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A Mechanical Comparison of the Compressive Force Generated by Various Headless Compression Screws and the Impact of Fracture Gap Size
Journal article   Open access   Peer reviewed

A Mechanical Comparison of the Compressive Force Generated by Various Headless Compression Screws and the Impact of Fracture Gap Size

Asif M. Ilyas, Jonathan M. Mahoney and Brandon S. Bucklen
Hand (New York, N.Y.), v 16(5), pp 604-611
01 Sep 2021
DOI: https://doi.org/10.1177/1558944719877890
PMID: 31565968
url
https://doi.org/10.1177/1558944719877890View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

Background: There is evidence that interfragmentary fracture gap size may affect the compression achievable with a modern headless compression screw (HCS). This mechanical study compared the compression achieved by 3 commercial HCS systems through various fracture gaps: CAPTIVATE Headless (Globus Medical, Inc, Audubon, Pennsylvania), Synthes (DePuy Synthes, Westchester, Pennsylvania), and Acumed Acutrak 2 (Acumed LLC, Hillsboro, Oregon). Methods: Screws were inserted into a custom test fixture composed of polyurethane synthetic bone foam fragments, separated by a layer of easily compressible polyurethane foam simulating a fracture gap. Compression was measured after final insertion and countersinking. The effect of the interfragmentary fracture gap size on the compression generated was also investigated. Results: The CAPTIVATE Headless 3.0 mm screw (70.1 ± 5.7 N) and the Synthes 3.0 mm screw (64.9 ± 7.3 N) achieved similar compressive forces after final countersink. Similar comparisons were found for the CAPTIVATE Headless 2.5 mm and Synthes 2.4 mm screws, and the CAPTIVATE Headless 4.0 mm and Acutrak 2 Standard screws. The final compression of the CAPTIVATE Headless 2.5 mm and Synthes 2.4 mm screws was not significantly affected when the fracture gap was doubled from 2 to 4 mm, but was reduced significantly by 95.9% with the Acutrak 2 Micro screw. Conclusion: When comparing like-sized screws, the CAPTIVATE, Synthes, and Acutrak 2 HCS systems demonstrated similar potential compressive forces. However, compared with the CAPTIVATE Headless and Synthes HCS systems, which are inserted with a compression sleeve that is not gap distance–dependent, the Acutrak 2 HCS system demonstrated less compression when the simulated fracture gap size was increased to 4 mm.

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Web of Science research areas
Orthopedics
Surgery
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