Projects per year
Twelve studies were included, with 260 surgeons inserting a total of 2793 screws; an average of 11 screws each, although only 1510 screws have been inserted by 145 surgeons where tightness was measured – average tightness was 78±10% for cortical (n = 1079) and 80±6% for cancellous screw insertions (n = 431).
An average of 26% of all inserted screws irreparably damaged and stripped screw holes, reducing the construct pullout strength. Furthermore, awareness of bone stripping is very poor, meaning that screws must be considerably overtightened before a surgeon will typically detect it.
Variation between individual surgeons’ ability to optimally insert screws was seen, with some surgeons stripping more than 90% of samples and others hardly any. Contradictory findings were seen for the relationship between the tightness achieved and bone density.
The optimum tightness for screws remains unknown, thus subjectively chosen screw tightness, which varies greatly, remains without an established target to generate the best possible construct for any given situation. Work is needed to establish these targets, and to develop methods to accurately and repeatably achieve them.
- Bone screws
- Fracture fixation
- Internal fixation
- Screw insertion
- Screw tightness
- Stripping torque
- Surgical technique
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
FingerprintDive into the research topics of 'Surgical performance when inserting non-locking screws – a systematic review'. Together they form a unique fingerprint.
- 2 Finished
Fellowship for James Fletcher - Optimal surgical techniques to reduce screw failure in fragility fractures
Fletcher, J. & Preatoni, E.
14/09/18 → 13/09/19
Project: UK charity
Preatoni, E. & Fletcher, J.
1/02/17 → 30/09/18
Project: UK charity
Dataset for "Non-locking screw insertion: no benefit seen if tightness exceeds 80% of the maximum torque"
Data for "Juvenile bovine bone is an appropriate surrogate for normal and reduced density human bone in biomechanical testing"