English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Poor screw purchase because of osteoporosis presents difficulties in ankle fracture fixation. The aim of our study was to determine if cortical thickness, unicortical versus bicortical purchase, and bone mineral density are predictors of inadvertent screw stripping and overtightening. Ten paired cadaver ankles (average donor age, 81.7 years; range, 50-97 years) were used for the study. Computed tomography scanning with phantoms of known density was used to determine the bone density along the distal fibula. A standard small-fragment, 7-hole, one-third tubular plate was applied to the lateral surface of the fibula, with 3 proximal bicortical cortical screws and 2 distal unicortical cancellous screws. A posterior plate, in which all 5 screws were cortical and achieved bicortical purchase, was subsequently applied to the same bones and positioned so that the screw holes did not overlap. A torque sensor was used to measure the torque of each screw during insertion (T i ) and then stripping (T s ). The effect of bone density, screw location, cortical thickness, and unicortical versus bicortical purchase on T i  and T s  was checked for significance ( P &lt; .05) using a general linearized latent and mixed model. We found that 9% of the screws were inadvertently stripped and 12% were overtightened. Despite 21% of the screws being stripped or being at risk for stripping, we found no significant predictors to warn of impending screw stripping. Additional work is needed to identify clinically useful predictors of screw stripping.

Inadvertent Screw Stripping During Ankle Fracture Fixation in Elderly Bone