Salvaging Pull-Out Strength in a Previously Stripped Screw Site: A Comparison of Three Rescue Techniques

Screw stripping during bone fixation is a common occurrence during operations that results in decreased holding capacity and bone healing. We aimed to evaluate the rescue of the stripped screw site using screws of different dimensions. Five screw configurations were tested on cadaveric specimens for...

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Main Authors: Francesco Addevico, Giovanni F. Solitro, Massimo Max Morandi
Format: Article
Language:English
Published: MDPI AG 2021-08-01
Series:Journal of Functional Morphology and Kinesiology
Subjects:
Online Access:https://www.mdpi.com/2411-5142/6/3/71
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author Francesco Addevico
Giovanni F. Solitro
Massimo Max Morandi
author_facet Francesco Addevico
Giovanni F. Solitro
Massimo Max Morandi
author_sort Francesco Addevico
collection DOAJ
description Screw stripping during bone fixation is a common occurrence during operations that results in decreased holding capacity and bone healing. We aimed to evaluate the rescue of the stripped screw site using screws of different dimensions. Five screw configurations were tested on cadaveric specimens for pull-out strength (POS). The configurations included a control screw tightened without stripping, a configuration voluntarily stripped and left in place, and three more configurations in which the stripped screws were replaced by a different screw with either increased overall length, diameter, or thread length. Each configuration was tested five times, with each screw tested once. The POS of the control screw, measured to be 153.6 ± 27 N, was higher than the POS measured after stripping and leaving the screw in place (57.1 ± 18 N, <i>p</i> = 0.001). The replacement of the stripped screw resulted in a POS of 158.4 ± 64 N for the screw of larger diameter, while the screws of the same diameter but increased length or those with extended thread length yielded POS values of 138.4 ± 42 and 185.7 ± 48 N, respectively. Screw stripping is a frequent intraoperative complication that, according to our findings, cannot be addressed by leaving the screw in place. The holding capacity of a stripped screw implanted in cancellous bone can successfully be restored with a different screw of either larger diameter, longer length, or extended thread length.
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spelling doaj.art-ba7a8f547e904ee190d810866e6df9572023-11-22T13:43:43ZengMDPI AGJournal of Functional Morphology and Kinesiology2411-51422021-08-01637110.3390/jfmk6030071Salvaging Pull-Out Strength in a Previously Stripped Screw Site: A Comparison of Three Rescue TechniquesFrancesco Addevico0Giovanni F. Solitro1Massimo Max Morandi2Department of Orthopedic and Traumatology, Niguarda Hospital, 20162 Milano, ItalyDepartment of Orthopaedic Surgery, Louisiana State University Health-Shreveport, Shreveport, LA 71103, USADepartment of Orthopaedic Surgery, Louisiana State University Health-Shreveport, Shreveport, LA 71103, USAScrew stripping during bone fixation is a common occurrence during operations that results in decreased holding capacity and bone healing. We aimed to evaluate the rescue of the stripped screw site using screws of different dimensions. Five screw configurations were tested on cadaveric specimens for pull-out strength (POS). The configurations included a control screw tightened without stripping, a configuration voluntarily stripped and left in place, and three more configurations in which the stripped screws were replaced by a different screw with either increased overall length, diameter, or thread length. Each configuration was tested five times, with each screw tested once. The POS of the control screw, measured to be 153.6 ± 27 N, was higher than the POS measured after stripping and leaving the screw in place (57.1 ± 18 N, <i>p</i> = 0.001). The replacement of the stripped screw resulted in a POS of 158.4 ± 64 N for the screw of larger diameter, while the screws of the same diameter but increased length or those with extended thread length yielded POS values of 138.4 ± 42 and 185.7 ± 48 N, respectively. Screw stripping is a frequent intraoperative complication that, according to our findings, cannot be addressed by leaving the screw in place. The holding capacity of a stripped screw implanted in cancellous bone can successfully be restored with a different screw of either larger diameter, longer length, or extended thread length.https://www.mdpi.com/2411-5142/6/3/71screwstrippingrescuethread
spellingShingle Francesco Addevico
Giovanni F. Solitro
Massimo Max Morandi
Salvaging Pull-Out Strength in a Previously Stripped Screw Site: A Comparison of Three Rescue Techniques
Journal of Functional Morphology and Kinesiology
screw
stripping
rescue
thread
title Salvaging Pull-Out Strength in a Previously Stripped Screw Site: A Comparison of Three Rescue Techniques
title_full Salvaging Pull-Out Strength in a Previously Stripped Screw Site: A Comparison of Three Rescue Techniques
title_fullStr Salvaging Pull-Out Strength in a Previously Stripped Screw Site: A Comparison of Three Rescue Techniques
title_full_unstemmed Salvaging Pull-Out Strength in a Previously Stripped Screw Site: A Comparison of Three Rescue Techniques
title_short Salvaging Pull-Out Strength in a Previously Stripped Screw Site: A Comparison of Three Rescue Techniques
title_sort salvaging pull out strength in a previously stripped screw site a comparison of three rescue techniques
topic screw
stripping
rescue
thread
url https://www.mdpi.com/2411-5142/6/3/71
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AT massimomaxmorandi salvagingpulloutstrengthinapreviouslystrippedscrewsiteacomparisonofthreerescuetechniques