.2.94.

The Efficacy of Newly Designed Screw for Prevention of the Screw Breakage in Syndesmosis Fixation: Biomechanical Study

• Lee DO
• Song SH

• KMID: 2502916
• DOI: http://doi.org/10.14193/jkfas.2020.24.2.94

Abstract

Purpose
Fatigue breakage of cortical screws sometimes occurs after syndesmosis fixation, regardless of the period of screw retention. This study compared the fatigue strength of a novel screw design to conventional cortical screws in the fixed state of syndesmosis.
Materials and Methods
Twelve sawbone models were tested mechanically to determine the fatigue strength of three screw designs. The first group was composed of cortical screws, while the second and third groups were newly-designed screws. The second group was composed of screws with a 2.4-mm diameter thread-free portion of the mid-shank while the third group had a 2.0-mm diameter threadfree mid-shank. A 400 N load was applied repetitively to a fibula model and the number of cycles until screw failure was recorded. Four screws from each group were tested, giving a total of 12 fatigue tests.
Results
The average cycles until screw failure for groups 1, 2, and 3 were 8,134, 63,186, and 2,581, respectively. The second group showed the highest fatigue strength (p=0.018). The other two screw designs showed similar fatigue strength (p=0.401).
Conclusion
New screw designs with a thread-free portion in the mid-shank could reduce the occurrence of fatigue breakage after syndesmosis fixation.

Keyword

Ankle syndesmosis; Bone screws; Fatigue breakage; Biomechanical study

Figure

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  Figure. 1 Schematic drawing of a novel screw design.

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  Figure. 2 Testing machine to apply repetitive load to sawbone model.

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