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Sample records for bone screws

  1. Cancellous Screws Are Biomechanically Superior to Cortical Screws in Metaphyseal Bone.

    Science.gov (United States)

    Wang, Tim; Boone, Christopher; Behn, Anthony W; Ledesma, Justin B; Bishop, Julius A

    2016-09-01

    Cancellous screws are designed to optimize fixation in metaphyseal bone environments; however, certain clinical situations may require the substitution of cortical screws for use in cancellous bone, such as anatomic constraints, fragment size, or available instrumentation. This study compares the biomechanical properties of commercially available cortical and cancellous screw designs in a synthetic model representing various bone densities. Commercially available, fully threaded, 4.0-mm outer-diameter cortical and cancellous screws were tested in terms of pullout strength and maximum insertion torque in standard-density and osteoporotic cancellous bone models. Pullout strength and maximum insertion torque were both found to be greater for cancellous screws than cortical screws in all synthetic densities tested. The magnitude of difference in pullout strength between cortical and cancellous screws increased with decreasing synthetic bone density. Screw displacement prior to failure and total energy absorbed during pullout strength testing were also significantly greater for cancellous screws in osteoporotic models. Stiffness was greater for cancellous screws in standard and osteoporotic models. Cancellous screws have biomechanical advantages over cortical screws when used in metaphyseal bone, implying the ability to both achieve greater compression and resist displacement at the screw-plate interface. Surgeons should preferentially use cancellous over cortical screws in metaphyseal environments where cortical bone is insufficient for fixation. [Orthopedics.2016; 39(5):e828-e832.].

  2. Use of polymethylmethacrylate to enhance screw fixation in bone.

    Science.gov (United States)

    Cameron, H U; Jacob, R; Macnab, I; Pilliar, R M

    1975-07-01

    Pull-out testing of screws inserted into cement and bone under various conditions showed that the cement-screw complex was significantly stronger when the screw was placed in soft cement and the cement was allowed to polymerize without further manipulation. When screw fixation in osteoporotic bone was reinforced with cement, the bone was the weakest component in the system. Fixation under these conditions should be enhanced by increasing the area of contact between the cement and bone. By cooling the cement to prolong its working time, it could be injected with a syringe in such a way that maximum endosteal and periosteal contact was provided. PMID:1150708

  3. Lumbar pedicle cortical bone trajectory screw

    Institute of Scientific and Technical Information of China (English)

    Song Tengfei; Wellington K Hsu; Ye Tianwen

    2014-01-01

    Objective The purpose of this study was to demonstrate the lumbar pedicle cortical bone trajectory (CBT) screw fixation technique,a new fixation technique for lumbar surgery.Data sources The data analyzed in this review are mainly from articles reported in PubMed published from 1994 to 2014.Study selection Original articles and critical reviews relevant to CBT technique and lumbar pedicle fixation were selected.Results CBT technique was firstly introduced as a new fixation method for lumbar pedicle surgery in 2009.The concepts,morphometric study,biomechanical characteristics and clinical applications of CBT technique were reviewed.The insertional point of CBT screw is located at the lateral point of the pars interarticularis,and its trajectory follows a caudocephalad path sagittally and a laterally directed path in the transverse plane.CBT technique can be used for posterior fixation during lumbar fusion procedures.This technique is a minimally invasive surgery,which affords better biomechanical stability,fixation strength and surgical safety.Therefore,CBT technique has the greatest benefit in lumbar pedicle surgery for patients with osteoporosis and obesity.Conclusion CBT technique is a better alternative option of lumbar pedicle fixation,especially for patients with osteoporosis and obesity.

  4. Experimental determination of bone cortex holding power of orthopedic screw

    Directory of Open Access Journals (Sweden)

    Bolliger Neto Raul

    1999-01-01

    Full Text Available Cylindrical specimens of bone measuring 15 mm in diameter were obtained from the lateral cortical layer of 10 pairs of femurs and tibias. A central hole 3.2 mm in diameter was drilled in each specimen. The hole was tapped, and a 4.5 mm cortical bone screw was inserted from the outer surface. The montage was submitted to push-out testing up to a complete strip of the bone threads. The cortical thickness and rupture load were measured, and the shear stress was calculated. The results were grouped according to the bone segment from which the specimen was obtained. The results showed that bone cortex screw holding power is dependent on the bone site. Additionally, the diaphyseal cortical bone tissue is both quantitatively and qualitatively more resistant to screw extraction than the metaphyseal tissue.

  5. Repair of microdamage in osteonal cortical bone adjacent to bone screw.

    Directory of Open Access Journals (Sweden)

    Lei Wang

    Full Text Available Up to date, little is known about the repair mode of microdamage in osteonal cortical bone resulting from bone screw implantation. In this study, self-tapping titanium cortical bone screws were inserted into the tibial diaphyses of 24 adult male rabbits. The animals were sacrificed at 1 day, 2 weeks, 1 month and 2 months after surgery. Histomorphometric measurement and confocal microscopy were performed on basic fuchsin stained bone sections to examine the morphological characteristics of microdamage, bone resorption activity and spatial relationship between microdamage and bone resorption. Diffuse and linear cracks were coexisted in peri-screw bone. Intracortical bone resorption was significantly increased 2 weeks after screw installation and reach to the maximum at 1 month. There was no significant difference in bone resorption between 1-month and 2-months groups. Microdamage was significantly decreased within 1 month after surgery. Bone resorption was predisposed to occur in the region of <100 µm from the bone-screw interface, where had extensive diffuse damage mixed with linear cracks. Different patterns of resorption cavities appeared in peri-screw bone. These data suggest that 1 the complex microdamage composed of diffuse damage and linear cracks is a strong stimulator for initiating targeted bone remodeling; 2 bone resorption activities taking place on the surfaces of differently oriented Haversian and Volkmann canals work in a team for the repair of extensive microdamage; 3 targeted bone remodeling is a short-term reaction to microdamage and thereby it may not be able to remove all microdamage resulting from bone screw insertion.

  6. Comparison of headless screws used in the treatment of proximal nonunion of scaphoid bone

    OpenAIRE

    Gereli, Arel; Nalbantoglu, Ufuk; Sener, Ismail Ugur; Kocaoglu, Barıs; Turkmen, Metin

    2010-01-01

    Screws with different levels of compression force are available for scaphoid fixation and it is known that the Acutrak screw generates greater compression than the Herbert screw. We retrospectively compared two types of headless compression screw for their effectiveness in the repair of scaphoid nonunion. Twenty-nine cases of proximal scaphoid nonunion were surgically treated with non-vascularised bone graft: the Acutrak screw was used in 17 patients and the cannulated Herbert screw in 12 pat...

  7. Development and Testing of X-Ray Imaging-Enhanced Poly-L-Lactide Bone Screws.

    Directory of Open Access Journals (Sweden)

    Wei-Jen Chang

    Full Text Available Nanosized iron oxide particles exhibit osteogenic and radiopaque properties. Thus, iron oxide (Fe3O4 nanoparticles were incorporated into a biodegradable polymer (poly-L-lactic acid, PLLA to fabricate a composite bone screw. This multifunctional, 3D printable bone screw was detectable on X-ray examination. In this study, mechanical tests including three-point bending and ultimate tensile strength were conducted to evaluate the optimal ratio of iron oxide nanoparticles in the PLLA composite. Both injection molding and 3D printing techniques were used to fabricate the PLLA bone screws with and without the iron oxide nanoparticles. The fabricated screws were implanted into the femoral condyles of New Zealand White rabbits. Bone blocks containing the PLLA screws were resected 2 and 4 weeks after surgery. Histologic examination of the surrounding bone and the radiopacity of the iron-oxide-containing PLLA screws were evaluated. Our results indicated that addition of iron oxide nanoparticles at 30% significantly decreased the ultimate tensile stress properties of the PLLA screws. The screws with 20% iron oxide exhibited strong radiopacity compared to the screws fabricated without the iron oxide nanoparticles. Four weeks after surgery, the average bone volume of the iron oxide PLLA composite screws was significantly greater than that of PLLA screws without iron oxide. These findings suggested that biodegradable and X-ray detectable PLLA bone screws can be produced by incorporation of 20% iron oxide nanoparticles. Furthermore, these screws had significantly greater osteogenic capability than the PLLA screws without iron oxide.

  8. Development and Testing of X-Ray Imaging-Enhanced Poly-L-Lactide Bone Screws.

    Science.gov (United States)

    Chang, Wei-Jen; Pan, Yu-Hwa; Tzeng, Jy-Jiunn; Wu, Ting-Lin; Fong, Tsorng-Harn; Feng, Sheng-Wei; Huang, Haw-Ming

    2015-01-01

    Nanosized iron oxide particles exhibit osteogenic and radiopaque properties. Thus, iron oxide (Fe3O4) nanoparticles were incorporated into a biodegradable polymer (poly-L-lactic acid, PLLA) to fabricate a composite bone screw. This multifunctional, 3D printable bone screw was detectable on X-ray examination. In this study, mechanical tests including three-point bending and ultimate tensile strength were conducted to evaluate the optimal ratio of iron oxide nanoparticles in the PLLA composite. Both injection molding and 3D printing techniques were used to fabricate the PLLA bone screws with and without the iron oxide nanoparticles. The fabricated screws were implanted into the femoral condyles of New Zealand White rabbits. Bone blocks containing the PLLA screws were resected 2 and 4 weeks after surgery. Histologic examination of the surrounding bone and the radiopacity of the iron-oxide-containing PLLA screws were evaluated. Our results indicated that addition of iron oxide nanoparticles at 30% significantly decreased the ultimate tensile stress properties of the PLLA screws. The screws with 20% iron oxide exhibited strong radiopacity compared to the screws fabricated without the iron oxide nanoparticles. Four weeks after surgery, the average bone volume of the iron oxide PLLA composite screws was significantly greater than that of PLLA screws without iron oxide. These findings suggested that biodegradable and X-ray detectable PLLA bone screws can be produced by incorporation of 20% iron oxide nanoparticles. Furthermore, these screws had significantly greater osteogenic capability than the PLLA screws without iron oxide. PMID:26466309

  9. Finite element analysis of osteosynthesis screw fixation in the bone stock: an appropriate method for automatic screw modelling.

    Science.gov (United States)

    Wieding, Jan; Souffrant, Robert; Fritsche, Andreas; Mittelmeier, Wolfram; Bader, Rainer

    2012-01-01

    The use of finite element analysis (FEA) has grown to a more and more important method in the field of biomedical engineering and biomechanics. Although increased computational performance allows new ways to generate more complex biomechanical models, in the area of orthopaedic surgery, solid modelling of screws and drill holes represent a limitation of their use for individual cases and an increase of computational costs. To cope with these requirements, different methods for numerical screw modelling have therefore been investigated to improve its application diversity. Exemplarily, fixation was performed for stabilization of a large segmental femoral bone defect by an osteosynthesis plate. Three different numerical modelling techniques for implant fixation were used in this study, i.e. without screw modelling, screws as solid elements as well as screws as structural elements. The latter one offers the possibility to implement automatically generated screws with variable geometry on arbitrary FE models. Structural screws were parametrically generated by a Python script for the automatic generation in the FE-software Abaqus/CAE on both a tetrahedral and a hexahedral meshed femur. Accuracy of the FE models was confirmed by experimental testing using a composite femur with a segmental defect and an identical osteosynthesis plate for primary stabilisation with titanium screws. Both deflection of the femoral head and the gap alteration were measured with an optical measuring system with an accuracy of approximately 3 µm. For both screw modelling techniques a sufficient correlation of approximately 95% between numerical and experimental analysis was found. Furthermore, using structural elements for screw modelling the computational time could be reduced by 85% using hexahedral elements instead of tetrahedral elements for femur meshing. The automatically generated screw modelling offers a realistic simulation of the osteosynthesis fixation with screws in the adjacent

  10. Finite element analysis of osteosynthesis screw fixation in the bone stock: an appropriate method for automatic screw modelling.

    Directory of Open Access Journals (Sweden)

    Jan Wieding

    Full Text Available The use of finite element analysis (FEA has grown to a more and more important method in the field of biomedical engineering and biomechanics. Although increased computational performance allows new ways to generate more complex biomechanical models, in the area of orthopaedic surgery, solid modelling of screws and drill holes represent a limitation of their use for individual cases and an increase of computational costs. To cope with these requirements, different methods for numerical screw modelling have therefore been investigated to improve its application diversity. Exemplarily, fixation was performed for stabilization of a large segmental femoral bone defect by an osteosynthesis plate. Three different numerical modelling techniques for implant fixation were used in this study, i.e. without screw modelling, screws as solid elements as well as screws as structural elements. The latter one offers the possibility to implement automatically generated screws with variable geometry on arbitrary FE models. Structural screws were parametrically generated by a Python script for the automatic generation in the FE-software Abaqus/CAE on both a tetrahedral and a hexahedral meshed femur. Accuracy of the FE models was confirmed by experimental testing using a composite femur with a segmental defect and an identical osteosynthesis plate for primary stabilisation with titanium screws. Both deflection of the femoral head and the gap alteration were measured with an optical measuring system with an accuracy of approximately 3 µm. For both screw modelling techniques a sufficient correlation of approximately 95% between numerical and experimental analysis was found. Furthermore, using structural elements for screw modelling the computational time could be reduced by 85% using hexahedral elements instead of tetrahedral elements for femur meshing. The automatically generated screw modelling offers a realistic simulation of the osteosynthesis fixation with

  11. The use of bovine screws to promote bone formation using a tibia model in dogs

    Science.gov (United States)

    Bianchini, Marco Aurélio; Pontual, Marco Antônio B; Bez, Leonardo; Benfatti, César Augusto M; Boabaid, Fernanda; Somerman, Martha J; Magini, Ricardo S

    2013-01-01

    The objective of this study was to evaluate the use of a unique resorbable bovine bone screw, to stimulate bone formation. Bovine bone screws were inserted in the tibia beagle dogs. Each animal received 8 screws, divided into Groups A (screws + no membranes), B (screws + titanium reinforced membranes) and C (bone defects treated with autogenous bone grafts). Animals were sacrificed at 2, 4 and 6 months. New bone was measured with a periodontal probe and reported an average of 7.4 mm in vertical bone gain for Group B, 3.6 mm for Group A and 1.7 mm for Group C. Submission to Kruskal-Wallis test showed statistical differences between groups (p<0,05). Histological examination revealed an intimate contact between the newly formed bone and the resorbing bone screws. Conclusion: Bovine bone screws provide environment for new bone formation and thus may provide an alternative therapy for enhancing bone formation vertically, including for regenerative procedures as well as prior to implant therapy. PMID:23058228

  12. Hollow-Bone-Graft Dynamic Hip Screw Can Fix and Promote Bone Union after Femoral Neck Fracture: an Experimental Research

    OpenAIRE

    SHEN, Jia-zuo; YAO, Jian-fei; LIN, Da-sheng; Lian, Ke-jian; Ding, Zhen-qi; Lin, Bin; GUO, Zhi-min; Zhang, Ming-Hua; Li, Qiang; LI, Lin; Qi, Peng

    2012-01-01

    Background: Delayed bone union, nonunion or osteonecrosis often occur after femoral neck fractures in young adults. Secondary bone healing requires strong internal fixation, intramedullary pressure reduction and early functional exercise. Objective: To compare bone healing of femoral neck fractures treated with hollow-bone-graft dynamic hip screws (Hb-DHS) and standard dynamic hip screws (DHS) in an animal model. Design: Testing of specifically designed fixation devices in a pig animal model....

  13. Hollow-Bone-Graft Dynamic Hip Screw Can Fix and Promote Bone Union after Femoral Neck Fracture: an Experimental Research

    OpenAIRE

    Jia-zuo SHEN, Jian-fei YAO, Da-sheng LIN, Ke-jian LIAN, Zhen-qi DING, Bin LIN, Zhi-min GUO, Ming-hua ZHANG, Qiang LI, Lin LI, Peng QI

    2012-01-01

    Background: Delayed bone union, nonunion or osteonecrosis often occur after femoral neck fractures in young adults. Secondary bone healing requires strong internal fixation, intramedullary pressure reduction and early functional exercise.Objective: To compare bone healing of femoral neck fractures treated with hollow-bone-graft dynamic hip screws (Hb-DHS) and standard dynamic hip screws (DHS) in an animal model.Design: Testing of specifically designed fixation devices in a pig animal model.In...

  14. Effects of bone materials on the screw pull-out strength in human spine.

    Science.gov (United States)

    Zhang, Qing Hang; Tan, Soon Huat; Chou, Siaw Meng

    2006-10-01

    A three-dimensional finite element model simulating the threaded connections including detailed helix curve for the bone and surgical screw was constructed. Validation of the FE model was conducted by comparing the predicted screw pull-out strength in different foam materials against experimental study. The FE model was then further analyzed to investigate the interaction of bone material and purchase length on the screw pull-out strength. The results show that failure of the connection was due to bone shearing which occurred along a cylindrical surface determined by the outer perimeter of the screw. The cortical shell resists around 50% of the pull-out strength for a screw of 4mm in major diameter and 22 mm in length. The effects of purchase length on the pull-out strength were different for different bone material. It is the bone material that determines the stability of the inserted surgical screw. The significance of the purchase length on the pull-out strength of cortical screw will be much lower than that in cancellous bone screw. PMID:16414303

  15. Augmentation of screw fixation with injectable calcium sulfate bone cement in ovariectomized rats.

    Science.gov (United States)

    Yu, Xiao-Wei; Xie, Xin-Hui; Yu, Zhi-Feng; Tang, Ting-Ting

    2009-04-01

    The objective of this study was to determine the effect of augmenting screw fixation with an injectable calcium sulfate cement (CSC) in the osteoporotic bone of ovariectomized rats. The influence of the calcium sulfate (CS) on bone remodeling and screw anchorage in osteoporotic cancellous bone was systematically investigated using histomorphometric and biomechanical analyses. The femoral condyles of 55 Sprague-Dawley ovariectomized rats were implanted with screw augmented with CS, while the contralateral limb received a nonaugmented screw. At time intervals of 2, 4, 8, 12, and 16 weeks, 11 rats were euthanized. Six pair-matched samples were used for histological analysis, while five pair-matched samples were preserved for biomechanical testing. Histomorphometric data showed that CS augmented screws activated cancellous bone formation, evidenced by a statistically higher (p < 0.05) percentage of osteoid surface at 2, 4, and 8 weeks and a higher rate of bone mineral apposition at 12 weeks compared with nonaugmented screws. The amount of the bone-screw contact at 2, 8, and 12 weeks and of bone ingrowth on the threads at 4 and 8 weeks was greater in the CS group than in the nonaugmented group (p < 0.05), although these parameters increased concomitantly with time for both groups. The CS was resorbed completely at 8 weeks without stimulating fibrous encapsulation on the screw surface. Also, the cement significantly increased the screw pull-out force and the energy to failure at 2, 4, 8, and 12 weeks after implantation, when compared with the control group (p < 0.05). These results imply that augmentation of screw fixation with CS may have the potential to decrease the risk of implant failure in osteoporotic bone.

  16. Is there enough evidence to regularly apply bone screws for intermaxillary fixation in mandibular fractures?

    NARCIS (Netherlands)

    A. Bins; M.A.E. Oomens; P. Boffano; T. Forouzanfar

    2015-01-01

    Purpose Intermaxillary fixation (IMF) is traditionally achieved with arch bars; however, this method has several well-known disadvantages and other techniques, such as bone screws, are available. This study evaluated current evidence regarding these IMF screws (IMFSs) for mandibular trauma and to as

  17. Biomechanical and finite element analyses of bone cement-Injectable cannulated pedicle screw fixation in osteoporotic bone.

    Science.gov (United States)

    Liu, Yaoyao; Xu, Jianzhong; Sun, Dong; Luo, Fei; Zhang, Zehua; Dai, Fei

    2016-07-01

    The objectives of this study were to investigate the safety and biomechanical stability of a polymethylmethacrylate (PMMA)-augmented bone cement-injectable cannulated pedicle screw (CICPS) in cancellous bone model, and to analyze the stress distribution at the screw-cement-bone interface. The OMEGA cannulated pedicle screw (OPS) and conventional pedicle screw (CPS) were used as control groups. Safety of the CICPS was evaluated by the static bending and bending fatigue tests. Biomechanical stability was analyzed by the maximum axial pullout strength and maximum torque tests. Stress distribution at the screw-cement-bone interface was analyzed by the finite element (FE) method. The CICPS and CPS produced statistically similar values for bending stiffness, bending structural stiffness, and bending yield moment. The maximum pullout force was 53.47 ± 8.65 N in CPS group, compared to 130.82 ± 7.32 N and 175.45 ± 43.01 N in the PMMA-augmented OPS and CICPS groups, respectively (p screw-cement-bone interface in the CICPS group. In conclusion, PMMA-augmentation with CICPS may be a potentially useful method to increase the stability of pedicle screws in patients with osteoporosis. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 960-967, 2016. PMID:25976272

  18. Study of Bone-screw Surface Fixation in Lumbar Dynamic Stabilization

    Directory of Open Access Journals (Sweden)

    Yun-Gang Luo

    2015-01-01

    Full Text Available Background: We aimed to use the animal model of dynamic fixation to examine the interaction of the pedicle screw surface with surrounding bone, and determine whether pedicle screws achieve good mechanical stability in the vertebrae. Methods: Twenty-four goats aged 2-3 years had Cosmic ® pedicle screws implanted into both sides of the L2-L5 pedicles. Twelve goats in the bilateral dynamic fixation group had fixation rods implanted in L2-L3 and L4-L5. Twelve goats in the unilateral dynamic fixation group had fixation rods randomly fixed on one side of the lumbar spine. The side that was not implanted with fixation rods was used as a static control group. Results: In the static control group, new bone was formed around the pedicle screw and on the screw surface. In the unilateral and bilateral dynamic fixation groups, large amounts of connective tissue formed between and around the screw threads, with no new bone formation on the screw surface; the pedicle screws were loose after the fixed rods were removed. The bone mineral density and morphological parameters of the region of interest (ROI in the unilateral and bilateral dynamic fixation group were not significantly different (P > 0.05, but were lower in the fixed groups than the static control group (P 0.05; however the maximum pull force of the fixation groups was significantly less than the static control group (P < 0.01. Conclusions: Fibrous connective tissue formed at the bone-screw interface under unilateral and bilateral pedicle dynamic fixation, and the pedicle screws lost mechanical stability in the vertebrae.

  19. A study of the bone healing kinetics of plateau versus screw root design titanium dental implants.

    LENUS (Irish Health Repository)

    Leonard, Gary

    2009-03-01

    This study was designed to compare the bone healing process around plateau root from (PRF) and screw root from (SRF) titanium dental implants over the immediate 12 week healing period post implant placement.

  20. Micro-CT evaluation and histological analysis of screw-bone interface of expansive pedicle screw in osteoporotic sheep

    Institute of Scientific and Technical Information of China (English)

    WAN Shi-yong; LEI Wei; WU Zi-xiang; L(U) Rong; WANG Jun; FU Suo-chao; LI Bo; ZHAN Ce

    2008-01-01

    To investigate the properties of screwbone interface of expansive pedicle screw(EPS)in osteoporotic sheep by micro-CT and histological observation.Methods:Six female sheep with bilateral ovariectomyinduced osteoporosis were employed in this experiment.After EPS insertion in each femoral condvle, the sheep were randomly divided into two groups:3 sheep were bred for 3 months(Group A),while the other 3 were bred for 6 months(Group B). After the animals being killed,the femoral condyles with EPS were obtained,which were three-dimensionally-imaged and reconstructed by micro-CT. Histological evaluation was made thereafter.Results:The trabecular microstructure was denser at the screw-bone interface than in the distant parts in expansive section,especially within the spiral marking.In the nonexpansive section,however,there was no significant difference between the interface and the distant parts. The regions of interest(ROI)adjacent to EPS were reconstructed and analyzed by micro-CT with the same thresholds. The three-dimensional(3-D)parameters,including tissue mineral density(TMD),bone volume fraction(BVF,BV/TV),bone surface/bone volume(BS/BV) ratio, trabecular thickness(Tb. Th),and trabecular separation(Tb. Sp),were significantly better in expansive sections than non-expansive sections(P<0.05).Histologically,newly-formed bony trabeculae crawled along the expansive fissures and into the center of EPS. The newly-formed bones,as well as the bones at the bone-screw interface,closely contacted with the EPS and constructed four compartments.Conclusions:The findings of the current study,based on micro-CT and histological evaluation, suggest that EPS can significantly provide stabilization in osteoporotic cancellous bones.

  1. Improved Bone Formation in Osteoporotic Rabbits with the Bone Morphogenetic Protein-2 (rhBMP-2) Coated Titanium Screws Which Were Coated By Using Plasma Polymerization Technique

    OpenAIRE

    Salih Gulsen; Dilek Cokeliler; Hilal Goktas; Aysu Kucukturhan; Bilgehan Ozcil; Hakan Caner

    2014-01-01

    Delaying of bone fusion in osteoporotic patients underwent spinal stabilization surgery leads to screw loosening, and this causes pseudoarticulation, mobility and fibrosis at vertebral segments. To prevent these complications, the screws coated with recombinant bone morphogenetic protein-2 (rhBMP-2) could be used. To verify this hypothesis, we coated 5 Titanium screws with rhBMP-2 using plasma polymerization method, and also used 10 uncoated screws for making comparison between coated and unc...

  2. In vivo study of extracellular matrix coating enhancing fixation of the pedicle screw-bone's interface

    Institute of Scientific and Technical Information of China (English)

    LIU Guo-min; ZHANG Xing-yi; XU Chuan-jie; ZHU Xiao-min; WANG Jun; LIU Yi

    2011-01-01

    Background Based on in vivo research on the effect of the coating of the extracellular matrix composition of pedicle screws on the conduction and induction of bone formation in young sheep,the aim of this study was to investigate the application of coated pedicle screws in sheep with scoliosis whose spines are under constant development.Methods Four groups of pedicle screws were randomly implanted into bilateral L2-L5 pedicles of 2.5- to 3-month-old sheep.A static experiment was performed on one side and a loading test was performed on the other side by implanting connecting rods at the L2-L3 and L4-L5 segments.The changes in the force on the coated screws and the combination of the surface of the coated screws with the surrounding bone in the growth process of young sheep's spines with aging were observed.After 3 months,the lumbar vertebrae with the screws were removed and examined by micro-CT,histological,and biomechanical analyses.Results Under nonloading conditions,there is bone formation around the surfaces of coated screws.The bone forming on the surface of collagen/chondroitin sulfate/hydroxyapatite coating of pedicle screws is the most,the one of the collagen / chondrcitin sulfate coating and hydroxyapatite coating is followed,and no significant difference between the two groups.In terms of the trabecular bone morphology parameters of the region of interest around the surface of the pedicle screws,such as bone mineral content,bone mineral density,tissue mineral content,tissue bone mineral density,bone volume fraction,and connection density,those associated with collagen/chondroitin sulfate/hydroxyapatite coatings are largest and those unassociated with coatings are smallest.Under nonloading conditions,the pullout strength of the collagen/chondroitin sulfate/hydroxyapatite-coated screws was largest,and that of the uncoated screws was minimal (P <0.01).Under loading conditions,the maximum pullout strength of each group of pedicle screws was less than that

  3. Implicit modeling of screw threads for efficient finite element analysis of complex bone-implant systems.

    Science.gov (United States)

    Inzana, Jason A; Varga, Peter; Windolf, Markus

    2016-06-14

    Finite element analysis is commonly used to assist in the development and evaluation of orthopedic devices. The physics of these models are simplified through approximations that enable more efficient simulations, without compromising the accuracy of the relative comparisons between implant designs or configurations. This study developed and evaluated a technique to approximate the behavior of a finely threaded screw using a smooth cylinder with the threads implicitly represented through interfacial contact conditions. This pseudo-threaded model was calibrated by comparing to simulations that explicitly modeled the thread geometry with frictional contact. A parametric analysis was performed with a single screw-in-bone system, five loading directions, and three Young׳s moduli that span the range of cancellous bone (200, 600, and 1,000MPa). Considering that screw cut-out from cancellous bone is a critical clinical issue in the osteoporotic proximal humerus, the pseudo-threaded model was compared with a bonded interface to examine three different screw configurations in a 3-part proximal humerus fracture across 10 patients. In the single screw-in-bone system, the pseudo-threaded model predicted the screw displacement of the explicitly threaded model with 1-5% difference and estimated the strain distributions and magnitudes more accurately than a bonded interface. Yet, the relative comparisons of implant stability across the three different screw configurations in the proximal humerus were not affected by the modeling choice for the bone-screw interface. Therefore, the bonded interface could serve as a more efficient methodology for making relative comparisons between implants that utilize the same thread profile. PMID:27157243

  4. Study of Bone-screw Surface Fixation in Lumbar Dynamic Stabilization

    Institute of Scientific and Technical Information of China (English)

    Yun-Gang Luo; Tao Yu; Guo-Min Liu; Nan Yang

    2015-01-01

    Background:We aimed to use the animal model of dynamic fixation to examine the interaction of the pedicle screw surface with surrounding bone,and determine whether pedicle screws achieve good mechanical stability in the vertebrae.Methods:Twenty-four goats aged 2-3 years had Cosmic(R) pedicle screws implanted into both sides of the L2-L5 pedicles.Twelve goats in the bilateral dynamic fixation group had fixation rods implanted in L2-L3 and L4-L5.Twelve goats in the unilateral dynamic fixation group had fixation rods randomly fixed on one side of the lumbar spine.The side that was not implanted with fixation rods was used as a static control group.Results:In the static control group,new bone was formed around the pedicle screw and on the screw surface.In the unilateral and bilateral dynamic fixation groups,large amounts of connective tissue formed between and around the screw threads,with no new bone formation on the screw surface; the pedicle screws were loose after the fixed rods were removed.The bone mineral density and morphological parameters of the region of interest (ROI) in the unilateral and bilateral dynamic fixation group were not significantly different (P > 0.05),but were lower in the fixed groups than the static control group (P < 0.05).This showed the description bone of the ROI in the static control group was greater than in the fixation groups.Under loading conditions,the pedicle screw maximum pull force was not significantly different between the bilateral and unilateral dynamic fixation groups (P > 0.05); however the maximum pull force of the fixation groups was significantly less than the static control group (P < 0.01).Conclusions:Fibrous connective tissue formed at the bone-screw interface under unilateral and bilateral pedicle dynamic fixation,and the pedicle screws lost mechanical stability in the vertebrae.

  5. Improved Bone Formation in Osteoporotic Rabbits with the Bone Morphogenetic Protein-2 (rhBMP-2 Coated Titanium Screws Which Were Coated By Using Plasma Polymerization Technique

    Directory of Open Access Journals (Sweden)

    Salih Gulsen

    2014-06-01

    Full Text Available Delaying of bone fusion in osteoporotic patients underwent spinal stabilization surgery leads to screw loosening, and this causes pseudoarticulation, mobility and fibrosis at vertebral segments. To prevent these complications, the screws coated with recombinant bone morphogenetic protein-2 (rhBMP-2 could be used. To verify this hypothesis, we coated 5 Titanium screws with rhBMP-2 using plasma polymerization method, and also used 10 uncoated screws for making comparison between coated and uncoated screws in different groups. And 15 skeletally mature white New Zealand female rabbits were assigned into three different groups: Group 1(N = 5: No osteoporosis induction and insertion of uncoated Titanium screw into right sacrum of each rabbit in group 1; group 2 (N = 5: Osteoporosis induction and insertion of uncoated Titanium screw into right sacrum of each rabbit in group 2; group 3 (N = 5 rhBMP-2 coated Titanium screw inserted into right sacrum of each rabbit in group 3. In summary, using of these coated screws provides new bone formation, but causes less fibrosis and less inflammation than uncoated screws at the interface between the coated screw and bone. Then the plasma polymerization technique provides controlled releasing of rhBMP-2 from the screw to the bone tissue in osteoporotic rabbits.

  6. Biomechanical competence of six different bone screws for reconstructive surgery in three different transplants: Fibular, iliac crest, scapular and artificial bone.

    Science.gov (United States)

    Pietsch, Arnold P; Raith, Stefan; Ode, Jan-Eric; Teichmann, Jan; Lethaus, Bernd; Möhlhenrich, Stephan C; Hölzle, Frank; Duda, Georg N; Steiner, Timm

    2016-06-01

    The goal of this study was to determine a combination of screw and transplantation type that offers optimal primary stability for reconstructive surgery. Fibular, iliac crest, and scapular transplants were tested along with artificial bone substrate. Six different kinds of bone screws (Medartis(©)) were compared, each type utilized with one of six specimens from human transplants (n = 6). Controlled screw-in-tests were performed and the required torque was protocolled. Subsequently, pull-out-tests were executed to determine the retention forces. The artificial bone substitute material showed significantly higher retention forces than real bone samples. The self-drilling screws achieved the significantly highest retention values in the synthetic bone substitute material. Cancellous screws achieved the highest retention in the fibular transplants, while self-drilling and cancellous screws demonstrated better retention than cortical screws in the iliac crest. In the scapular graft, no significant differences were found between the screw types. In comparison to the human transplant types, the cortical screws showed the significantly highest values in the fibula and the lowest values in the iliac crest. The best retention was found in the combination of cancellous screws with fibular graft (514.8 N + -252.3 N). For the flat bones (i.e., scapular and illiac crest) we recommend the cancellous screws. PMID:27107477

  7. Osteosynthesis-screw augmentation by ultrasound-activated biopolymer - an ovine in vivo study assessing biocompatibility and bone-to-implant contact

    OpenAIRE

    Neumann, Hanjo; Breer, Stefan; Reimers, Nils; Kasch, Richard; Schulz, Arndt-Peter; Kienast, Benjamin

    2015-01-01

    Objectives Screw fixation and fragment anchoring in osteoporotic bones is often difficult. Problems like the cut out phenomenon and implant migration in osteoporotic bones have been reported. One possibility of improving the anchoring force of screws is augmentation of the screw. Cement-augmented screws in spinal surgery could exhibit a better anchoring in osteoporotic bones. Methods The purpose of this study was to examine the effect of screw augmentation using a resorbable polymer. Ultrasou...

  8. Treatment of the benign bone tumors including femoral neck lesion using compression hip screw and synthetic bone graft

    OpenAIRE

    Nakamura Tomoki; Matsumine Akihiko; Asanuma Kunihiro; Matsubara Takao; Sudo Akihiro

    2015-01-01

    Purpose: The proximal femur is one of the most common locations for benign bone tumors and tumor like conditions. We describe the clinical outcomes of the surgical treatment of benign lesions of the proximal femur including femoral neck using compression hip screw and synthetic bone graft. Methods: Thirteen patients with benign bone tumors or tumor like conditions of the proximal femur including femoral neck were surgically treated. Their average age at the time of presentatio...

  9. Study of new sheep bone and Zn/Ca ratio around TiAlV screw: PIXE-RBS analysis

    International Nuclear Information System (INIS)

    This study reports on in vivo particle induced X-ray emission (PIXE) measurements combined with Rutherford backscattering spectroscopy (RBS) analyses of new remodeled sheep bone formed around TiAlV screws. The implants (screws) were anodized by a modified TiMaxTM process. The interface between the implant and the bone was carefully investigated. [Zn]/[Ca] in-depth composition profiles as well as Ca, Fe elemental maps were recorded. The thickness of new bone formed around the screw reached 300-400 μm. Osteon and Osteoid phases were identified in the new bone. A higher [Zn]/[Ca] ratio was observed in the new bone as compared to the mature bone. Blood vessels were observed in the bone in close contact with the screw. This study shows the potential of ion beam analysis for biological and biomedical characterization

  10. Degradation behaviour of LAE442-based plate–screw-systems in an in vitro bone model

    Energy Technology Data Exchange (ETDEWEB)

    Wolters, Leonie [Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559 Hannover (Germany); Besdo, Silke [Institute of Continuum Mechanics, Leibniz Universität Hannover, Appelstraße 11, 30167 Hannover (Germany); Angrisani, Nina [Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559 Hannover (Germany); Wriggers, Peter [Institute of Continuum Mechanics, Leibniz Universität Hannover, Appelstraße 11, 30167 Hannover (Germany); Hering, Britta [Institute of Production Engineering and Machine Tools, Leibniz Universität Hannover, An der Universität 2, 30823 Garbsen (Germany); Seitz, Jan-Marten [Institute of Materials Science, Leibniz Universität Hannover, An der Universität 2, 30823 Garbsen (Germany); Reifenrath, Janin, E-mail: janin.reifenrath@tiho-hannover.de [Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559 Hannover (Germany)

    2015-04-01

    The use of absorbable implant materials for fixation after bone fracture helps to avoid a second surgery for implant removal and the risks and costs involved. Magnesium (Mg) is well known as a potential metallic material for degradable implants. The aim of the present in vitro study was to evaluate if degradable LAE442-based magnesium plate–screw-systems are suitable candidates for osteosynthesis implants in load-bearing bones. The corrosion behaviour was tested concerning the influence of different surface treatments, coatings and screw torques. Steel plates and screws of the same size served as control. Plates without special treatment screwed on up to a specified torque of 15 cNm or 7 cNm, NaOH treated plates (15 cNm), magnesium fluoride coated plates (15 cNm) and steel plates as control (15 cNm) were examined in pH-buffered, temperature-controlled SBF solution for two weeks. The experimental results indicate that the LAE442 plates and screws coated with magnesium fluoride revealed a lower hydrogen evolution in SBF solution as well as a lower weight loss and volume decrease in μ-computed tomography (μCT). The nanoindentation and SEM/EDX measurements at several plate areas showed no significant differences. Summarized, the different screw torques did not affect the corrosion behaviour differently. Also the NaOH treatment seemed to have no essential influence on the degradation kinetics. The plates coated with magnesium fluoride showed a decreased corrosion rate. Hence, it is recommended to consider this coating for the next in vivo study. - Highlights: • Mg-based plate screw systems were examined in an in vitro corrosion setup. • Different screw torques did not affect the corrosion behaviour. • Pretreatment with NaOH showed no increase in corrosion resistance. • Fluoride coating slowed down the corrosion rate of plates. • Fluoride coating might be an alternative for decrease of corrosion rate in vivo.

  11. Degradation behaviour of LAE442-based plate–screw-systems in an in vitro bone model

    International Nuclear Information System (INIS)

    The use of absorbable implant materials for fixation after bone fracture helps to avoid a second surgery for implant removal and the risks and costs involved. Magnesium (Mg) is well known as a potential metallic material for degradable implants. The aim of the present in vitro study was to evaluate if degradable LAE442-based magnesium plate–screw-systems are suitable candidates for osteosynthesis implants in load-bearing bones. The corrosion behaviour was tested concerning the influence of different surface treatments, coatings and screw torques. Steel plates and screws of the same size served as control. Plates without special treatment screwed on up to a specified torque of 15 cNm or 7 cNm, NaOH treated plates (15 cNm), magnesium fluoride coated plates (15 cNm) and steel plates as control (15 cNm) were examined in pH-buffered, temperature-controlled SBF solution for two weeks. The experimental results indicate that the LAE442 plates and screws coated with magnesium fluoride revealed a lower hydrogen evolution in SBF solution as well as a lower weight loss and volume decrease in μ-computed tomography (μCT). The nanoindentation and SEM/EDX measurements at several plate areas showed no significant differences. Summarized, the different screw torques did not affect the corrosion behaviour differently. Also the NaOH treatment seemed to have no essential influence on the degradation kinetics. The plates coated with magnesium fluoride showed a decreased corrosion rate. Hence, it is recommended to consider this coating for the next in vivo study. - Highlights: • Mg-based plate screw systems were examined in an in vitro corrosion setup. • Different screw torques did not affect the corrosion behaviour. • Pretreatment with NaOH showed no increase in corrosion resistance. • Fluoride coating slowed down the corrosion rate of plates. • Fluoride coating might be an alternative for decrease of corrosion rate in vivo

  12. In vivo degradation of a new concept of magnesium-based rivet-screws in the minipig mandibular bone.

    Science.gov (United States)

    Schaller, Benoit; Saulacic, Nikola; Beck, Stefan; Imwinkelried, Thomas; Goh, Bee Tin; Nakahara, Ken; Hofstetter, Willy; Iizuka, Tateyuki

    2016-12-01

    Self-tapping of magnesium screws in hard bone may be a challenge due to the limited torsional strength of magnesium alloys in comparison with titanium. To avoid screw failure upon implantation, the new concept of a rivet-screw was applied to a WE43 magnesium alloy. Hollow cylinders with threads on the outside were expanded inside drill holes of minipig mandibles. During the expansion with a hexagonal mandrel, the threads engaged the surrounding bone and the inside of the screw transformed into a hexagonal screw drive to allow further screwing in or out of the implant. The in vivo degradation of the magnesium implants and the performance of the used coating were studied in a human standard-sized animal model. Four magnesium alloy rivet-screws were implanted in each mandible of 12 minipigs. Six animals received the plasmaelectrolytically coated magnesium alloy implants; another six received the uncoated magnesium alloy rivet-screws. Two further animals received one titanium rivet-screw each as control. In vivo radiologic examination was performed at one, four, and eight weeks. Euthanasia was performed for one group of seven animals (three animals with coated, three with uncoated magnesium alloy implants and one with titanium implant) at 12weeks and for the remaining seven animals at 24weeks. After euthanasia, micro-computed tomography and histological examination with histomorphometry were performed. Significantly less void formation as well as higher bone volume density (BV/TV) and bone-implant contact area (BIC) were measured around the coated implants compared to the uncoated ones. The surface coating was effective in delaying degradation despite plastic deformation. The results showed potential for further development of magnesium hollow coated screws for bone fixation. PMID:27612710

  13. Hollow-Bone-Graft Dynamic Hip Screw Can Fix and Promote Bone Union after Femoral Neck Fracture: an Experimental Research

    Directory of Open Access Journals (Sweden)

    Jia-zuo SHEN, Jian-fei YAO, Da-sheng LIN, Ke-jian LIAN, Zhen-qi DING, Bin LIN, Zhi-min GUO, Ming-hua ZHANG, Qiang LI, Lin LI, Peng QI

    2012-01-01

    Full Text Available Background: Delayed bone union, nonunion or osteonecrosis often occur after femoral neck fractures in young adults. Secondary bone healing requires strong internal fixation, intramedullary pressure reduction and early functional exercise.Objective: To compare bone healing of femoral neck fractures treated with hollow-bone-graft dynamic hip screws (Hb-DHS and standard dynamic hip screws (DHS in an animal model.Design: Testing of specifically designed fixation devices in a pig animal model.Interventions/Methods: We designed Hb-DHS and DHS devices appropriate to the femoral neck and head of experimental animals and used them in eight pigs (4-month-old, male or female, 30-40 kg/each. Under anesthesia, we induced medium neck type, Garden III type femoral neck fractures in each pig with fracture gaps of 0.5 mm and then fixed each left femur with Hb-DHS and each right femur with DHS. We assessed the animals radiographically and by postmortem visual appraisal of evidence of bone healing 8 and 16 weeks postoperatively.Results: There were significant differences in radiographic and general findings between the Hb-DHS and DHS groups at weeks 8 and 16 postoperatively. We found statistically significant differences between the Hb-DHS and DHS groups in bone healing scores, trabecular bone volume percentage and bone mineral density as assessed on plain radiographs and computed tomography images (P < 0.05. There were also significant differences between the Hb-DHS and DHS groups in postmortem visually assessed indicators of bone healing at both 8 and 16 weeks postoperatively.Conclusions: The Hb-DHS device promotes femoral neck bone union, stimulates trabecular bone formation, increases BMD and has advantages over DHS for internal fixation of femoral neck fractures. This animal experiment will contribute to developing optimal treatment for femoral neck fractures in young adults.

  14. TREATMENT OF SCAPHOID NONUNION WITH OLECRANON BONE GRAFT AND COMPRESSION SCREW

    Science.gov (United States)

    NEDER, ANTONIO TUFI; FRANCESCHINI, EDUARDO TRALDI; PARDINI, ARLINDO GOMES; RIBERTO, MARCELO; MAZZER, NILTON

    2016-01-01

    ABSTRACT Objective: To evaluate the outcome of olecranon bone graft and compression screw for the treatment of nonunion of the Lichtman type I scaphoid. Method: We evaluated 15 patients of 32 who underwent surgical treatment for nonunion of the Lichtman type I scaphoid with olecranon bone graft and screw compression. Results: We obtained 100% consolidation in our sample. The mean flexion of the wrist on the affected side was 68° and 75° on the non-affected side. The average extension was 63° and 72°, respectively. The average grip strength was 35 kgf. This corresponds to 98% of the handgrip strength of the non-affected side, which was 37 kgf. The DASH score averaged 5 points. Conclusion: We believe that the use of bone graft obtained from the olecranon and secured with cannulated screw is a resolute technique for cases of linear nonunion of the Lichtmann type I scaphoid. It has the advantages of a new anesthesia for removal of the graft and the access is easy, providing a good exposure for removal and good aesthetic results. Level of evidence IV. Case series. PMID:27217819

  15. Posterior lumbar inter-body fusion (PLIF) using autogenous bone and cage with pedicle screw instrumentation versus PLIF using cage with pedicle screw instrumentation in adult spondylolisthesis

    Institute of Scientific and Technical Information of China (English)

    Dou Yusheng; Hao Dingjun; Wen Shiming

    2005-01-01

    Objective: To compare the clinical outcomes of PLIF using autogenous bone and cage with pedicle screw fixation (group 2) and simple cage fusion with pedicle screw fixation (group 1) in adult spondylolisthesis.Methods: 27 patients with minimum follow-up of 24 months, treated by inter-body fusion with pedicle screw fixation were prospectively studied. Disc space height, degree of slippage and fusion rate had been compared before and after operation between the two groups. Results: After minimum 24 month's follow-up, there was no significant difference between the two groups in terms of the amount of blood loss, duration of hospital stay, back pain,radiating pain, fusion rate, or complication (P>0.05). however, there was a significant difference between the two groups in terms of disc space height and percentage of slippage (P<0.05). Conclusion: PLIF using autogenous bone and cage with pedicle screw fixation more beneifical to improve fusion rate and prevent long-term instabilities than simple cage fusion with pedicle screw fixation in adult spondylolisthesis.

  16. Biomechanical analysis of different types of pedicle screw augmentation: a cadaveric and synthetic bone sample study of instrumented vertebral specimens.

    Science.gov (United States)

    Chao, Kuo-Hua; Lai, Yu-Shu; Chen, Wen-Chuan; Chang, Chia-Ming; McClean, Colin J; Fan, Chang-Yuan; Chang, Chia-Hao; Lin, Leou-Chyr; Cheng, Cheng-Kung

    2013-10-01

    This study aims to determine the pull-out strength, stiffness and failure pull-out energy of cement-augmented, cannulated-fenestrated pedicle screws in an osteoporotic cadaveric thoracolumbar model, and to determine, using synthetic bone samples, the extraction torques of screws pre-filled with cement and those with cement injected through perforations. Radiographs and bone mineral density measurements from 32 fresh thoracolumbar vertebrae were used to define specimen quality. Axial pull-out strength of screws was determined through mechanical testing. Mechanical pull-out strength, stiffness and energy-to-failure ratio were recorded for cement-augmented and non-cement-augmented screws. Synthetic bone simulating a human spinal bone with severe osteoporosis was used to measure the maximum extraction torque. The pull-out strength and stiffness-to-failure ratio of cement pre-filled and cement-injected screws were significantly higher than the non-cement-augmented control group. However, the cement pre-filled and cement-injected groups did not differ significantly across these values (p=0.07). The cement pre-filled group had the highest failure pull-out energy, approximately 2.8 times greater than that of the cement-injected (pcement-injected group had a greater maximum extraction torque than the cement pre-filled group, but was statistically insignificant (p=0.17). The initial fixation strength of cannulated screws pre-filled with cement is similar to that of cannulated screws injected with cement through perforations. This comparable strength, along with the heightened pull-out energy and reduced extraction torque, indicates that pedicle screws pre-filled with cement are superior for bone fixation over pedicle screws injected with cement. PMID:23669371

  17. Hybrid technique of cortical bone trajectory and pedicle screwing for minimally invasive spine reconstruction surgery : A technical note

    OpenAIRE

    Takata, Yoichiro; Matsuura, Tetsuya; Higashino, Kosaku; Sakai, Toshinori; Mishiro, Takuya; Suzue, Naoto; Kosaka, Hirofumi; Hamada, Daisuke; Goto, Tomohiro; Nishisho, Toshihiko; Goda, Yuichiro; Sato, Ryosuke(Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Oho, Tsukuba, 305-0801, Japan); Tsutsui, Takahiko; Tonogai, Ichiro; Tezuka, Fumitake

    2014-01-01

    The pedicle screw (PS) system is widely used for spinal reconstruction. Recently, screw insertion using the cortical bone trajectory (CBT) technique has been reported to provide increased holding strength of the vertebra, even in an osteoporotic spine. CBT is also beneficial due to its low invasiveness. We have been performing hybrid reconstruction with CBT at the cranial level and PS at the caudal level based on the concept of minimal invasiveness. We applied this hybrid technique to 6 cases...

  18. Estudo histomorfométrico da interface óssea do parafuso expansor cervical Histomorphometric analysis of bone-screw interface of expansive cervical screw

    Directory of Open Access Journals (Sweden)

    Leandro Sérgio da Silva

    2008-03-01

    experimental study for the Histomorphometric analysis of the bone interface of expansive screws used in the anterior cervical spine fixation system. METHODS: Five sheep cervical vertebrae (C4 were used in the study, in which screws were inserted. The 18.5 mm long and 5.0 mm outer diameter expansive screws (Ulrich were inserted in both sides of the C4 vertebra. On the left side, the screw was inserted without the internal expansive screw, which was used on the right side. A pilot hole was made on the lower portion of the vertebra with a 2.5 mm bore, but no implant was introduced. The vertebral region containing the screws and the pilot hole was prepared for a histological study of the interface between implants and bone screws, and of the pilot hole wall. Histomorphometric analysis evaluated total bone density, external bone density (outside the screw thread, internal density (inside the screw thread and the linear measurement of the contact between bone tissue and the implant. RESULTS: Total bone density was greater in group I (expansive screw as compared to group III (control. External bone density was greater in groups I (expansive screw and II (non-expansive screw when compared to group III. Internal bone density was greater in group I when compared to groups II and III, and greater in group II when compared to group III. Linear contact was greater in group I when compared to groups II and III. CONCLUSION: structural changes around expansive screws detected immediately after their application provide subsidies for a better understanding of the greater tearing resistance of the implant, which could be related to the compacting of cancellous bone around the implant, while providing a larger contact area between the implant and the bone tissue.

  19. When Planning Screw Fracture Fixation Why the 5.5 mm Screw is the Goldilocks Screw. An Observational Computer Tomographic Study of Fifth Metatarsal Bone Anatomy in a Sample of Patients.

    Science.gov (United States)

    Iselin, Lukas D; Ramawat, Sunil; Hanratty, Brian; Klammer, Georg; Stavrou, Peter

    2015-05-01

    We wanted to verify our clinical experience that the 5.5 mm screw was ideal in the majority of fifth metatarsal fracture fixation. The size of a screw is important for the successful surgical treatment of these fractures in order to obtain the maximal stability while reducing the risk for iatrogenic fracture.A sample of patients undergoing computer tomographic imaging of the foot for investigation other than fifth metatarsal pathology were recruited. The parameters of the fifth metatarsal bone anatomy were measured.These parameters of the 5.5 mm screw were correlated with this data. The upper parameter (the diameter of the threads) was 5.5 and the lower parameter (the diameter of the shank) was 4.0 mm.Twenty seven patients were recruited.The proximal third internal diameter ranged from 3.6 to 7.0 mm with a mean of 5.0 mm. 93% of the metatarsals could easily accommodate the 5.5 mm screw. Two of the metatarsals had an internal diameter of < 4 mm (7%).It is our belief that the 5.5 mm screw may be used safely in the majority of patients with fifth metatarsal fractures.

  20. Biomechanical Comparison Between Bashti Bone Plug Technique and Biodegradable Screw for Fixation of Grafts in Ligament surgery

    Directory of Open Access Journals (Sweden)

    Kaveh Bashti

    2015-01-01

    Full Text Available   Background: Ligament reconstruction is a common procedure in orthopedic surgery. Although several popular techniques are currently in use, new methods are proposed for secure fixation of the tendon graft into the bone tunnel. Purposes: We sought to introduce our new technique of Bashti bone plug for fixation of soft tissue graft in anterior cruciate ligament (ACL reconstruction and to compare its biomechanical features with conventional absorbable interference screw technique in a bovine model. Methods: Twenty pairs of bovine knees were harvested after death. Soft tissue was removed and the Achilles tendon was harvested to be used as an ACL graft. It was secured into the bone tunnel on the tibial side via two different methods: Bashti Bone Plug technique and conventional screw method. Biomechanical strength was measured using 200 N and 300 N cyclic loading on the graft. Pull out strength was also tested until the graft fails. Results: No graft failure was observed after 200 N and 300 N cyclic loading in either fixation methods. When testing for pull out failure, 21 tendons (53% were torn and 19 tendons (48% slipped out. No fixation failure occurred, which did not reveal a significant difference between the bone plug or interference screw group (P=0.11. The mean pull out force until failure of the graft was 496±66 N in the screw group and 503±67 N in the bone plug group (P=0.76. Conclusions: Our suggested fixation technique of Bashti bone plug is a native, cheap, and feasible method that provides comparable biomechanical strength with interference screw when soft tissue fixation was attempted in bovine model.

  1. Bone cement enhanced pedicle screw fixation combined with vertebroplasty for elderly patients with malignant spinal tumors

    Institute of Scientific and Technical Information of China (English)

    TAN Jiang-wei; SHEN Bing-hua; DU Wei; LIU Jiang-qing; LU Shi-qiao

    2013-01-01

    Background Older patients with malignant spinal tumors are difficult to treat because they have many co-morbidities including osteoporosis.The purpose of this research is to discuss the technique and clinical outcome of bone cement enhanced pedicle screw fixation combined with vertebroplasty (the Sandwich Procedure) for elderly patients with severe osteoporosis and malignant spinal tumors.Methods This study includes 28 consecutive elderly patients with malignant thoracic or lumbar spinal tumors.There were nine patients with myelomas,and 19 patients with metastatic bone tumors.The Sandwich Procedure began with curettage of the tumor and a vertebroplasty with bone cement (polymethyl methacrylate,PMMA),followed by PMMA enhanced pedicle screw fixation.Patients were evaluated with the visual analogue scale (VAS),oswestry disability index (ODI),American Spinal Cord Injury Association (ASIA) neurological function classification,and the radiographic degree of kyphosis (Cobb angle).Data were analyzed using paired t-test to compare the pre-and post-operative values.The complications,local recurrences,and the survival status were also recorded.Results There was no operative mortality,and the mean operative time was 210 minutes (range 150-250 minutes).The average blood loss was 1550 ml (range 650-3300 ml).The average amount of cement for vertebroplasty was 3.6 ml (range 3-5 ml).The VAS,ODI,and ASIA scores were significantly improved after surgery (P <0.05).However,we found no differences between the pre and post-operative Cobb angles.The shortest survival time was 3 months,and we found no evidence of local recurrence in this group of patients.Conclusion The Sandwich Procedure is a safe operation and provides symptomatic relief in these difficult patients,permitting further treatment with chemotherapy or radiotherapy.

  2. Biomechanical Comparison Between Bashti Bone Plug Technique and Biodegradable Screw for Fixation of Grafts in Ligament surgery

    OpenAIRE

    Kaveh Bashti; Mohammad Naghi Tahmasebi; Hasan Kaseb; Farzam Farahmand; Mohammad Akbar; Amir Mobini

    2015-01-01

      Background: Ligament reconstruction is a common procedure in orthopedic surgery. Although several popular techniques are currently in use, new methods are proposed for secure fixation of the tendon graft into the bone tunnel. Purposes: We sought to introduce our new technique of Bashti bone plug for fixation of soft tissue graft in anterior cruciate ligament (ACL) reconstruction and to compare its biomechanical features with conventional absorbable interference screw technique in a bovine ...

  3. Accuracy of bone SPECT/CT for identifying hardware loosening in patients who underwent lumbar fusion with pedicle screws

    Energy Technology Data Exchange (ETDEWEB)

    Hudyana, Hendrah; Maes, Alex [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); University Hospital Leuven, Department of Morphology and Medical Imaging, Leuven (Belgium); Vandenberghe, Thierry; Fidlers, Luc [AZ Groeninge, Department of Neurosurgery, Kortrijk (Belgium); Sathekge, Mike [University of Pretoria, Department of Nuclear Medicine, Pretoria (South Africa); Nicolai, Daniel [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); Wiele, Christophe van de [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); University Ghent, Department of Radiology and Nuclear Medicine, Ghent (Belgium)

    2016-02-15

    The aim of this retrospective study was to evaluate the accuracy of bone SPECT (single photon emission computed tomography)/CT (computed tomography) in diagnosing loosening of fixation material in patients with recurrent or persistent back pain that underwent lumbar arthrodesis with pedicle screws using surgery and clinical follow-up as gold standard A total of 48 patients (median age 49 years, range 21-81 years; 17 men) who had undergone lumbar spinal arthrodesis were included in this retrospective analysis. SPECT/CT results were compared to the gold standard of surgical evaluation or clinical follow-up. Positive SPECT/CT results were considered true positives if findings were confirmed by surgery or if clinical and other examinations were completely consistent with the positive SPECT/CT finding. They were considered false positives if surgical evaluation did not find any loose pedicle screws or if symptoms subsided with non-surgical therapy. Negative SPECT/CT scans were considered true negatives if symptoms either improved without surgical intervention or remained stable over a minimum follow-up period of 6 months. Negative SPECT/CT scans were determined to be false negatives if surgery was still required and loosening of material was found. The median length of time from primary surgery to bone SPECT/CT referral was 29.5 months (range 12-192 months). Median follow-up was 18 months (range 6-57) for subjects who did not undergo surgery. Thirteen of the 48 patients were found to be positive for loosening on bone SPECT/CT. Surgical evaluation (8 patients) and clinical follow-up (5 patients) showed that bone SPECT/CT correctly predicted loosening in 9 of 13 patients, while it falsely diagnosed loosening in 4 patients. Of 35 negative bone SPECT/CT scans, 12 were surgically confirmed. In 18 patients, bone SPECT/CT revealed lesions that could provide an alternative explanation for the symptoms of pain (active facet degeneration in 14 patients, and disc and sacroiliac

  4. EVALUATION OF POSTERIOR SPINAL FUSION WITH PEDICLE SCREWS AND RODS WITH BONE SUBSTITUTES IN GRADE I AND II SPONDYLOLISTHESIS

    Directory of Open Access Journals (Sweden)

    Chaitanya Reddy

    2016-04-01

    Full Text Available BACKGROUND Low-back pain is the commonest condition encountered day in and day out of an orthopaedic practice. Incidence of spondylolisthesis in normal population is around 5-7%. No matter what the aetiology is, patient has significant functional disability. OBJECTIVES To study the efficacy of pedicular screw rod system and posterolateral fusion with bone substitutes in spondylolisthesis, and to study the complications associated with this treatment modality. METHODOLOGY From July 2012 to September 2014, a total of 30 patients operated with posterolateral fusion were followed up and evaluated based on VAS for low back pain and Japanese orthopaedic association scoring system. RESULTS The mean difference between pre-operative and post-operative VAS score is 3SD with a p value of <0.001, which is strongly significant. The pre-operative and post-operative JOA score has an improvement of 73.4% with a p value of <0.001, which is strongly significant. Rate of improvement was excellent in 16.7%, good in 53.3%, fair in 23.3% and poor in 6.3% of patients; 82% of patients had bone fusion by the end of 8 months. CONCLUSION Pedicular screw rod system with postero-lumbar fusion with bone substitute is safe, promising and appealing technique for low-grade spondylolisthesis with early post-operative pain relief.

  5. Poly(L-lactide) bone plates and screws for internal fixation of mandibular swing osteotomies

    NARCIS (Netherlands)

    Tams, J; Rozema, FR; Bos, RRM; Roodenburg, JLN; Nikkels, PGJ; Vermey, A

    1996-01-01

    This study evaluated bone healing after mandibular swing osteotomies fixed with biodegradable poly(L-lactide) (PLLA) bone plates in four patients. A step osteotomy treated with two PLLA bone plates (n=3), and a straight osteotomy treated with one PLLA bone plate (n=1) were performed. Bone healing wa

  6. Treatment of Thoracolumbar Vertebrate Fracture by Transpedicular Morselized Bone Grafting in Vertebrae for Spinal Fusion and Pedicle Screw Fixation

    Institute of Scientific and Technical Information of China (English)

    Jinguo WANG; Hua WU; Xiaolin DING; Yutian LIU

    2008-01-01

    To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction, short-segment pedicle screw fixation was reinforced with posterior moselizee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures. Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups. Fractures in group A (n=20) were reinforced with posterior morselized bone grafting in vertebrae for spinal fusion, while patients group B (n=50) did not receive the morselized bone grafting for bone fusion. The two groups were compared in terms of kyphotic deformity, anterior vertebral height, instrument failure and neurological functions after the treatment. Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment. The results showed that the kyphosis correction was achieved in both group A and group B (group A: 6.4 degree; group B: 5.4 degree)/At the end of follow-up, kyphosis correction was maintained in group A but lost in group B (P=0.0001). Postoperatively, greater anterior height was achieved in group A than in group B (P<0.01). During follow-up study, anterior vertebral height was maintained only in Group A (P<0.001). Both group A and group B showed good Denis pain scores (P1 and P2) but group A outdid group B in terms of control of severe and constant pain (P4 and P5). By Frankel criteria, the changes in neurological functions in group A was better than those of group B (P<0.001). It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Morselized bone grafting in vertebrae offers immediate spinal stability in patients with

  7. Surgical treatment of the osteoporotic spine with bone cement-injectable cannulated pedicle screw fixation: technical description and preliminary application in 43 patients

    Directory of Open Access Journals (Sweden)

    Fei Dai

    2015-02-01

    Full Text Available OBJECTIVES: To describe a new approach for the application of polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws. METHODS: Between June 2010 and February 2013, 43 patients with degenerative spinal disease and osteoporosis (T-score <-2.5 underwent lumbar fusion using cement-injectable cannulated pedicle screws. Clinical outcomes were evaluated using a Visual Analog Scale and the Oswestry Disability Index. Patients were given radiographic follow-up examinations after 3, 6, and 12 months and once per year thereafter. RESULTS: All patients were followed for a mean of 15.7±5.6 months (range, 6 to 35 months. The Visual Analog Scale and Oswestry Disability Index scores showed a significant reduction in back pain (p = 0.018 and an improvement in lower extremity function (p = 0.025 in patients who underwent lumbar fusion using the novel screw. Intraoperative cement leakage occurred in four patients, but no neurological complications were observed. Radiological observation indicated no loosening or pulling out of the novel screw, and bone fusion was excellent. CONCLUSIONS: The described polymethylmethacrylate augmentation technique using bone cement-injectable cannulated pedicle screws can reduce pain and improve spinal dysfunction in osteoporotic patients undergoing osteoporotic spine surgery.

  8. Femoral tunnel-interference screw divergence in anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft: A comparison of two techniques

    Directory of Open Access Journals (Sweden)

    Vivek Pandey

    2011-01-01

    Conclusion: Femoral interference screw placement through the PT portal leads to significantly less screw divergence as compared with screw placement through the AM portal. However, this difference in divergence is not reflected in clinical outcome.

  9. 骨水泥加固椎弓根螺钉的生物力学特性%Biomechanical properties of bone cement injectable canulated pedicle screw

    Institute of Scientific and Technical Information of China (English)

    隆海滨; 孙桂森; 王卫国

    2015-01-01

    BACKGROUND:Bony and structural feature often cause pulout strength decrease of pedicle screw, which induces loosening and pulout, and finaly results in fixation failure. Thus, it is very important to elevate the stability of pedicle screw. OBJECTIVE:To detect the biomechanical stability of bone cement injectable canulated pedicle screw, and to provide reference for bone cement dosage. METHODS: We selected T11-L4 samples of seven fresh adult corpses, containing 40 vertebral bodies. They were randomly divided into bone cement injectable canulated pedicle screw group and DTPSTM pedicle screw group (n=20). After screw implantation, 1, 2, 3 and 5 mL bone cement was injected. The diffuse distribution of bone cement was observed by imaging. The maximum axial pulout strength was measured. RESULTS AND CONCLUSION:When the dose of bone cement was 1-3 mL, the average maximum axial pulout strength was significantly greater in the bone cement injectable canulated pedicle screw group than in the DTPSTM pedicle screw group (P 0.05). The regression equation was Y=25.269X+133.681 (R2=0.837) in the bone cement injectable canulated pedicle screw, and Y=32.039X+99.251 (R2=0.936) in the DTPSTM pedicle screw group. When the dosage of bone cement was 1-5 mL, the maximum axial pulout strength was highly positively correlated with bone cement dosage (|R| > 0.8). These results suggested that bone cement augmentation pedicle screw could apparently elevate the stability of the screw. The maximum axial pulout strength of the pedicle screw was positively correlated with bone cement dosage. After reaching the satisfactory fixation effects, the bone cement injectable canulated pedicle screw can reduce bone cement dosage, diminish the risk of bone cement leakage, and have more advantages than DTPSTM pedicle screw.%背景:由于骨质原因及结构特点导致椎弓根螺钉经常出现把持力下降,从而发生松动、拔出,导致内固定失败,因此提高椎弓根螺钉的稳定

  10. Quantitative dual-energy CT for phantomless evaluation of cancellous bone mineral density of the vertebral pedicle: correlation with pedicle screw pull-out strength

    Energy Technology Data Exchange (ETDEWEB)

    Wichmann, Julian L.; Booz, Christian; Bauer, Ralf W.; Kerl, J.M.; Fischer, Sebastian; Lehnert, Thomas; Vogl, Thomas J.; Khan, M.F. [University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Wesarg, Stefan [Fraunhofer IGD, Cognitive Computing and Medical Imaging, Darmstadt (Germany); Kafchitsas, Konstantinos [Spine Center, Asklepios Klinik Lindenlohe, Schwandorf (Germany)

    2015-06-01

    To evaluate quantitative dual-energy computed tomography (DECT) for phantomless analysis of cancellous bone mineral density (BMD) of vertebral pedicles and to assess the correlation with pedicle screw pull-out strength. Twenty-nine thoracic and lumbar vertebrae from cadaver specimens were examined with DECT. Using dedicated post-processing software, a pedicle screw vector was mapped (R1, intrapedicular segment of the pedicle vector; R2, intermediate segment; R3, intracorporal segment; global, all segments) and BMD was calculated. To invasively evaluate pedicle stability, pedicle screws were drilled through both pedicles and left pedicle screw pull-out strength was measured. Resulting values were correlated using the paired t test and Pearson's linear correlation. Average pedicle screw vector BMD (R1, 0.232 g/cm{sup 3}; R2, 0.166 g/cm{sup 3}; R3, 0.173 g/cm{sup 3}; global, 0.236 g/cm{sup 3}) showed significant differences between R1-R2 (P < 0.002) and R1-R3 (P < 0.034) segments while comparison of R2-R3 did not reach significance (P > 0.668). Average screw pull-out strength (639.2 N) showed a far stronger correlation with R1 (r = 0.80; P < 0.0001) than global BMD (r = 0.42; P = 0.025), R2 (r = 0.37; P = 0.048) and R3 (r = -0.33; P = 0.078) segments. Quantitative DECT allows for phantomless BMD assessment of the vertebral pedicle. BMD of the intrapedicular segment shows a significantly stronger correlation with pedicle screw pull-out strength than other segments. (orig.)

  11. Screw-bone finite element models for screw pullout simulation%螺钉-骨抗拔出力试验有限元模型的建立与验证

    Institute of Scientific and Technical Information of China (English)

    严亚波; 裴国献; 桑宏勋; 马真胜; 雷伟

    2013-01-01

    Objective To establish screw-bone finite element (FE) models for screw pullout simulation.Methods A pedicle screw model with a diameter of 6.5 mm,a model of screw-low density porous foam and a model of screw-high density porous foam were established and validated against the published data.Next,a screw-bone model was established and imported into the ANSYS software for FE simulation to study the dynamic bone responses during screw pullout according to the criteria set by American Association for Testing Materials (ASTM).A velocity loading of 0.01 mm/s with a maximum displacement of 2.7 mm was applied on the screw.For validation,the screw-foam models with 2 different densities were used for comparison of the pullout forces with the experimental data published.Results In validation,the predicted pullout forces were 2028.8 N in the high density foam model and 607.0 N in the low density foam model,respectively.They were in good agreement with the data of Hashemi et al.(2132.5 ± 119.3 N and 688.2 ±91.4 N,respectively).The load-displacement curves in the FE models were similar to the published (1.8 mm versus 1.5mm).In the simulation of screw pullout,the areas around the crew changed in volume in the process of pullout.Conclusion The dynamic screw-bone FE model established and validated by the present study can be used in simulation of pullout of pedicle screws to study mechanical bone responses to the pullout.%目的 建立螺钉-骨抗拔出力试验的动态有限元模型,模拟螺钉的拔出过程. 方法 基于螺钉的国标尺寸,建立直径为6.5 mm的椎弓根螺钉模型,并建立对应骨组织的高密度和低密度多孔泡沫三维模型进行验证,最后建立螺钉-骨模型研究螺钉拔出过程中骨骼的动态响应.在Ansys中对三维模型进行网格划分,并按照美国材料试验协会(ASTM)标准对螺钉进行拔出力加载分析.拔出方向为轴向拔出,拔出速度为0.01 mm/s.建立模型后,对模型进行加载计算并与

  12. Analysis the Reason of 1 Case With Fracture Reason of Metal Bone Screw%一例金属接骨螺钉断裂原因分析

    Institute of Scientific and Technical Information of China (English)

    李涛

    2016-01-01

    目的:研究探讨一例金属接骨螺钉断裂原因,为今后金属接骨螺钉的实际应用提供参考。方法回顾性分析本院收治的1例外科手术治疗骨折并行金属接骨板固定患者,患者术后1月出现金属接骨螺钉断裂失效情况,对此采取现代试验检测技术进行宏观观察、金属化学成分检测、硬度试验、显微组织观察及表面质量检测进行分析。结果螺钉断裂主因是由材质表面存在的裂纹,造成螺距根部应力集中爆发,使之出现较作用力后扩展表面裂纹,造成受力不均断裂。结论金属接骨螺钉断裂主因材质本身存在的不连续裂纹,在钢板连接接骨固定后,循环作用力因素影响,不断加剧裂纹扩张,造成金属螺纹钉发生疲劳性断裂。笔者结合光学金相显微镜技术及电子探针设备辅助对螺纹断口原因进行分析,明确螺钉断裂因素,为今后金属接骨螺钉的实际应用提供参考。%Objective To investigate a case of metal bone screw fracture, and provide a reference for the practical application of metal bone screw in the future.Methods A retrospective analysis of our hospital 1 cases of surgical treatment of fracture of parallel metal plate fixation patients, patients postoperative 1 month appear metal bone screw fracture failure. For this to take modern test technology of macro observation, metal chemical composition test, hardness test and microstructure observation organization and surface quality detection are analyzed.Results Screw fracture is mainly caused by the cracks on the surface of the material, which causes the stress concentration at the root of the pitch, which causes the crack to crack, which is caused by the uneven stress.Conclusion Metal bone screw fracture cause of material itself and the discontinuous crack, in the plate connection after osteosynthesis and circulating acting force factors, increasing the crack expansion, caused by metal

  13. 皮质骨通道置椎弓根螺钉技术的研究进展%Cortical bone trajectory for pedicle screws

    Institute of Scientific and Technical Information of China (English)

    宣俊; 徐道亮; 王向阳

    2016-01-01

    Pedicle screw fixation is widely used in spine surgery, which allows 3⁃dimensional fixation with a more rigid construct and permits a shorter fusion length. However, conventional pedicle screw fixation has some drawbacks, including signifi⁃cant muscle dissection for the exposure of bone marks. Although percutaneous pedicle screw technique can compensate for above defects, it requires an additional approach for decompression and bone graft insertion. Besides, the percutaneous pedicle screw technique depends on intraoperative multiplanar fluoroscopy, which results in high risk of radiation exposure of the surgeons and patients. Screw loosening is a well⁃known complication, especially in osteoporosis patients. Several methods can enhance screw stability, for example, modifying screw design and augmenting vertebral bodies with reinforcing materials that can improve the structural capacity of the deteriorated tissue, however, they also have some disadvantages. Although we can enhance bone⁃screw by modifying screw design, it is not useful in severe osteoporosis patients. At the same time, bone cement can increase pedicle screw axial pullout strength and fatigue resistance, however, it is associated with a number of inherent disadvantages such as its high exothermic polymerizing temperature, toxicity of the monomer, and risk of leakage to the spinal canal. Santoni et al. intro⁃duced cortical bone trajectory (CBT) for lumbar pedicle screw with a new screw design that is shorter and smaller in diameter which has been proposed to maximize the thread contact with this higher density bone surface. In addition, the CBT technique fol⁃lows a caudocephalad path sagittally and a laterally directed path in the transverse plane, engaging only cortical bone in the pedi⁃cle without the involvement of the vertebral body trabecular space. Finally, the screw insertion point of this technique locates around lateral pars, enabling less tissue dissection. Therefore, it can be

  14. The influence of sacral morphology on the existence of secure S1 and S2 transverse bone corridors for iliosacroiliac screw fixation.

    Science.gov (United States)

    Mendel, T; Noser, H; Kuervers, J; Goehre, F; Hofmann, G O; Radetzki, F

    2013-12-01

    Sacroiliac (SI) screw fixation for unstable pelvic fractures stands out as the only minimally invasive method among all other ORIF procedures. A strictly transverse screw trajectory is needed for central or bilateral fracture patterns up to a complete iliosacroiliac fixation. However, secure screw insertion is aggravated by a narrow sacroiliac bone stock. This study investigates the influence of a highly variable sacral morphology to the existence of S1 and S2 transverse corridors. The analysis contained in this study is based on 125 CT datasets of intact human pelvises. First, sacral dysplasia was identified using the "lateral sacral triangle" method in a lateral 3-D semi-transparent pelvic view. Second, 3-D corridors for a 7.3mm screw in the upper two sacral levels were visualised using a proprietary IT workflow of custom-made programme scripts based on the Amira(®)-software. Shape-describing measurement variables were calculated as output variables. The results show a significant linear correlation between ratioT and the screw-limiting S1 isthmus height (Pearson coefficient of 0.84). A boundary ratio of 1.5 represented a positive predictive value of 96% for the existence of a transverse S1-corridor for at least one 7.3mm screw. In 100 out of 125 pelvises (80%), a sufficient S1 corridor existed, whereas in 124 specimens (99%), an S2 corridor was found. Statistics revealed significantly larger S1 and S2 corridors in males compared to females (pS1 and 1 screw in S2. The expanse of the S1 corridor is highly influenced by the dimensions of the dysplastic elevated upper sacrum, whereas the S2 corridor is not affected. Hence, in dysplastic pelvises, sacroiliac screw insertion should be recommended into the 2nd sacral segment. Our IT workflow for the automatic computation of 3-D corridors may assist in surgical pre-operative planning. Furthermore, the workflow could be implemented in computer-assisted surgery applications involving pelvic trauma.

  15. Possible Usage of Cannulated Pedicle Screws without Cement Augmentation

    Directory of Open Access Journals (Sweden)

    Teyfik Demir

    2014-01-01

    Full Text Available Background: The use of pedicle screws is becoming increasingly popular for spinal surgery practice as the technology advances. Screw pullout due to bone quality and loading conditions is one of the most common problems observed after pedicle screw fixation. Several solutions were studied to prevent screw pullout. These can be investigated under three main categories: screw design, expandable screws and cement augmentation.

  16. A Biomechanical Comparison of Expansive Pedicle Screws for Severe Osteoporosis: The Effects of Screw Design and Cement Augmentation.

    Science.gov (United States)

    Tai, Ching-Lung; Tsai, Tsung-Ting; Lai, Po-Liang; Chen, Yi-Lu; Liu, Mu-Yi; Chen, Lih-Huei

    2015-01-01

    Expansive pedicle screws significantly improve fixation strength in osteoporotic spines. However, the previous literature does not adequately address the effects of the number of lengthwise slits and the extent of screw expansion on the strength of the bone/screw interface when expansive screws are used with or without cement augmentation. Herein, four designs for expansive pedicle screws with different numbers of lengthwise slits and different screw expansion levels were evaluated. Synthetic bones simulating severe osteoporosis were used to provide a comparative platform for each screw design. The prepared specimens were then tested for axial pullout failure. Regardless of screw design, screws with cement augmentation demonstrated significantly higher pullout strength than pedicle screws without cement augmentation (p screws without cement augmentation, solid screws exhibited the lowest pullout strength compared to the four expansive groups (p screws with different designs (p > 0.05). Taken together, our results show that pedicle screws combined with cement augmentation may greatly increase screw fixation regardless of screws with or without expansion. An increase in both the number of slits and the extent of screw expansion had little impact on the screw-anchoring strength. Cement augmentation is the most influential factor for improving screw pullout strength. PMID:26720724

  17. geneX®骨水泥强化椎弓根螺钉体内的实验研究%The experiment study of geneX® bone cement augmentation of pedicle screw in animal model

    Institute of Scientific and Technical Information of China (English)

    张树芳; 江建明; 陈荣春; 朱青安; 黄志平

    2015-01-01

    目的:通过动物实验,评估新型带负电荷硫酸钙/β-磷酸三钙复合骨水泥(geneX®)用于强化体内椎弓根螺钉的生物力学性质变化及可行性。方法选取6只健康山羊腰椎L1~5双侧共30个椎弓根随机分为3组:geneX®组,聚甲基丙烯酸甲酯骨水泥(Polymethylmethacrylate,PMMA)组,空白对照组,每组10个椎弓根。术后3个月处死动物取材行Mirco-CT检查、组织学检查及生物力学实验。结果轴向拔出力实验:geneX®组(803±155) N, PMMA组为(994±122) N,两者差异无统计学意义(P>0.05)。两组均明显高于对照组的(524±118) N,差异具有统计学意义(P<0.05)。组织学观察及Mirco-CT显示geneX®组中螺钉周围骨水泥已经完全降解、吸收,骨小梁排列致密,成熟骨小梁附近可见大量新生骨组织,明显优于对照组及PMMA组。结论 geneX®骨水泥可有效强化椎弓根螺钉内固定的强度,其强化作用随时间推移而增强,对防止骨质疏松症患者内固定的拔出发生率有重要意义。%Objective To evaluate the long-term in vivo biomechanical effects of a newly developed biphasic calcium composite bone cement (geneX®)with a negative surface charge augmentation of pedicle screw. Methods Bilateral pedicles of lumbar vertebrae (L1~5) of 6 female sheep were fi xed with pedicle screws. One pedicle of each vertebral body was treated with a screw augmented with either geneX®(geneX® group) or PMMA (PMMA group) and the contralateral pedicle was treated with a screw without any augmentation (control group). Three months later, the sheep were killed and biomechanical tests, micro-CT analysis and histological observation were conducted on the isolated specimen vertebrae. Results Both the axial and vertical stabilities of the pedicle screws in geneX® group were significantly enhanced compared with those in the control group (P<0.05). Micro-CT reconstruction and analysis showed that there were more bone

  18. 中空加压螺钉及带旋髂深血管髂骨移位对青壮年股骨颈骨折髋关节功能恢复的影响%Effect of canulate compression bone screws and iliac bone flap with deep iliac circumflex vessel on functional restoration of hip joint after femoral neck fracture of young people

    Institute of Scientific and Technical Information of China (English)

    袁宏伟; 叶应荣

    2002-01-01

    Objective To retrospect therapeutic effects of iliac flap with deep iliac circumflex vessel with canulate compression bone screws internal fixation on femoral neck fracture of young people. Method 34 cases of femoral neck fracture had been treated with pedicle bone flap with deep iliac circumflex artery and canulate bone screws internal fixation. Result By follow-up for 1 to 1.5 years, 32 cases were healing by first intention, and patients obtained satisfactory joint function. Conclusion Femoral neck fracture can be treated by transplanting pedicle bone flap with deep iliac circumflex vessel and canulate bone screws internal fixation.

  19. Salvage of failed osteosynthesis of an intracapsular fracture of the femoral neck using two cannulated compression screws and a vascularised iliac crest bone graft.

    Science.gov (United States)

    Xiaobing, Y; Dewei, Z

    2015-07-01

    We evaluated the outcome of treatment of nonunion of an intracapsular fracture of the femoral neck in young patients using two cannulated screws and a vascularised bone graft. A total of 32 patients (15 women and 17 men, with a mean age of 36.5 years; 20 to 50) with failed internal fixation of an intracapsular fracture were included in the study. Following removal of the primary fixation, two cannulated compression screws were inserted with a vascularised iliac crest bone graft based on the ascending branch of the lateral femoral circumflex artery. At a mean follow-up of 6.8 years (4 to 10), union was achieved in 27 hips (84%). A total of five patients with a mean age of 40.5 years (35 to 50) had a persistent nonunion and underwent total hip arthroplasty as also did two patients whose fracture united but who developed osteonecrosis of the femoral head two years post-operatively. Statistical analysis showed that younger patients achieved earlier and more reliable union (p 45 years (p osteosynthesis of a displaced intracapsular fractures of the femoral neck has failed.

  20. Therapeutic efficacy of pedicle screw-rod internal fixation after one-stage posterior transforaminal lesion debridement and non-structural bone grafting for tuberculosis of lumbar vertebra

    Directory of Open Access Journals (Sweden)

    Jia-ming LIU

    2015-11-01

    Full Text Available Objective To evaluate the efficacy and safety of pedicle screw-rod internal fixation after one-stage posterior transforaminal lesion debridement and non-structural bone grafting in the treatment of tuberculosis of mono-segmental lumbar vertebra. Methods From January 2010 to April 2013, 21 patients (9 males and 12 females with an average age of 49.1 years with mono-segmental tuberculosis of lumbar vertebra underwent surgery in our hospital were included. Eight patients had neurological deficit. The focus of tuberculosis was located on one side of the vertebral body, and all the patients had obvious signs of bone destruction on CT and MRI. All the patients were given anti-tuberculosis chemotherapy for 2-3 weeks before surgery. The local bone chips and autologous iliac cancellous bone were used as the intervertebral bone graft. Postoperative plain radiographs and CT were obtained to evaluate the fusion rate and degree of lumbar lordosis. The visual analogue scale score (VAS, erythrocyte sedimentation rate (ESR, and C-reactive protein (CRP before and after operation, and at final follow-up date were recorded. Results All the patients were followed up for 25.3±4.2 months. The mean operation time was 157±39 minutes, and the average blood loss was 470±143ml. The fusion rate of the interbody bone graft was 95.2%, with an average fusion period of 6.1±2.5 months. The neurological function was improved by 100%, and no severe complication or neurological injury occured. The preoperative and postoperative lordosis angles of the lumbar spine were 21.4°±5.7° and 33.6°±3.1°, respectively, and it was 31.3°±2.7° at the final follow up. The preoperative and postoperative VAS scores were 7.8±2.6 and 2.4±1.7 respectively, and it was 0.9±0.7 at the final follow up. The ESR and CRP were significantly decreased 3 months after surgery, and they became normal at 6 months. Conclusion Pedicle screw-rod internal fixation after one-stage posterior

  1. Influence of screw holes and gamma sterilization on properties of phosphate glass fiber-reinforced composite bone plates.

    Science.gov (United States)

    Han, Na; Ahmed, Ifty; Parsons, Andrew J; Harper, Lee; Scotchford, Colin A; Scammell, Brigitte E; Rudd, Chris D

    2013-05-01

    Polymers prepared from polylactic acid (PLA) have found a multitude of uses as medical devices. For a material that degrades, the main advantage is that an implant would not necessitate a second surgical event for removal. In this study, fibers produced from a quaternary phosphate-based glass (PBG) in the system 50P2O5-40CaO-5Na2O-5Fe2O3 were used to reinforce PLA polymer. The purpose of this study was to assess the effect of screw holes in a range of PBG-reinforced PLA composites with varying fiber layup and volume fraction. The flexural properties obtained showed that the strength and modulus values increased with increasing fiber volume fraction; from 96 MPa to 320 MPa for strength and between 4 GPa and 24 GPa for modulus. Furthermore, utilizing a larger number of thinner unidirectional (UD) fiber prepreg layers provided a significant increase in mechanical properties, which was attributed to enhanced wet out and thus better fiber dispersion during production. The effect of gamma sterilization via flexural tests showed no statistically significant difference between the sterilized and nonsterilized samples, with the exception of the modulus values for samples with screw holes. Degradation profiles revealed that samples with screw holes degraded faster than those without screw holes due to an increased surface area for the plates with screw holes in PBS up to 30 days. Scanning electron microscope (SEM) analysis revealed fiber pullout before and after degradation. Compared with various fiber impregnation samples, with 25% volume fraction, 8 thinner unidirectional prepreg stacked samples had the shortest fiber pull-out lengths in comparison to the other samples investigated. PMID:22207606

  2. [Cement augmentation of pedicle screws : Pros and cons].

    Science.gov (United States)

    Schnake, K J; Blattert, T R; Liljenqvist, U

    2016-09-01

    Cement augmentation of pedicle screws biomechanically increases screw purchase in the bone. However, clinical complications may occur. The pros and cons of the technique are discussed from different clinical perspectives. PMID:27514827

  3. Design and biomechanical study of bone cement injectable canulated pedicle screw%新型可注射骨水泥椎弓根螺钉的设计及生物力学研究

    Institute of Scientific and Technical Information of China (English)

    刘瑶瑶; 孙东; 罗飞; 张泽华; 代飞; 许建中

    2012-01-01

    目的 探讨一种新型可注射骨水泥椎弓根螺钉(bone cement injectable canulated pedicle screw,CICPS)的设计和生物力学性能,为骨质疏松脊柱疾病的内固定治疗提供一种安全有效的新选择. 方法 (1)在体外、骨质疏松松质骨模型和椎体标本内行骨水泥注射实验,X线片、CT观察骨水泥分布和钉-骨界面情况.(2)取10枚灌注骨水泥后的CICPS和普通椎弓根螺钉行剪切力试验.(3)在松质骨模型中用2~3ml骨水泥强化CICPS行轴向拔出力试验,与普通椎弓根螺钉进行比较. 结果 CICPS各个侧孔均有骨水泥流出,且仅分布于螺钉前部,弥散均匀广泛,未见骨水泥渗漏.CICPS的剪切力为(10600.8±360.1)N,普通螺钉为(15 458.1±311.4)N(P<0.05).CICPS的最大轴向拔出力为(209.3±13.3)N,普通螺钉为(27.0±5.0)N(P<0.05).结论 CICPS使骨水泥弥散均匀一致,减少骨水泥渗漏风险,并可显著提高骨质疏松椎体中椎弓根螺钉的把持力.CICPS具有良好的有效性和安全性,为其临床应用提供了理论基础.%Objective To investigate the design and mechanical properties of bone cement injectable canulated pedicle screw (CICPS) so as to provide a safe and effective internal fixation for osteoporotic spinal disorder. Methods ( 1 ) Bone cement injection test was performed in vitro,and within osteoporotic cancellous bone models and osteoporotic vertebrae respectively.The distribution of bone cement and screw-bone interface were observed by X-ray films and CT.(2) Ten CICPSs already injected with bone cement and ten conventional pedicle screws were respectively examined by shear strength test.(3) CICPS in the cancellous bone models was augmented with 2-3 ml of bone cement.Then,the maximum axial pull-out strength of the CICPS was measured and were compared with that of conventional screws. Results Bone cement overflowed from each side hole of the CICPS and distributed only around the front of screws in an even and extensive

  4. A new variant of scaphoid reconstruction: Treatment of scaphoid non-union with avascular bone interponate and high compression screw (Synthes

    Directory of Open Access Journals (Sweden)

    Eder, Christian

    2015-08-01

    Full Text Available Scaphoid fractures as frequently overseen injuries often result in scaphoid non-unions, that need to be treated to prevent carpal collapse and secondary cartilage damage. Vital bone tissue and compression of fracture and bone graft ends seem to be crucial in for ossification and final bone healing. In the present study we compare our results using a high compression screw (HCS Synthes to results in the literature using different kinds of internal fixation including compression screws of various types. We present 22 patients with scaphoid non-unions treated with a bone graft and a HCS Synthes. We evaluated our post-operative results. The Manchester-Modified Disability of the Shoulder, Arm and Hand–Score (M-Dash imposed with an average of 29.8 points (MD=29 / SD=9.46 / MIN=18 / MAX=48. None of the re-evaluated patients sorrowed for pain in rest. Five patients stated pain (ranging from 4 to 8 on numeric analogue scale after heavy burden (e.g. boxing, weight lifting.In exploring the range of motion of the operated hand we deliver the following results: dorsal extension: average 72.73° (MD=80° / SD=17.23° / MIN=30° / MAX=85°, flexion: average 73.64° (MD=80° / SD=8.97° / MIN=60° / MAX=80°, ulnar deviation: average 39.09°, (MD=40° / SD=2.02° / MIN=35° / MAX=40°, radial deviation: average 29.09°, (MD=30° / SD=3.01° / MIN=20° / MAX=30°. Additionally a performance testing was conducted: fist clenching sign: complete without pain in 100%, pinch grip: complete in 100%, moderate pain in n=1 (8.33%, opposition digitus manus I–V complete in 100%, moderate pain n=2 (16.67%. Three patients with persisting fracture gap had a scaphoid bone fractured in the proximal third; one patient even with a very small proximal fragment. One persisting non-union was localized in the middle third (period between injury and operation = . In conclusion, our patients showed better healing rates compared to results presented in the literature. Non

  5. A Biomechanical Comparison of Expansive Pedicle Screws for Severe Osteoporosis: The Effects of Screw Design and Cement Augmentation.

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    Ching-Lung Tai

    Full Text Available Expansive pedicle screws significantly improve fixation strength in osteoporotic spines. However, the previous literature does not adequately address the effects of the number of lengthwise slits and the extent of screw expansion on the strength of the bone/screw interface when expansive screws are used with or without cement augmentation. Herein, four designs for expansive pedicle screws with different numbers of lengthwise slits and different screw expansion levels were evaluated. Synthetic bones simulating severe osteoporosis were used to provide a comparative platform for each screw design. The prepared specimens were then tested for axial pullout failure. Regardless of screw design, screws with cement augmentation demonstrated significantly higher pullout strength than pedicle screws without cement augmentation (p 0.05. Taken together, our results show that pedicle screws combined with cement augmentation may greatly increase screw fixation regardless of screws with or without expansion. An increase in both the number of slits and the extent of screw expansion had little impact on the screw-anchoring strength. Cement augmentation is the most influential factor for improving screw pullout strength.

  6. 人工骨或自体骨移植联合椎弓根钉内固定修复脊柱结核%Artificial bone or autologous bone grafting combined with pedicle screw fixation for repair of spinal tuberculosis

    Institute of Scientific and Technical Information of China (English)

    姜棚菲; 翟文斌

    2015-01-01

    BACKGROUND:With the development of fixation materials and technology, scholars began to use artificial bone materials combined with pedicle screw fixation in the repair of spinal tuberculosis. OBJECTIVE: To summarize the characteristics of artificial bone materials combined with pedicle screw fixation in the repair of spinal tuberculosis. METHODS:The literatures about artificial bone graft materials in repair of spinal tuberculosis were retrieved from CNKI and PubMed database during 1985 to 2014 by computer. The keywords were “spinal tuberculosis, bone transplantation, internal fixation” in Chinese and English, respectively. RESULTS AND CONCLUSION:In the repair of spinal tuberculosis using artificial bone materials combined with pedicle screw fixation, autologous bone is the gold standard for bone grafting, presenting with no immune rejection. To avoid the occurrence of limited bone mass, pain and other complications, however, artificial bone materials have been extensively studied. Currently used artificial materials mainly include titanium and its aloys, hydroxyapatite composites and medical calcium sulfate, which al have good biocompatibility. But there are stil certain limitations and shortcomings.%背景:随着内固定材料和内固定技术的发展,越来越多的国内外学者开始应用人工骨材料联合椎弓根钉内固定修复脊柱结核。目的:综述人工骨修复材料联合椎弓根内固定修复脊柱结核的特点。方法:应用计算机检索CNKI和PubMed数据库1985至2014年有关人工骨移植材料修复脊椎结核方面的文献,中文关键词为“脊椎结核、骨移植、内固定”,英文关键词为“Spinal tuberculosis,Bone graft,Fixation”。结果与结论:在骨修复材料联合椎弓根内固定修复脊柱结核中,自体骨是骨移植的金标准,无免疫排斥反应,但为了避免自体骨取骨量有限、取骨后疼痛等并发症的发生,人工骨材料得到了广泛

  7. Biomechanical evaluation of dynamic hip screw with bone cement augmentation in normal bone%骨水泥强化正常骨质DHS固定的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    黎宁; 彭阿钦; 聂喜增; 李锋; 赵永涛; 毕靖博; 韩长伶

    2008-01-01

    背景:DHS是治疗股骨转子间骨折的标准内固定,对于伴有骨质疏松的骨折,容易发生拉力螺钉切割.国内外文献建议骨水泥强化DHS以达到坚强内固定,但是对于正常骨质,骨水泥强化是否有效还缺少报道.目的:选取正常骨密度的股骨转子间骨折标本,观察骨水泥强化对DHS固定的生物力学影响.设计、时间及地点:同一标本两侧对比观察实验,于2005-03/05在河北省骨科研究所生物力学实验室完成.材料:选取河北医科大学解剖教研室提供的成年男性防腐尸体双侧股骨上段标本.X射线证实无结核、畸形、肿瘤.方法:取成年男性防腐尸体双侧股骨上段标本24对48侧,制备A2型股骨转子间骨折模型.右侧标本行骨水泥强化DHS固定(在股骨头近端钉道用刮匙扩大.股骨头朝下,注入2mL低黏稠度骨水泥,拧入拉力螺钉,保持位置不变直至骨水泥凝固.置入套筒,拧紧尾钉适当加压,皮质骨螺钉固定钢板),为强化组;左侧行DHS常规固定,为对照组.两组标本进行弯曲强度试验及扭转强度试验.主要观察指标:两组标本的最大负荷及最大扭矩.结果:强化组最大负荷及最大扭矩与对照组比较,差异均无统计学意义[最大负荷分别为:(3852.1602±143.6031)N和(3702.9667±133.8601)N;最大扭矩分别为(15.5±2.6)N·m,(14.7±3.4)N·m, P>0.0⑤.结论:对于正常骨密度的股骨转子间骨折,骨水泥强化对DHS固定强度及骨折整体稳定性无显著的影响.%BACKGROUND: Dynamic hip screw (DHS) is a standard internal fixation for intertrochanteric fracture, whereas the patient combined with osteoporosis, cut-out incidence of lag screw is common. The articles in China and abroad indicate bone cement augmentation of DHS to achieve firm fixation. As for normal bone, no reports is published that whether bone cement augmentation is effective.OBJECTIVE: To investigate the biomechanics of DHS with bone cement augmentation for

  8. Effectiveness and limitations of reconstruction of the medial patellofemoral ligament using a titanium interference screw in single patellar and femoral bone tunnels

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    Nobuyuki Kumahashi

    2014-01-01

    Full Text Available No standard surgical procedure for medial patellofemoral ligament (MPFL reconstruction exists. The purpose of this study was to evaluate the clinical effectiveness and limitation of the reconstructions of the MPFL in single patellar and femoral bone tunnels. The methods used a hamstring tendon and titanium interference screws in patients with recurrent patellar dislocation. Nineteen knees in 17 patients were studied. Subjects underwent MPFL reconstruction with or without lateral release using interference screws in single patellar and femoral tunnels. Patients were evaluated using preoperative and postoperative physical and radiographic examinations, including apprehension testing, assessment of tilting and congruence angles, medial and lateral shift ratios under stress X-ray imaging, and Kujala and Lysholm scores. Average follow-up was 22 months (12–71 months. None experienced recurrent postoperative episodes of dislocation or subluxation. By the final follow-up, patellar apprehension had disappeared in all patients except for one with generalized joint laxity. In addition, patients showed significant improvement in the following areas: tilting angle (from 14.4 ± 5.6° to 6.4 ± 4.6°, p < 0.0001, congruence angle (0.5 ± 16° to −9.2 ± 6.9°, p < 0.001, lateral shift ratio (23.8 ± 11.3% to 11.6 ± 13.4%, p < 0.001, Kujala score (74.0 ± 7.8 points to 95.7 ± 4.4 points, p < 0.0001, and Lysholm score (71.0 ± 10 points to 95.5 ± 5.3 points, p < 0.0001. MPFL reconstruction methods, using titanium interference screws in single patellar and femoral tunnels provide acceptable short-term results for the treatment of recurrent patellar dislocations.

  9. Bone cement and bone grafting in nail path to strengthen dynamic hip screw fixation for senile osteoporotic intertrochanteric fracture%骨水泥、钉道植骨强化动力髋螺钉固定修复老年骨质疏松性股骨转子间骨折

    Institute of Scientific and Technical Information of China (English)

    林周胜; 孙鸿涛; 夏雄智; 江成; 黎飞猛

    2015-01-01

    背景:对于老年骨质疏松性髋部骨折的动力髋螺钉固定,如能避免使用过程中造成的骨量丢失,或是采用其他手段增加固定螺钉把持力,将改善动力髋螺钉固定的治疗效果。目的:对比研究3种固定方式修复老年骨质疏松性股骨转子间骨折的效果。方法:回顾性分析近5年来采用常规动力髋螺钉内固定、骨水泥强化后动力髋螺钉固定及主钉道压配植骨配合动力髋螺钉固定3种固定方式治疗老年骨质疏松性股骨转子间骨折患者的资料,分别设为对照组、骨水泥组和植骨组。结果与结论:经固定后2年随访,植骨组、骨水泥组和对照组Harris髋关节功能评分优良率分别为95%,80%,70%。植骨组骨折临床愈合时间明显缩短(P <0.05),出现螺钉固定失败情况与骨水泥组相当。对照组较其他2组相对更多出现退钉等内固定失败情况。结果表明,与其他常规动力髋螺钉内固定、骨水泥强化后动力髋螺钉固定方式相比较,主钉道压配植骨配合动力髋螺钉内固定的疗效及安全性更好。%BACKGROUND:In dynamic hip screw fixation for treating aged osteoporotic intertrochanteric fracture, avoiding the loss of bone mass, or by other means that can increase the fixed screw pulout strength, wil improve the therapeutic effect of dynamic hip screw fixation. OBJECTIVE: To compare the effects of three kinds of repair methods on aged osteoporotic intertrochanteric fracture. METHODS:Data of aged osteoporosis intertrochanteric fracture patients, who received conventional dynamic hip screw fixation, bone cement augmentation with dynamic hip screw fixation and bone grafting with dynamic hip screw fixation, were retrospectively analyzed. They were divided into control group, bone cement group and bone grafting group. RESULTS AND CONCLUSION:After two years of folow-up, the excelent and good rates of Harris hip function were 95%, 80% and 70% in

  10. A processing method for orthodontic mini-screws reuse

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    Saeed Noorollahian

    2012-01-01

    Conclusion: Cleaning of used mini-screws with phosphoric acid 37% (10 minutes and sodium hypochlorite 5.25% (30 minutes reduces tissue remnants to the level of as-received mini-screws. So it can be suggested as a processing method of used mini-screws. Previous insertion of mini-screws into the bone and above-mentioned processing method and resterilization with autoclave had no adverse effects on insertion, removal, and fracture torque values as mechanical properties indices.

  11. 骨水泥强化椎弓根螺钉固定对骨质疏松患者有利无弊?★%Pedicle screw fixation augmented with bone cement benefits osteoporosis patients?

    Institute of Scientific and Technical Information of China (English)

    岳文峰; 夏虹; 王建华

    2013-01-01

    BACKGROUND:During the pedicle screw fixation for lumbar disease patients accompanied with osteoporosis, addition of bone cement in osteoporotic vertebral body can significantly increase the stability of internal fixation, but the effect on adjacent segments is not clear. OBJECTIVE:To observe the effect on adjacent segments of osteoporosis patients after pedicle screw fixation augmented with bone cement in early and medium-term fol ow-up period. METHODS:We reviewed the medical information of 87 patients suffering from lumbar disease accompanied with osteoporosis who underwent operation of pedicle screw fixation and posterior lumbar spinal decompression, and the patients were divided into three groups:conventional pedicle screw group, conventional pedicle screw+bone cement group, novel perfusional pedicle screw+bone cement group. The samples were fol owed-up for 6-18 months, averaged 9 months. The Oswestry disability index, intervertebral distance of the upper adjacent segments, deformation index of the upper adjacent vertebral body, concave angle of the fixed lumbar vertebrae superior end-plate and the upper adjacent vertebral body inferior end-plate, and Cobb angle were measured before operation, at 3 days postoperation and during final fol ow-up. RESULTS AND CONCLUSION:The Oswestry disability index of the final fol ow-up in the three groups were decreased when compared with that before operation (P0.05). This showed that in posterior spinal fixation operation, there was no significant difference in the early and medium-term subjective effect between addition of bone cement or not and different adding ways, and addition of bone cement or not and different adding ways could remarkably improve the life quality of the patients. The change of Cobb angle of fixed lumbar vertebrae between the final fol ow-up and 3 days after operation in conventional pedicle screw+bone cement group and novel perfusional pedicle screw+bone cement group was both less than that in the

  12. 骨水泥强化椎弓根螺钉固定L1压缩性骨折:与单纯椎弓根螺钉固定的比较%Pedicle screw fixation with bone cementversus pedicle screw fixation alone for L1 compression fractures

    Institute of Scientific and Technical Information of China (English)

    亚力坤•亚森

    2015-01-01

    背景:椎体成形术与椎弓根螺钉内固定都是胸腰椎骨折的有效修复方案,但胸腰椎压缩性骨折内固定取出后脊柱角度丢失是较为常见的并发症,经皮椎体成形术可能是预防脊柱角度丢失的较好选择。  目的:观察骨水泥强化椎弓根螺钉置入内固定修复L1压缩性骨折的临床疗效及并发症,并与单纯椎弓根螺钉内固定比较。  方法:纳入L1压缩性骨折患者76例,根据内固定修复方案分为两组,经皮椎体成形组40例行骨水泥联合椎弓根螺钉置入内固定治疗,单纯椎弓根内固定组36例仅行椎弓根螺钉置入内固定治疗。比较两组的修复效果,置入后即刻、置入后3,6个月以伤椎为中心进行MRI检查测量Cobb角、伤椎椎体前缘高度,同时记录目测类比评分;另外了解有无内固定松动断裂。  结果与结论:两组患者随访6个月内均获骨性愈合,无螺钉松动、折断。两组置入后6个月损伤节段后凸Cobb角、伤椎椎体前缘高度均较置入前明显改善(P0.05)。表明应用骨水泥强化椎弓根螺钉内固定及椎弓根钉内固定修复L1压缩性均可获得满意复位,重建椎体高度。但抗压稳定性结果表明应用骨水泥强化椎弓根螺钉内固定的固定效果更好一些,未见短期断钉、矫正丢失等并发症,椎体骨水泥灌注可提高椎弓根螺钉置入后的稳定性。%BACKGROUND:Vertebroplasty and edicle screw fixation are effective repair methods for thoracolumbar fractures. Spine angle loss is a more common complication after removal of implant for thoracolumbar compression fractures. Percutaneous vertebroplasty may be a better choice for preventing spine angle loss. OBJECTIVE:To investigate the clinical curative effect and complication of pedicle screw fixation with bone cement for repair of L1 compression fractures, and to compare with pedicle screw fixation alone. METHODS: A total

  13. Coracoid bone graft osteolysis after Latarjet procedure: A comparison study between two screws standard technique vs mini-plate fixation

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    Giovanni Di Giacomo

    2013-01-01

    Full Text Available Aims: One of the reason for Latarjet procedure failure may be coracoid graft osteolysis. In this study, we aimed to understand if a better compression between the coracoid process and the glenoid, using a mini-plate fixation during the Latarjet procedure, could reduce the amount of coracoid graft osteolysis. Materials and Methods: A computed tomography scan analysis of 26 prospectively followed-up patients was conducted after modified Latarjet procedure using mini-plate fixation technique to determine both the location and the amount of coracoid graft osteolysis in them. We then compared our current results with results from that of our previous study without using mini-plate fixation to determine if there is any statistical significant difference in terms of corcacoid bone graft osteolysis between the two surgical techniques. Results: The most relevant osteolysis was represented by the superficial part of the proximal coracoid, whereas the deep part of the proximal coracoid graft is least involved in osteolysis and has best bone healing. The current study showed a significant difference only for the deep part of the distal coracoid with our previous study (P < 0.01. Discussion: To our knowledge, there are no studies in literature that show the causes of coracoid bone graft osteolysis after Latarjet procedure. Conclusion: Our study suggests that there is a significant difference only for the deep part of the distal coracoid in terms of osteolysis. At clinical examination, this difference did not correspond with any clinical findings. Level of Evidence: Level 4. Clinical Relevance: Prospective case series, Treatment study.

  14. Micro-CT中椎弓根螺钉伪影对其周围骨计量学检测结果的影响及其校正%Influence and Calibration Pedical Screw Artifact on Peri-screw Bone Analysis by Micro-CT

    Institute of Scientific and Technical Information of China (English)

    石磊; 王陵; 王军; 张扬; 雷伟

    2011-01-01

    目的:减少椎弓根螺钉伪影对其周围骨计量学结果的影响.方法:通过在绵羊腰椎内植入椎弓根螺钉后,行去钉扫描和带钉扫描后,以去钉扫描组为对照组,带钉扫描组为实验组,分别采用不同的分割阈值对实验组螺钉周围骨质进行图像重建分析,结果与对照组钉道周围骨质情况进行比较,观察不同分割阈值对于减少螺钉伪影的影响及真实反映螺钉周围骨质情况的能力.结果:与对照组分割阈值为1 000时比较,当实验组分割阈值为1000时,实验组螺钉周围骨量明显优于对照组钉道周围骨量(P<0.05);当实验组分割阈值为1 500时,2组之间无显著差异(P>05);当实验组分割阈值为2000时,对照组钉道周围骨量明显优于实验组螺钉周围骨量(P<0.05).结论:通过一定程度的提高分割阈值,有效地减少了螺钉伪影的影响,有利于准确了解螺钉周围骨质的情况.%Objecbre To decrease the influence of the artifact of pedicle screw on the peri-screw bone analysis. Methods The pedicle screws were inserted into the lumbar vertebrae of the sheep, and the samples were scanned with screw and without screw. The samples with screws fell under the experimental group and the ones without screws under the control group. The scanning results with different segmentation thresholds in the experimental group were compared to those with threshold 1000 in the control group respectively. Results With the threshold 1000, the results of the experimental group were significantly better those of the control group(P0.05), while with the threshold 2000, the results of the control group were significantly better than those of the experimental group(P<0.05). Conclusion The influence of the artifact of pedicle screw on the peri-screw bone analysis can be decreased through enhancing the threshold.[Chinese Medical Equipment Journal,2011,32 (12):60-61,76

  15. Pullout strength of pedicle screws with cement augmentation in severe osteoporosis: A comparative study between cannulated screws with cement injection and solid screws with cement pre-filling

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    Lee Yen-Chen

    2011-02-01

    Full Text Available Abstract Background Pedicle screws with PMMA cement augmentation have been shown to significantly improve the fixation strength in a severely osteoporotic spine. However, the efficacy of screw fixation for different cement augmentation techniques, namely solid screws with retrograde cement pre-filling versus cannulated screws with cement injection through perforation, remains unknown. This study aimed to determine the difference in pullout strength between conical and cylindrical screws based on the aforementioned cement augmentation techniques. The potential loss of fixation upon partial screw removal after screw insertion was also examined. Method The Taguchi method with an L8 array was employed to determine the significance of design factors. Conical and cylindrical pedicle screws with solid or cannulated designs were installed using two different screw augmentation techniques: solid screws with retrograde cement pre-filling and cannulated screws with cement injection through perforation. Uniform synthetic bones (test block simulating severe osteoporosis were used to provide a platform for each screw design and cement augmentation technique. Pedicle screws at full insertion and after a 360-degree back-out from full insertion were then tested for axial pullout failure using a mechanical testing machine. Results The results revealed the following 1 Regardless of the screw outer geometry (conical or cylindrical, solid screws with retrograde cement pre-filling exhibited significantly higher pullout strength than did cannulated screws with cement injection through perforation (p = 0.0129 for conical screws; p = 0.005 for cylindrical screws. 2 For a given cement augmentation technique (screws without cement augmentation, cannulated screws with cement injection or solid screws with cement pre-filling, no significant difference in pullout strength was found between conical and cylindrical screws (p >0.05. 3 Cement infiltration into the open cell of

  16. 骨水泥强化治疗骨质疏松症伴脊柱侧弯疗效分析%Effects of pedicle screw fixation with bone cement tract augmentation on scoliolosis accompanying osteoporosis

    Institute of Scientific and Technical Information of China (English)

    丁金勇; 洪少勇; 晋大祥; 梁德; 江晓兵

    2012-01-01

    目的 探讨对伴骨质疏松症的退行性脊柱侧弯病人行后路减压、骨水泥强化钉道椎弓根内固定融合治疗的临床疗效.方法 2006-10-2009-07收治伴骨质疏松症的退变性脊柱侧弯患者18例,女11例,男7例,平均年龄64.5岁,均冠状面畸形,Cobb's角>15°或合并椎体旋转半脱位以及合并椎体骨质疏松性病理性骨折.手术采取部分椎板切除,松解神经根以充分减压,骨水泥强化钉道的椎弓根长节段钉棒系统进行矫形,记录手术前后Cobb's角、前凸角,手术前后进行ODI评分.结果 所有病例切口均Ⅰ期愈合,无感染或深静脉血栓等近期并发症;进行24~54个月随访(平均36个月),未出现断钉、断棒,及椎弓根钉拔出、松动、融合节段假关节形成或感染等远期并发症.患者术后冠状面Cobb's角均低于术前(P<0.05),腰椎矢状面前凸角均高于术前(P<0.05),ODI综合评分均低于术前(P<0.05).结论 在充分减压消除症状的基础上,用骨水泥强化钉道进行侧弯的矫形,可以获得脊柱平衡并能够避免矫形的丢失.%Objective To evaluate the clinical effect of the treatment that part or full laminecto-my and correction with posterior long segment pedicle screw/rod internal fixation system by augmentation and restoration with bone cement in the screw tract and posterolateral or intervertebral spinal fusion, about degenerative scoliolosis accompanying with osteoporosis. Methods Eighteen patients, 11 females and 7 males (average age of 643 years),with degenerative scoliosis accompanying by osteoporosis were selected from our hospital, between October 2006 and July 2009. The patients were treated with part or full laminectomy and posterior long segment pedicle screw/rod internal fixation system by augmentation and restoration with bone cement in the screw tract and posterolateral or intervertebral spinal fusion. Result All cases were followed up for 36 months (range 24-54 months). No

  17. 骨水泥和纳米骨浆强化椎弓根螺钉植入固定骨质疏松椎体的生物力学特点%Bone cement and nano bone putty strengthen pedicle screw implantation in the fixation of osteoporotic vertebral body:biomechanical characteristics

    Institute of Scientific and Technical Information of China (English)

    卢小兵; 孟祥翔

    2015-01-01

    BACKGROUND:Nano bone putty and bone cement injection are two common methods to strengthen the fixation of pedicle screws, but there are relatively few reports on the comparison of their strengthening effects. OBJECTIVE:To compare the biomechanical characteristics of bone cement and nano bone putty strengthening pedicle screw implantation in the fixation of osteoporotic vertebral body. METHODS: Totaly 24 human cadaveric pedicles were obtained, which were al in line with osteoporosis standards, and randomly divided into 3 groups: control group (only implanted pedicle screws), bone cement group (first injected bone cement in the nail channel, and then implanted pedicle screws) and nano bone putty group (first injected nano bone putty in the nail channel, and then implanted pedicle screws). After 2 hours of implantation, the maximum axial pulout strength and the maximum rotation torque of specimens in each group were determined. RESULTS AND CONCLUSION:The maximum axial pulout strength and maximum rotation torque of the bone cement and the nano bone putty groups were greater than those of the control group (P < 0.05), and the maximum axial pulout strength and the maximum rotation torque of the bone cement group were greater than those of the nano bone putty group (P < 0.05). These results demonstrate that the maximum axial pulout strength and the maximum rotation torque of pedicle screw implantation in the fixation of osteoporotic vertebral body can be effectively improved by injection of bone cement and nano bone putty, and the strengthening effect of bone cement is more obvious. %背景:纳米骨浆和骨水泥注入是强化椎弓根螺钉固定的两种常用方法,但目前关于两种加强方法的强化效果比较的报道相对较少。目的:对比骨水泥或纳米骨浆强化椎弓根螺钉植入固定骨质疏松椎体的生物力学特点。方法:取24个人尸体椎弓根,均符合骨质疏松标准,随机均分为3组,对照组仅植

  18. A laboratory investigation to assess the influence of cement augmentation of screw and plate fixation in a simulation of distal femoral fracture of osteoporotic and non-osteoporotic bone.

    Science.gov (United States)

    Wähnert, D; Lange, J H; Schulze, M; Gehweiler, D; Kösters, C; Raschke, M J

    2013-10-01

    The augmentation of fixation with bone cement is increasingly being used in the treatment of severe osteoporotic fractures. We investigated the influence of bone quality on the mechanics of augmentation of plate fixation in a distal femoral fracture model (AO 33 A3 type). Eight osteoporotic and eight non-osteoporotic femoral models were randomly assigned to either an augmented or a non-augmented group. Fixation was performed using a locking compression plate. In the augmented group additionally 1 ml of bone cement was injected into the screw hole before insertion of the screw. Biomechanical testing was performed in axial sinusoidal loading. Augmentation significantly reduced the cut-out distance in the osteoporotic models by about 67% (non-augmented mean 0.30 mm (sd 0.08) vs augmented 0.13 mm (sd 0.06); p = 0.017). There was no statistical reduction in this distance following augmentation in the non-osteoporotic models (non-augmented mean 0.15 mm (sd 0.02) vs augmented 0.15 mm (sd 0.07); p = 0.915). In the osteoporotic models, augmentation significantly increased stability (p = 0.017). PMID:24078541

  19. Biomechanical analysis of a novel perfusional pedicle screw augmentation with bone cement in osteo-porotic vertebra%可灌注骨水泥椎弓根螺钉的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    杨惠林; 王志荣; 王根林; 朱若夫; 吴树华; 王以进; 唐天驷

    2009-01-01

    Objective To clarify the biomechanical stability of novel perfusional pedicle screw (NPPS) in spinal vertebrae with osteoporosis. Methods Forty-two vertebrae (T to L) obtained from 6 for-malin preserved cadavers (5 males and 1 females; mean age, 73 years) were used. The mean bone mineral density was (0.696±0.14) g/cm2. The NPPS was inserted into one pediele of each vertebra, then early-dough-time cement 2 ml was perfused with the bone cement pusher and perfusion tube under X-ray into the verte-bra body through the hollow part of NPPS, and the control screw, an improved CD2 screw, was inserted into the contralateral pedicle. Three vertebrae were chose to observe the distribution of cement, and the other 39 vertebrae were randomly divided into three groups to make the pull-out test, rotating-out torque test, and cyclic bending resistance test respectively. Ten novel perfusional pedicle screws and ten control screws were respectively examined by three-point bend test. Results Cement perfused around the side holes of the distal screw in all vertebral body and no cement leakage occurred. The mean maximum force at pull-out was (760± 178) N for the NPPS and (355±87) N for the control screw. The mean maximum rotating-out torque was (1.347±0.377) N'm for the NPPS and (0.488±0.205) N'm for the control screw. In cyclic bending resistance test, the NPPS was found to withstand a greater number of cycles or greater loading before loosening. About 30.8% (4/13) of the NPPS became loosing (displacement>2.000 mm), the mean load of the loosening screws was (150±46) N and the mean displacement of the non-loosening screws was (0.661±0.289) mm. All of the control screws were loosening among 50-200 N before 800 cycles. Conclusion The manipulation of NPPS is simple with the application of cement pusher and perfusion tube. It is effective in the control of cement leakage and could enhance the fixation stability of the pedicel screw significantly in osteoporotic vertebrae. The

  20. Biomechanical evaluation of an expansive pedicle screw in calf vertebrae

    Institute of Scientific and Technical Information of China (English)

    雷伟; 吴子祥

    2005-01-01

    Objective: To obtain a comprehensive understanding of the effect of the improvement of fixation strength of a newly designed expansive pedicle screw through biomechanical analyses.Metheds: 100 (200 pedicles) fresh calf lumber vertebrae were used. A total of four instrumentation systems were tested including CDH (CD Horizon), USS (Universal Spine System pedicle screw), Tenor (Sofamor Denek) and expansive pedicle screw (EPS). Pullout and turning-back tests were performed to compare the holding strength of the expansive pedicle screw with conventional screws, i.e. USS, CDH and Tenor. Revision tests were performed to evaluate the mechanical properties of the expansive pedicle screw as a "rescue" revision screw. A fatigue simulation using perpendicular load up to 1 500 000 cycles was carried out.Results: The turning back torque (Tmax) and pull-out force (Fmax) of EPS were significantly greater than those of USS, Tenor and CDH screws (6.5 mm×40 mm). In revision tests, the Fmax of both kinds of EPS (6.5 mm×40 mm; 7.0 mm×40 mm) were greater than that of CDH, USS and Tenor screws significantly (P<0.05). No screws were broken or bent at the end of fatigue tests.Conclusions: EPS can significantly improve the bone purchase and the pull-out strength compared to USS, Tenor and CDH screws with similar dimensions before and after failure simulation. The fatigue characteristic of EPS is similar to that of CDH, USS and Tenor screws.

  1. Results of screw fixation combined with cortical drilling for treatment of dorsal cortical stress fractures of the third metacarpal bone in 56 Thoroughbred racehorses

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate screw fixation with cortical drilling as a surgical treatment for dorsal cortical stress fractures of MCIII in the Thoroughbred racehorse. Details of age, sex, limb affected, fracture assessment, and post operative recommendations were obtained from medical records and radiographs. Fracture healing was assessed radiographically at the time of screw removal. Performance evaluation was determined from race records obtained from The Jockey Club Information System, Lexington, Kentucky. Fifty-six Thoroughbred racehorses were treated surgically for stress fracture of MCIII with screw fixation and cortical drilling. Stress fractures occurred primarily in the left front limb of the male 3-year-olds, in the dorsolateral cortex of the middle third of MCIII. Ninety-seven percent of the fractures travelled in a dorsodistal to palmaroproximal direction. Median period to screw removal was 2.0 months. Evaluation at time of screw removal revealed 98% of single stress fractures of the left front limb were healed radiographically. Median period to resume training was 2.75 months (single stress fractures); median period to race was 7.62 months. There was no statistically significant difference in earnings/start before and after surgical intervention. Of the 63 fractures treated, two recurred. There were no catastrophic failures, and no incisional infections

  2. Reinforcement of osteosynthesis screws with brushite cement.

    Science.gov (United States)

    Van Landuyt, P; Peter, B; Beluze, L; Lemaître, J

    1999-08-01

    The fixation of osteosynthesis screws remains a severe problem for fracture repair among osteoporotic patients. Polymethyl-methacrylate (PMMA) is routinely used to improve screw fixation, but this material has well-known drawbacks such as monomer toxicity, exothermic polymerization, and nonresorbability. Calcium phosphate cements have been developed for several years. Among these new bone substitution materials, brushite cements have the advantage of being injectable and resorbable. The aim of this study is to assess the reinforcement of osteosynthesis screws with brushite cement. Polyurethane foams, whose density is close to that of cancellous bone, were used as bone model. A hole was tapped in a foam sample, then brushite cement was injected. Trabecular osteosynthesis screws were inserted. After 24 h of aging in water, the stripping force was measured by a pull-out test. Screws (4.0 and 6.5 mm diameter) and two foam densities (0.14 and 0.28 g/cm3) were compared. Cements with varying solid/liquid ratios and xanthan contents were used in order to obtain the best screw reinforcement. During the pull-out test, the stripping force first increases to a maximum, then drops to a steady-state value until complete screw extraction. Both maximum force and plateau value increase drastically in the presence of cement. The highest stripping force is observed for 6.5-mm screws reinforced with cement in low-density foams. In this case, the stripping force is multiplied by 3.3 in the presence of cement. In a second experiment, cements with solid/liquid ratio ranging from 2.0 to 3.5 g/mL were used with 6.5-mm diameter screws. In some compositions, xanthan was added to improve injectability. The best results were obtained with 2.5 g/mL cement containing xanthan and with 3.0 g/mL cements without xanthan. A 0.9-kN maximal stripping force was observed with nonreinforced screws, while 1.9 kN was reached with reinforced screws. These first results are very promising regarding screw

  3. Double insurance transfacetal screws for lumbar spinal stabilization

    Directory of Open Access Journals (Sweden)

    Atul Goel

    2014-01-01

    Full Text Available Aim: The authors report experience with 14 cases where two screws or ′′double insurance′′ screws were used for transfacetal fixation of each joint for stabilization of the lumbar spinal segment. The anatomical subtleties of the technique of insertion of screws are elaborated. Materials and Methods: During the period March 2011 to June 2014, 14 patients having lumbar spinal segmental instability related to lumbar canal stenosis were treated by insertion of two screws into each articular assembly by transfacetal technique. After a wide surgical exposure, the articular cartilage was denuded and bone chips were impacted into the joint cavity. For screw insertion in an appropriate angulation, the spinous process was sectioned at its base. The screws (2.8 mm in diameter and 18 mm in length were inserted into the substance of the medial or inferior articular facet of the rostral vertebra via the lateral limit of the lamina approximately 6-8 mm away from the edge of the articular cavity. The screws were inserted 3 mm below the superior edge and 5 mm above the inferior edge of the medial (inferior facets and directed laterally and traversed through the articular cavity into the lateral (superior articular facet of the caudal vertebra toward and into the region of junction of base of transverse process and of the pedicle. During the period of follow-up all treated spinal levels showed firm bone fusion. There was no complication related to insertion of the screws. There was no incidence of screw misplacement, displacementor implant rejection. Conclusions: Screw insertion into the firm and largely cortical bones of facets of lumbar spine can provide robust fixation and firm stabilization of the spinal segment. The large size of the facets provides an opportunity to insert two screws at each spinal segment. The firm and cortical bone material and absence on any neural or vascular structure in the course of the screw traverse provides strength and

  4. CT-based three-dimensional reconstruction navigation technique assisted pedicle screw placement in lumbar and sacral bone%腰骶骨椎弓根螺钉置入内固定:CT三维重建虚拟导航的辅助

    Institute of Scientific and Technical Information of China (English)

    陈晓明; 陈前芬; 肖增明; 宗少晖

    2015-01-01

      结果与结论:共置入腰骶椎椎弓根螺钉1088枚,其中1068枚螺钉位置为Ⅰ级,置钉准确率达98.2%。152例获得随访,随访时间12个月,无内固定物移位、断裂等并发症。术前CT三维重建虚拟导航技术能为腰骶骨椎弓根螺钉内固定提供三维立体的解剖信息,制定最优置钉计划,使置钉更加精确安全,从而提高整体的修复质量。%BACKGROUND:Pedicle screw fixation techniques have been widely used in the treatment of lumbar and sacral disease, such as trauma, deformity, tumor and degeneration. How to improve the accuracy of screw placement is a hot topic. CT-based three-dimensional reconstruction navigation technique provides real-time, multi-perspective, three-dimensional visualization of lumbar and sacral anatomy, and surgeons can perform the pedicle screw insertion procedures confidently with increase of accuracy and safety. OBJECTIVE:To study the clinical value of CT-based three-dimensional reconstruction navigation technique in the application of lumbar and sacral pedicle screw placement. METHODS:A total of 203 patients with lumbar and sacral diseases, including lumbar fracture, lumbar spondylolysis and lumbar spinal stenosis, were recruited from Department of Spine&Osteopathy, the First Affiliated Hospital of Guangxi Medical University between July 2008 and November 2014. Patients received pedicle screw placement in lumbar and sacral bone under the guidance of CT-based three-dimensional reconstruction navigation. Postoperative X-ray films and three-dimensional CT scan of lumbar bone were routinely examined in each patient. The accuracy of pedicle screw insertion was evaluated with postoperative CT scan according to Andrew classification. RESULTS AND CONCLUSION:A total of 1 088 screws were inserted in the lumbar and sacral bone. The accuracy of pedicle screw insertion was rated as grade I in 1 068 screws (98.2%) according to postoperative CT scan. 152 cases were fol owed

  5. 腰椎内固定中两种椎弓根钉加强技术与骨水泥的应用%Two strengthening pedicle screw techniques and bone cement in lumbar internal fixation

    Institute of Scientific and Technical Information of China (English)

    江泽华; 朱如森; 袁建军; 邵高升; 张学利

    2013-01-01

    BACKGROUND:Screw loosening and shedding may occur after osteoporosis associated with lumbar degenerative disease treated with pedicle screw fixation. Application of pedicle screw enhanced with cured materials can improve the therapeutic effect. OBJECTIVE:To compare the clinical effect of pedicle screws enhanced with poly(methyl methacrylate) and injectable calcium sulfate cement in the lumbar internal fixation of osteoporosis. METHODS:Sixty-one patients diagnosed with osteoporosis combined with lumbar spondylolisthesis, lumbar spinal instability, and severe lumbar spinal stenosis were col ected. Al patients were divided into two groups according to the treatment method:poly(methyl methacrylate) bone cement enhanced pedicle screw group and calcium sulfate bone cement enhanced pedicle screw group. RESULTS AND CONCLUSION:There were no significant differences in the operation time, blood loss, preoperative and postoperative visual analog scale score, Japanese Orthopedic Association scores and the Japanese Orthopedic Association score improvement rate between two groups (P>0.05). The results showed that two patients had bone cement leakage in poly(methyl methacrylate) group which had no neurological symptoms caused by new symptoms during fol ow-up period. The bone mineral density was not improved gradual y in poly(methyl methacrylate) group with fol ow-up time prolonging;however, in calcium sulfate group, the bone mineral density was increased significantly after treatment, and the change of bone mineral density was linearly related with Japanese Orthopaedic Association score improvement rate in calcium sulfate group. No screw loosening, pul ing out or neurological dysfunction occurred in both groups. The results indicate that like poly(methyl methacrylate), balcium sulfate bone cement can increase the stability of pedicle screws.%背景:骨质疏松伴腰椎退行性病变行椎弓根钉固定骨质疏松的椎体后可能会出现螺钉的松动、脱落,使用

  6. Biomechanical analysis of the percutaneous compression plate and sliding hip screw in intracapsular hip fractures: experimental assessment using synthetic and cadaver bones.

    NARCIS (Netherlands)

    Brandt, E.; Verdonschot, N.J.J.; Vugt, A.B. van; Kampen, A. van

    2006-01-01

    We compared the mechanical behaviour of osteosynthesis with the percutaneous compression plate (PCCP) compared with the standard osteosynthesis sliding hip screw (SHS) in intracapsular hip fractures. We created 10 stable and 10 unstable intracapsular hip fractures in 20 synthetic femurs. Each fractu

  7. An Investigation into the Correlation between the Density of Alveolar Bone around Micro-screws and Their Stability with Cone-Beam CT%利用Cone-Beam CT探讨支抗微螺钉周围骨密度与其稳定性的关系

    Institute of Scientific and Technical Information of China (English)

    秦璐; 邵奕奕; 赵颖

    2013-01-01

    目的:利用Cone-Beam CT测量支抗微螺钉周围骨密度值,探讨其与微螺钉稳定性的关系.方法:选取颌骨左右对称植入微螺钉后一侧松动而另一侧稳固的7名(共18枚微螺钉)正畸患者.拍摄CBCT,所得三维影像重建后用OnDemand 3D Application软件对微螺钉骨内部分周围2 mm范围内骨密度(以Hounsfield Unit表示)进行测量,自身对照比较分析双侧对称部位所植入微螺钉周围骨密度测量值间的差异.结果:松动微螺钉与稳定微螺钉骨内部分周围2 mm范围内骨密度无统计学差异,两侧微螺钉钉尖部1/3、钉中部1/3及钉颈部1/3周围骨密度均无统计学差异.结论:微螺钉种植支抗的稳定性与其周围骨密度间未发现明显相关性.%Objective:To study the relationship between the bone mineral density around micro-screws and their stability with Cone-Beam CT.Methods:7 patients who received orthodontic treatment with micro-screw anchorage were selected in this retrospective study.All of them had micro-screws implanted into symmetric locations,one screw became flexible while the other one stable.The total number of the micro-screws in this research was 18.CBCT films were taken after micro-screw were flexible,the DICOM data were reconstructed via OnDemand 3D Application software.The density of 2mm alveolar bone outside the micro-screws was evaluated,presented in Hounsfiled Unit.The difference of alveolar bone density between the loose and stable micro-screws were analyzed with self-control design.Results:No significant difference of the alveolar bone density outside the micro-screws were detected,no matter in the whole body,the tip,middle or neck area of them.Conclusion:No significant correlation between the alveolar bone density around micro-screwsand their stability was found.

  8. Pullout strength of misplaced pedicle screws in the thoracic and lumbar vertebrae - A cadaveric study

    Directory of Open Access Journals (Sweden)

    Shyam K Saraf

    2013-01-01

    Full Text Available Background: The objective of this cadaveric study was to analyze the effects of iatrogenic pedicle perforations from screw misplacement on the mean pullout strength of lower thoracic and lumbar pedicle screws. We also investigated the effect of bone mineral density (BMD, diameter of pedicle screws, and the region of spine on the pullout strength of pedicle screws. Materials and Methods: Sixty fresh human cadaveric vertebrae (D10-L2 were harvested. Dual-energy X-ray absorptiometry (DEXA scan of vertebrae was done for BMD. Titanium pedicle screws of different diameters (5.2 and 6.2 mm were inserted in the thoracic and lumbar segments after dividing the specimens into three groups: a standard pedicle screw (no cortical perforation; b screw with medial cortical perforation; and c screw with lateral cortical perforation. Finally, pullout load of pedicle screws was recorded using INSTRON Universal Testing Machine. Results: Compared with standard placement, medially misplaced screws had 9.4% greater mean pullout strength and laterally misplaced screws had 47.3% lesser mean pullout strength. The pullout strength of the 6.2 mm pedicle screws was 33% greater than that of the 5.2 mm pedicle screws. The pullout load of pedicle screws in lumbar vertebra was 13.9% greater than that in the thoracic vertebra ( P = 0.105, but it was not statistically significant. There was no significant difference between pullout loads of vertebra with different BMD ( P = 0.901. Conclusion: The mean pullout strength was less with lateral misplaced pedicle screws while medial misplaced pedicle screw had more pullout strength. The pullout load of 6.2 mm screws was greater than that of 5.2 mm pedicle screws. No significant correlation was found between bone mineral densities and the pullout strength of vertebra. Similarly, the pullout load of screw placed in thoracic and lumbar vertebrae was not significantly different.

  9. Biomechanical evaluation of expansive pedicle screws and injectable absorbable bone cement augmentation in the osteoporotic vertebral environment%膨胀螺钉及钉道强化在骨质疏松椎体中的力学可靠性研究

    Institute of Scientific and Technical Information of China (English)

    高明暄; 李旭升; 甄平; 吴智钢; 周胜虎; 田琦; 任民; 雷伟

    2014-01-01

    Objective To evaluate the fixation strengths of expansive pedicle screws in human cadaveric vertebrae with different bone mineral densities and with the augmentation by newly-developed injectable absorbable bone cement(IABC).Methods Fresh human cadaveric spines used for this study were grouped into 4 levels according to the measurements of bone mineral density:normal,osteopenia,osteoporosis and severe osteoporosis.The vertebrae were bilaterally instrumented with 4 pedicle screw protocols:conventional pedicle screw without augmentation,expansive pedicle screw without augmentation,conventional pedicle screw with augmentation and expansive pedicle screw with augmentation.The statistical method of balanced incomplete randomized blocks was used to assign the pedicles for the 4 protocols,resulting in 9 screws per group per level.Screw pullout tests were conducted.On the load-stroke curve,the maximum pullout strength and stiffness were determined.The differences between groups at the same bone mineral density level but with different screw protocols,or between groups at different bone mineral density levels but with the same screw protocol,were compared.Results Given the same bone mineral density level,the maximum pullout strength and stiffness of expansive screws were significantly higher than those of conventional screws (P < 0.05).When the same type of screw was used,the maximum pullout strength in the augmented group was significantly higher than in the non-augmented group (P < 0.05),but the cement augmentation had insignificant impact on the stiffness of either conventional or expansive pedicle screws (P > 0.05).The pullout strength and stiffness of expansive screws,augmented conventional screws and augmented expansive screws at the osteoporotic level were comparable to those of conventional screws at the osteopenic lcvel (P > 0.05).However,the pullout strength of any of the 4 protocols in the severe osteoporosis group was significantly lower than that of

  10. Hydroxyapatite composite resin cement augmentation of pedicle screw fixation.

    Science.gov (United States)

    Turner, Alexander W L; Gillies, R Mark; Svehla, Martin J; Saito, Masanobu; Walsh, William R

    2003-01-01

    Pedicle screw stability is poor in osteopenic vertebrae attributable, in part, to low screw-bone interface strength. The current authors examined cement augmentation using a low curing temperature hydroxyapatite and bis-phenol-A glycidol methacrylate-based composite resin. This cement may stiffen the screw-bone interface and reduce the harmful effects associated with polymethylmethacrylate regarding temperature and toxic monomer. Thirty-five lumbar vertebrae from human cadavers were instrumented with pedicle screws, with one pedicle previously injected with cement and the other as the control. Caudocephalad toggling of +/- 1 mm for 1600 cycles was applied to the pedicle screws, and the resulting forces supported by the implant-bone interface were captured by a load cell. A curve was constructed from the peak caudal load for each cycle and three mechanical measures parameterized this curve: (1) initial load; (2) rate of load decay during the first 400 cycles; and (3) final load. The initial load increased by 16% as a result of cement augmentation, the final load increased by 65%, and the rate of load decay decreased by 59%. Cement augmentation of pedicle screws increased the stiffness and stability of the screw-bone interface. PMID:12579026

  11. Supporting screws combined with bone cement filling for reconstructing tibial bone defect in knee arthroplasty%支撑螺钉结合骨水泥填充重建膝关节置换术中胫骨平台骨缺损

    Institute of Scientific and Technical Information of China (English)

    黄海; 张喜才

    2014-01-01

    Objective To observe the clinical effect of supporting screws combined with bone cement filling on reconstructing tibial bone defect in knee arthroplasty.Methods Thirty-one patients (47 lateral tibial plateau structural bone defect) underwent total knee replacement.After conventional tibial osteotomy,2 or 3 pieces of supporting screws were screwed according to bone defect area,and bone cement was pressurely filled,and then the tibial prosthesis was installed.The knee rehabilitation training was strengthened and the effect was regular followed up after the operation.Results Thirty-one patients were followed up for 1-5 years,average 2.8 years.The pain of the knee completely disappeared after operation,and the stability and function of the knee were good.The KSS knee score were 87 to 95 points,an average of 92.4 points,which were significantly improved after operation (t =6.41,P < 0.01).In the last follow-up through X-ray examination,there were no prosthesis loosening or signs of infection,no bone cement filling zone interface lucency or supporting screw loosening,displacement or other complications.Conclusions Supporting screws combined with bone cement filling technique can effectively resolve the tibial knee replacement of large bone defects,and the short-term curative effect is satisfactory.So it is one of the ideal methods for senile patients.%目的 观察支撑螺钉结合骨水泥填充重建膝关节置换术中胫骨平台骨缺损的临床疗效.方法 对31例47侧重度胫骨平台结构性骨缺损患者行全膝关节置换术,常规胫骨平台截骨,截骨后根据骨缺损面积,拧入2~3枚支撑螺钉,加压填充骨水泥,安置胫骨骨水泥假体.术后加强膝关节功能康复训练并定期随访疗效.结果 31例患者术后随访1~5年,平均2.8年,术后疼痛完全消失,膝关节稳定性及功能均良好.膝关节KSS评分87~95分,平均92.4分,较术前显著改善(t=6.41,P<0.01).术后末次随访复查X线片未见

  12. Comparison of expansive pedicle screw and polymethylmethacrylate-augmented pedicle screw in osteoporotic sheep lumbar vertebrae: biomechanical and interfacial evaluations.

    Directory of Open Access Journals (Sweden)

    Da Liu

    Full Text Available BACKGROUND: It was reported that expansive pedicle screw (EPS and polymethylmethacrylate-augmented pedicle screw (PMMA-PS could be used to increase screw stability in osteoporosis. However, there are no studies comparing the two kinds of screws in vivo. Thus, we aimed to compare biomechanical and interfacial performances of EPS and PMMA-PS in osteoporotic sheep spine. METHODOLOGY/PRINCIPAL FINDINGS: After successful induction of osteoporotic sheep, lumbar vertebrae in each sheep were randomly divided into three groups. The conventional pedicle screw (CPS was inserted directly into vertebrae in CPS group; PMMA was injected prior to insertion of CPS in PMMA-PS group; and the EPS was inserted in EPS group. Sheep were killed and biomechanical tests, micro-CT analysis and histological observation were performed at both 6 and 12 weeks post-operation. At 6-week and 12-week, screw stabilities in EPS and PMMA-PS groups were significantly higher than that in CPS group, but there were no significant differences between EPS and PMMA-PS groups at two study periods. The screw stability in EPS group at 12-week was significantly higher than that at 6-week. The bone trabeculae around the expanding anterior part of EPS were more and denser than that in CPS group at 6-week and 12-week. PMMA was found without any degradation and absorption forming non-biological "screw-PMMA-bone" interface in PMMA-PS group, however, more and more bone trabeculae surrounded anterior part of EPS improving local bone quality and formed biological "screw-bone" interface. CONCLUSIONS/SIGNIFICANCE: EPS can markedly enhance screw stability with a similar effect to the traditional method of screw augmentation with PMMA in initial surgery in osteoporosis. EPS can form better biological interface between screw and bone than PMMA-PS. In addition, EPS have no risk of thermal injury, leakage and compression caused by PMMA. We propose EPS has a great application potential in augmentation of

  13. The clinical effects of osteoporosis of lumbar degenerative disease by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation%骨质疏松腰椎退行性疾病的手术治疗分析

    Institute of Scientific and Technical Information of China (English)

    孔祥瑞; 刘德政; 刘海峰; 杨计策; 赵志超

    2015-01-01

    ObjectiveTo explore the clinical effects of osteoporosis of lumbar degenerative disease by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation. Methods 82 cases of patients with lumbar degenerative dis-ease of osteoporosis word randomly divided into experiment group(41 cases) and control group(41 cases). The control group were treated by transpedicle screws fixation, the experiment group were treated by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation. The time of operation, mean bleeding volum, the scores of VAS, ODI, JOA were com-pared for the two groups. ResultsThe time of operation, mean bleeding volum for the experiment group were better than the control group; There was no significant difference on the scores of VAS, ODI, JOA; The scores of VAS, ODI for the experiment group were lower than the control group postoperation for 1 week, 2 months, 12 months; The scores of JOA for the experiment group were higher than the control group postoperation for 1 week, 2 months, 12 months. ConclusionIt can improve the scores of VAS, ODI, JOA for the patients with osteoporosis of lumbar degenerative disease by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation. It is worthy of clinical promotion.%目的:探讨可注射硫酸钙骨水泥强化椎弓根钉内固定治疗骨质疏松腰椎退行性疾病的临床疗效。方法:按照随机数字表法将我院收治的82例骨质疏松腰椎退行性疾病患者均分为实验组和对照组,对照组给予单纯椎弓根内固定治疗,实验组给予可注射硫酸钙骨水泥强化椎弓根钉内固定治疗。比较两组患者手术时间、术中出血量以及治疗前后疼痛视觉模拟评分(VAS)、Oswestry 功能障碍指数(ODI)、JOA 腰椎病疗效评分变化情况。结果:实验组患者手术时间和术中出血量显著高于对照组;两组患者术前 VAS 评分、ODI 评分、JOA

  14. 骨水泥钉道强化联合空心侧孔椎弓根螺钉治疗伴骨质疏松症的腰椎退行性病变的临床疗效观察%Comparison of the clinical effect of PMMA bone cement augmented screw passageway and bone cement-injectable cannulated pedicle screw in treatment of degenerative lumbar disease with osteoporosis

    Institute of Scientific and Technical Information of China (English)

    刘松明; 宋洁富; 荆志振

    2016-01-01

    目的:比较空心侧孔椎弓根螺钉和骨水泥钉道( PMMA)强化方法应用于伴骨质疏松症的腰椎退行性病变的临床效果。方法选取伴骨质疏松症的腰椎退行性病变患者48例,男21例,女27例;年龄54~78岁,平均64.5岁。其中腰椎管狭窄症17例,腰椎间盘突出症18例,退行性腰椎滑脱症8例,腰椎退行性侧凸5例。按手术方式分为两组,A组23例采用空心侧孔椎弓根螺钉+PMMA。 B组25例采用PMMA行钉道强化+普通椎弓根螺钉内固定术。比较两组手术时间、出血量、住院时间。采用疼痛视觉模拟量表( visual analogue scale,VAS)评分,Oswestry功能障碍指数( Oswestry disability index,ODI)评价患者术后疼痛和功能恢复情况。术前及术后1、3、6、12个月及术后每年行X线检查评估椎间隙高度丢失、内固定失败率和椎间植骨融合率。结果48例患者均得到随访,随访时间1~3.5年。 A组手术时间、出血量、住院时间显著优于B组(均P<0.05)。 A组、B组植骨融合率分别为92.1%、91.2%,两组差异无统计学意义( P>0.05)。A组发生螺钉断裂1例,B组未出现此类情况(P<0.05)。 B组发生内固定松动、螺钉拔出内固定失败1例, A组未发生此类情况(P<0.05)。 A组椎间隙高度丢失(2.7±1.7)mm,B组椎间隙高度丢失(3.7±2.1)mm,两组差异有统计学意义(P<0.05)。根据VAS评分和ODI,两组患者术后疼痛与功能均得到改善,A组效果优于B组(均P<0.05)。结论空心侧孔椎弓根螺钉+PMMA强化内固定用于伴骨质疏松症的腰椎退行性病变是一种具有较好安全性和有效性的方法。%Objective To compare the clinical effect of PMMA bone cement augmented screw passageway and bone cement-injectable cannulated pedicle screw in treatment of degenerative lumbar disease with osteoporosis. Methods

  15. Comparative study of bone cement injectable canulated pedicle screw and conventional screw path-augmentation with bone cement in treatment of lumbar spondylolisthesis with osteoporosis%新型可注射骨水泥椎弓根螺钉与骨水泥钉道强化在治疗腰椎滑脱伴骨质疏松中的比较研究

    Institute of Scientific and Technical Information of China (English)

    代飞; 刘瑶瑶; 孙东; 徐美涛; 许建中

    2014-01-01

    目的:比较新型可注射骨水泥椎弓根螺钉( bone cement injectable canulated pedicle screw , CICPS)和传统骨水泥钉道强化方法应用于治疗腰椎滑脱伴骨质疏松患者的临床疗效。方法2011年7月~2013年11月序贯纳入腰椎滑脱伴骨质疏松患者( T<-2.5)43例,随机分为2组,A组20例采用CICPS行后路滑脱复位植骨融合内固定术。B组23例采用传统骨水泥钉道强化内固定术。比较2组手术时间、出血量、住院时间。采用疼痛视觉模拟量表(visual analogue scale, VAS)评分,Oswestry功能障碍指数(Oswestry disability index, ODI)评价患者术后疼痛和功能恢复。术前及术后1、3、6、12个月及术后每年行X线和CT检查评估椎间隙高度丢失、内固定失败率和椎间植骨融合率。结果43例患者均得到随访,随访时间为6~33个月,平均16.5个月。 A组手术时间、出血量、住院时间显著低于B组(P<0.05)。 A组和B组植骨融合率分别为94.6%、90.2%,2组比较差异无统计学意义(P>0.05)。 B组发生内固定松动、螺钉拔出3例,A组未发生此类情况。A组椎间隙高度丢失(2.3±1.2)mm,B组椎间隙高度丢失(3.6±2.2) mm,2组比较差异有统计学意义(P<0.05)。根据VAS评分和ODI,2组患者术后疼痛与功能均得到改善,A组效果优于B组(P<0.05)。结论 CICPS强化内固定稳定性是一种具有较好安全性和有效性的新方法。%Objective To compare the clinical effect of bone cement injectable canulated pedicle screw (CICPS) and conven-tional screw path-augmentation with bone cement in the treatment of lumbar spondylolisthesis with osteoporosis patients.Methods From July 2011 to November 2013, sequential 43 patients with osteoporosis (T≤-2.5) and lumbar spondylolisthesis were randomly divided into 2 groups.Group A of 20 cases were treated with CICPS and group B of

  16. EFFECT OF THE SCREW TORQUE LEVEL ON THE INTERFRAGMENTARY STRAIN AND THE INTERFRAGMENTARY MODULUS

    Directory of Open Access Journals (Sweden)

    Boonthum Wongchai

    2013-01-01

    Full Text Available The screw torque is applied at the screw head to fix the plate and the bone. It generates the compressive force between the plate and the bone to stabilize them. The interfragmentary strain is the main factor for healing the bone fractured. The screw torque level affects the interfragmentary strain and the stability of the fixation between the plates an the bone. The interfragmentary modulus is the new factor of the plate fixation stability and it is affected by the torque level. This research is proposed to study the effect of the screw torque level on the interfragmentary strain and the interfragmentary modulus. The interfragmentary strain and the interfragmentary modulus decrease by increasing the screw torque level.

  17. Transpedicular vertebral body augmentation reinforced with pedicle screw fixation in fresh traumatic A2 and A3 lumbar fractures: comparison between two devices and two bone cements.

    Science.gov (United States)

    Korovessis, Panagiotis; Vardakastanis, Konstantinos; Repantis, Thomas; Vitsas, Vasilios

    2014-07-01

    This retrospective study compares efficacy and safety of balloon kyphoplasty (BK) with calcium phosphate (Group A) versus KIVA implant with PMMA (Group B) reinforced with three vertebrae pedicle screw constructs for A2 and A3 single fresh non-osteoporotic lumbar (L1-L4) fractures in 38 consecutive age- and diagnosis-matched patient populations. Extracanal leakage of both low-viscosity PMMA and calcium phosphate (CP) as well as the following roentgenographic parameters: segmental kyphosis (SKA), anterior (AVBHr) and posterior (PVBHr) vertebral body height ratio, spinal canal encroachment (SCE) clearance, and functional outcome measures: VAS and SF-36, were recorded and compared between the two groups. All patients in both groups were followed for a minimum 26 (Group A) and 25 (Group B) months. Extracanal CP and PMMA leakage was observed in four (18 %) and three (15 %) vertebrae/patients of group A and B, respectively. Hybrid fixation improved AVBHr, SKA, SCE, but PVBHr only in group B. VAS and SF-36 improved postoperatively in the patients of both groups. Short-segment construct with the novel KIVA implant restored better than BK-fractured lumbar vertebral body, but this had no impact in functional outcome. Since there was no leakage difference between PMMA and calcium phosphate and no short-term adverse related to PMMA use were observed, we advice the use of PMMA in fresh traumatic lumbar fractures. PMID:23982115

  18. Cement leakage in pedicle screw augmentation: a prospective analysis of 98 patients and 474 augmented pedicle screws.

    Science.gov (United States)

    Mueller, Jan U; Baldauf, Joerg; Marx, Sascha; Kirsch, Michael; Schroeder, Henry W S; Pillich, Dirk T

    2016-07-01

    OBJECTIVE Loosening and pullout of pedicle screws are well-known problems in pedicle screw fixation surgery. Augmentation of pedicle screws with bone cement, first described as early as 1975, increases the pedicle-screw interface and pullout force in osteoporotic vertebrae. The aim of the present study was to identify cement leakage and pulmonary embolism rates in a large prospective single-center series of pedicle screw augmentations. METHODS All patients who underwent cement-augmented pedicle screw placement between May 2006 and October 2010 at the authors' institution were included in this prospective cohort study. Perivertebral cement leakage and pulmonary cement embolism were evaluated with a CT scan of the area of operation and with a radiograph of the chest, respectively. RESULTS A total of 98 patients underwent placement of cement-augmented pedicle screws; 474 augmented screws were inserted in 237 vertebrae. No symptomatic perivertebral cement leakage or symptomatic pulmonary cement embolism was observed, but asymptomatic perivertebral cement leakage was seen in 88 patients (93.6%) and in 165 augmented vertebrae (73.3%). Cement leakage most often occurred in the perivertebral venous system. Clinically asymptomatic pulmonary cement embolism was found in 4 patients (4.1%). CONCLUSIONS Perivertebral cement leakage often occurs in pedicle screw augmentation, but in most cases, it is clinically asymptomatic. Cement augmentation should be performed under continuous fluoroscopy to avoid high-volume leakage. Alternative strategies, such as use of expandable screws, should be examined in more detail for patients at high risk of screw loosening. PMID:26943258

  19. 腰椎皮质骨钉道螺钉在骨质疏松症患者中应用的三维有限元分析%Biomechanical evaluation of lumbar pedicle screws using cortical bone trajectory in osteoporosis:a finite element study

    Institute of Scientific and Technical Information of China (English)

    邵明昊; 吕飞舟; 马晓生; 夏新雷; 王洪立; 郑超君; 张帆; 姜建元

    2015-01-01

    目的:比较椎弓根皮质骨钉道(cortical bone trajectory,CBT)螺钉和传统椎弓根钉道(traditional trajectory,TT)螺钉抗拔出力、螺钉及椎体稳定性的差异。方法回顾性选取复旦大学附属华山医院2015年3月至9月骨质疏松症患者7例,年龄57~63岁,平均(61.4±3.1)岁,均为女性,骨密度T值均<-2.5 SD。使用Mimics和Abaqus 6.9建立L4椎体模型,选用TT螺钉(直径为6.5 mm、长度为45 mm)和CBT螺钉(直径为5.0 mm、长度为35 mm)模拟置钉,分析并比较两种螺钉的轴向抗拔出力、上下左右载荷情况下螺钉载荷位移比及前屈后伸、轴向及侧屈旋转工况下椎体载荷位移比情况。结果CBT螺钉组的抗拔出力[(1013.2±279.1)N]较TT螺钉组[(1277.1±331.3)N]高出26.04%(t=3.128,P=0.024)。CBT螺钉组在受到上下左右应力时载荷位移比明显大于TT螺钉组(t=3.217,P=0.021;t=3.216,P=0.021;t=3.214,P=0.017;t=3.221, P=0.016)。CBT螺钉组椎体前屈、后伸载荷位移比明显大于TT螺钉组(t=2.733,P=0.034;t=2.712,P=0.031);而TT螺钉组椎体轴向、侧屈旋转载荷位移比较CBT螺钉组高(t=3.941, P=0.011;t=4.432,P=0.007)。结论相比TT螺钉,CBT螺钉具有更强的抗拔出力及螺钉稳定性,且椎体前屈、后伸的稳定性强于TT螺钉固定。CBT螺钉内固定为骨质疏松患者的腰椎手术提供了更多的选择。%ObjectiveThe purpose of the present study was to evaluate the differences of pull-out strength and stability of screw and vertebrae between two models using cortical bone trajectory (CBT) screw and traditional trajectory (TT) screw and provide theoretical basis for the clinical application of CBT screw.Methods Finite element models of L4 vertebrae were builded using Mimics and Abaqus 6.9, according to 7 osteoporotic patients, ranging in age from 57 to 63 years, at average age of (61.4±3.1) years, admitted to

  20. Analysis the Clinical Curtive Effect of Thoracic Lumbar Spine Fractures of Posterior Pedicle Screw Fixation Combined Bone Graft Surgery%脊柱胸腰段骨折行后路椎弓根螺钉内固定联合植骨手术的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    慕志广

    2016-01-01

    Objective To evaluate the clinical curative effect for joint posterior pedicle screw internal fixation bone graft surgery in treatment of thoracic lumbar spine fractures.Methods Selected 72 cases of thoracic lumbar spine fracture patients in our hospital, which were randomly divided into two groups, each group had 36 cases, control group with posterior pedicle screw internal fixation treatment, the observation group patients give posterior pedicle screw internal fixation with bone graft surgery therapy.ResultsAfter surgery, VAS score, Cobb Angle observation group were better than the control group (P<0.05), two groups of data difference was statistically signiifcant (P<0.05).Conclusion Posterior pedicle screw internal fixation with bone graft surgery therapy thoracic lumbar spine fracture effect is remarkable was statistically significant (P<0.05). Conclusion Posterior pedicle screw internal fixation with bone graft surgery therapy thoracic lumbar spine fracture effect is remarkable.%目的:探讨后路椎弓根螺钉内固定联合植骨手术治疗脊柱胸腰段骨折的临床疗效。方法将我院收治的72例脊柱胸腰段骨折患者随机分为两组,各36例。对照组单用后路椎弓根螺钉内固定治疗,观察组给予后路椎弓根螺钉内固定联合植骨手术治疗。结果手术后,观察组VAS评分、Cobb角均优于对照组(P<0.05),差异有统计学意义(P<0.05)。结论后路椎弓根螺钉内固定联合植骨手术治疗脊柱胸腰段骨折效果显著。

  1. Bioresorbable screws reinforced with phosphate glass fibre: manufacturing and mechanical property characterisation.

    Science.gov (United States)

    Felfel, R M; Ahmed, I; Parsons, A J; Rudd, C D

    2013-01-01

    Use of bioresorbable screws could eliminate disadvantages associated with metals such as removal operations, corrosion, MRI interference and stress shielding. Mechanical properties of bioresorbable polymers alone are insufficient for load bearing applications application as screws. Thus, reinforcement is necessary to try and match or surpass the mechanical properties of cortical bone. Phosphate based glass fibres were used to reinforce polylactic acid (PLA) in order to produce unidirectionally aligned (UD) and unidirectionally plus randomly distributed (UD/RM) composite screws (P40 UD and P40 UD/RM). The maximum flexural and push-out properties for the composite screws (P40 UD and P40 UD/RM) increased by almost 100% in comparison with the PLA screws. While the pull-out strength and stiffness of the headless composite screws were ∼80% (strength) and ∼130% (stiffness) higher than for PLA, those with heads exhibited properties lower than those for PLA alone as a result of failure at the heads. An increase in the maximum shear load and stiffness for the composite screws (∼30% and ∼40%) in comparison to the PLA screws was also seen. Maximum torque for the PLA screws was ∼1000 mN m, while that for the composite screws were slightly lower. The SEM micrographs for P40 UD and P40 UD/RM screws revealed small gaps around the fibres, which were suggested to be due to buckling of the UD fibres during the manufacturing process.

  2. Bone

    Science.gov (United States)

    Helmberger, Thomas K.; Hoffmann, Ralf-Thorsten

    The typical clinical signs in bone tumours are pain, destruction and destabilization, immobilization, neurologic deficits, and finally functional impairment. Primary malignant bone tumours are a rare entity, accounting for about 0.2% of all malignancies. Also benign primary bone tumours are in total rare and mostly asymptomatic. The most common symptomatic benign bone tumour is osteoid osteoma with an incidence of 1:2000.

  3. Clinical application of augmented pedicle screw fixation with bone cement in lumber spondylolisthesis accompanied with osteoporosis%骨水泥强化椎弓根螺钉在腰椎滑脱伴骨质疏松椎体中的临床应用

    Institute of Scientific and Technical Information of China (English)

    李鹏; 毛克亚; 王岩; 肖嵩华; 张永刚; 张西峰; 张雪松; 程自申; 毛克政

    2011-01-01

    目的 探讨骨水泥强化椎弓根螺钉在腰椎滑脱伴骨质疏松患者的手术方法和疗效.方法 2008年7月至2010年11月年期间收治腰椎滑脱伴骨质疏松患者12例,平均68岁.骨质疏松按Jikei分级Ⅱ级4例,Ⅲ级8例.所有患者行经椎弓根螺钉内固定,术中采用骨水泥强化提高螺钉稳定性,植入椎弓根螺钉共26枚,观察椎弓根螺钉术中及术后的稳定性.结果 患者未发生手术并发症,腰腿痛症状改善明显,术后VAS评分较术前比较改善明显.12例患者均获得随访,随访时间8-16个月,平均14个月.12例均获得骨性融合,X线片显示内固定无松动、断裂或脱落,螺钉周围未见透亮线出现.结论 经椎弓根骨水泥强化椎弓根螺钉,固化椎体的同时增加了椎弓根螺钉界面把持力,能够满足腰椎滑脱伴骨质疏松患者脊椎后路固定手术对力学稳定的要求.%Objective To explore the surgical method and efficacy of augmented pedicle screw fixation with bone cement for the treatment of lumber spondyiolisthesis accompanied with osteoporosis. Methods Twelve lumber spondyiolisthesis patients accompanied with osteoporosis were collected and treated from July 2008 to November 2010, with an average age of 68 years old. According to Jikei scale for osteoporosis, 4 patients were in stage II and 8 patients were in stage III. All patients were treated with internal fixations of pedicle screws and the stabilities of screws were augmented by bone cement augment during operations. Twenty-six pedicle screws were instrumented in this study. The stabilities of pedicle screws during and after the operation were observed. Results There were no operative complications. The symptoms of waist and leg pain were clearly alleviated. The VAS scores after operations were clearly ameliorated compared to those before the operation. All 12 patients were followed up for 8-16 months, with a mean of 14 months. All 12 patients achieved bone unions. The X

  4. 不同量骨水泥强化新型空心椎弓根螺钉的体外生物力学研究%Influence of the volume of bone cement on the reinforcement of a novel canulated pedicle screw: a biomechanical study in vitro

    Institute of Scientific and Technical Information of China (English)

    刘瑶瑶; 代飞; 孙东; 罗飞; 张泽华; 许建中

    2012-01-01

    Objective To evaluate the bone cement distribution and biomechanical stability of self-designed bone cement injectable canulated pedicle screw (CICPS). Methods CICPS, DTPSTM and solid pedicle screws were implanted into osteoporotic bone models (density: 0. 16 g/cm3, n = 7) according to the clinical standard procedure. Four different volumes of bone cement (1,2,3 and 5 ml) were used to reinforce CICPS and DTPSTM , respectively, and the solid pedicle screws were used as control. X-ray and CT were applied to observe the bone cement distribution in different groups. Maximum axial pullout strength test was used to analyze the relationship between the bone cement volume and maximum axial pullout strength, and the biomechanical stabilities of CICPS, DTPS and solid pedicle screws were compared. Results X-ray showed that there was no bone cement rear leakage in all screws. Three-dimensional reconstruction of X-ray and CT showed bone cement well and widely distributed through the three side holes of the CICPS in bone models. Bone cement flowed out mainly through the proximal side hole of the DTPSTM But rarely through the distal side hole. The maximum axial pullout strength of each group was as follows: solid pedicle screws; (28.5 ±4.0) N; CICPS: 1 ml (140.3 ±15.9) N, 2 ml (197. 1 ±9.8) N, 3 ml (215.4 ±10.7) N and 5 ml (237.0 ±23.6) N; and DTPSTM: 1 ml (114. 3 ± 17.7) N, 2 ml (180.5 ±13.6) N, 3 ml (207.2 ±30.0) N and 5 ml (291.3 ± 25. 1) N. The maximum axial pullout strength of the CICPS and DTPSTM after reinforced by bone cement was significantly greater than that of the control group, and the strength increased along with the increase of bone cement volume. When the volume of bone cement was 1, 2 and 3 ml, the biomechanical stability of the CICPS was higher than that of the DTPSTM ( P <0. 05 ). When the volume of bone cement was 5 ml, the biomechanical stability of the DTPSTM Was higher than that of the CICPS (P <0. 05). Conclusion It is effective to enhance the

  5. Bone cement-augmented pedicle screw fixation for lumbar spondylolisthesis combined with osteoporosis:1-year follow-up%骨水泥强化椎弓根螺钉置入固定骨质疏松性腰椎滑脱:1年随访

    Institute of Scientific and Technical Information of China (English)

    丁权; 陈勇

    2015-01-01

    BACKGROUND:For patients with lumbar spondylolisthesis combined with osteoporosis, appropriate fixation system for effective reset and good fixation stability is currently a hot issue of clinical concern. Pedicle screw screw-rod system after bone cement perfusion can achieve the effective fixation between pedicle screw system and the vertebral bone. OBJECTIVE:To observe the therapeutic effect of bone cement-augmented pedicle screw on patients with lumbar spondylolisthesis combined with osteoporosis. METHODS:17 cases of lumbar spondylolisthesis combined with osteoporosis were identified by bone density test. They received the posterior open reduction and internal fixation, and implanted with 68 bone cement-augmented pedicle screws. Their repair effects were observed by short-term fol ow-up. Patients were evaluated using low back pain Visual Analog Scale and lower limb Oswestry Disability Index before treatment, 1 week, 3 months and 1 year after treatment. Vertebral height, intervertebral height, screw loosening and bone cement leakage were observed using imaging. RESULTS AND CONCLUSION:Compared with pre-treatment, low back pain Visual Analog Scale score and lower limb Oswestry Disability Index were significantly improved at 1 week, 3 months and 1 year after treatment (P0.05), which indicated that clinical repair effect could be effectively maintained. At 3 months of fol ow-up, one screw loosening occurred in two patients. During fixation, mild bone cement leakage appeared in seven vertebral bodies with screw fixation, no symptoms or subsequent complications were observed. There were no significant differences in vertebral height and intervertebral height before and after treatment and during fol ow-up (P>0.05). These results suggest that bone cement-augmented pedicle screw for patients with lumbar spondylolisthesis combined with osteoporosis can effectively reset vertebral slippage, effectively provide good anti-pul-out force for a long term, and the effect was

  6. Screw bondgraph contact dynamics

    NARCIS (Netherlands)

    Visser, Martijn; Stramigioli, Stefano; Heemskerk, Cock

    2002-01-01

    This paper presents an elegant contact dynamics model in screw bondgraph form. It can model the contact between any two objects of finite curvature. It does so by defining a Gauss frame on the surfaces of both objects in the points that are closest to each other. Then it describes how the Gauss fram

  7. Intraoperative insertion torque of lumbar pedicle screw and postoperative radiographic evaluation. Short-term observation

    International Nuclear Information System (INIS)

    The correlation between the insertion torque of a lumbar pedicle screw and the mechanical stability of the screw in the bone has been mentioned in in vitro studies. The purpose of this study was to confirm the factors affecting the insertion torque of such screws in vivo. Also, the contribution of insertion torque to the initial stability of the fusion area was to be analyzed in vivo. A series of 23 cases representing 50 lumbar vertebrae were included in this study, in which we examined bone mineral density using quantitative computed tomography (CT) prior to operation. Two screw shapes were utilized, with the insertion torque for each screw measured at two points in time. The correlation between insertion torque and mineral density was investigated. Screw positions were confirmed on postoperative CT scans, and the effect of the screw thread cutting into the cortex bone was investigated. Radiographic changes at three points during a period of 3 months were also measured, and we then evaluated the interrelations between these changes and insertion torque. Furthermore, the relation between insertion torque and instability at 3 months was investigated. Correlations of insertion torque and bone mineral density depended on screw shape. There was no correlation found with mineral density in the case of cylindrical screws. Insertion torque was not affected by the screw thread cutting into the cortex of bone. As for postoperative alignment changes, no definitive trends could be ascertained, and no interrelations with torque and alignment changes were observed. There is a possibility that insertion torque was related to early-stage stability, but no statistical relation could be determined. (author)

  8. Virtual estimates of fastening strength for pedicle screw implantation procedures

    Science.gov (United States)

    Linte, Cristian A.; Camp, Jon J.; Augustine, Kurt E.; Huddleston, Paul M.; Robb, Richard A.; Holmes, David R.

    2014-03-01

    Traditional 2D images provide limited use for accurate planning of spine interventions, mainly due to the complex 3D anatomy of the spine and close proximity of nerve bundles and vascular structures that must be avoided during the procedure. Our previously developed clinician-friendly platform for spine surgery planning takes advantage of 3D pre-operative images, to enable oblique reformatting and 3D rendering of individual or multiple vertebrae, interactive templating, and placement of virtual pedicle implants. Here we extend the capabilities of the planning platform and demonstrate how the virtual templating approach not only assists with the selection of the optimal implant size and trajectory, but can also be augmented to provide surrogate estimates of the fastening strength of the implanted pedicle screws based on implant dimension and bone mineral density of the displaced bone substrate. According to the failure theories, each screw withstands a maximum holding power that is directly proportional to the screw diameter (D), the length of the in-bone segm,ent of the screw (L), and the density (i.e., bone mineral density) of the pedicle body. In this application, voxel intensity is used as a surrogate measure of the bone mineral density (BMD) of the pedicle body segment displaced by the screw. We conducted an initial assessment of the developed platform using retrospective pre- and post-operative clinical 3D CT data from four patients who underwent spine surgery, consisting of a total of 26 pedicle screws implanted in the lumbar spine. The Fastening Strength of the planned implants was directly assessed by estimating the intensity - area product across the pedicle volume displaced by the virtually implanted screw. For post-operative assessment, each vertebra was registered to its homologous counterpart in the pre-operative image using an intensity-based rigid registration followed by manual adjustment. Following registration, the Fastening Strength was computed

  9. Comparison of migration behavior between single and dual lag screw implants for intertrochanteric fracture fixation

    Directory of Open Access Journals (Sweden)

    Katonis Pavlos G

    2009-05-01

    Full Text Available Abstract Background Lag screw cut-out failure following fixation of unstable intertrochanteric fractures in osteoporotic bone remains an unsolved challenge. This study tested if resistance to cut-out failure can be improved by using a dual lag screw implant in place of a single lag screw implant. Migration behavior and cut-out resistance of a single and a dual lag screw implant were comparatively evaluated in surrogate specimens using an established laboratory model of hip screw cut-out failure. Methods Five dual lag screw implants (Endovis, Citieffe and five single lag screw implants (DHS, Synthes were tested in the Hip Implant Performance Simulator (HIPS of the Legacy Biomechanics Laboratory. This model simulated osteoporotic bone, an unstable fracture, and biaxial rocking motion representative of hip loading during normal gait. All constructs were loaded up to 20,000 cycles of 1.45 kN peak magnitude under biaxial rocking motion. The migration kinematics was continuously monitored with 6-degrees of freedom motion tracking system and the number of cycles to implant cut-out was recorded. Results The dual lag screw implant exhibited significantly less migration and sustained more loading cycles in comparison to the DHS single lag screw. All DHS constructs failed before 20,000 cycles, on average at 6,638 ± 2,837 cycles either by cut-out or permanent screw bending. At failure, DHS constructs exhibited 10.8 ± 2.3° varus collapse and 15.5 ± 9.5° rotation around the lag screw axis. Four out of five dual screws constructs sustained 20,000 loading cycles. One dual screw specimens sustained cut-out by medial migration of the distal screw after 10,054 cycles. At test end, varus collapse and neck rotation in dual screws implants advanced to 3.7 ± 1.7° and 1.6 ± 1.0°, respectively. Conclusion The single and double lag screw implants demonstrated a significantly different migration resistance in surrogate specimens under gait loading simulation with

  10. 石膏固定和空心螺钉内固定修复腕部舟状骨新鲜骨折:功能恢复比较%Plaster fixationversus cannulated screw internal fixation for the wrist scaphoid bone fresh fracture:comparison of functional recovery

    Institute of Scientific and Technical Information of China (English)

    卡依沙尔•买买提明; 赵岩

    2015-01-01

      结果与结论:随访3-6个月对比分析石膏组和空心螺钉组患者腕关节功能Cooney评分,空心螺钉组优9例,良1例,可1例,差0例;石膏组优1例,良5例,可3例,差2例,空心螺钉组患者治疗后优良率为91%,石膏组患者治疗后优良率为55%,空心螺钉组显著高于石膏组(t=4.817,P OBJECTIVE:To compare and analyze functional recovery of the wrist scaphoid bone fresh fracture after plaster fixation and internal fixation. METHODS: Twenty-two patients with wrist scaphoid bone fresh fracture were recruited from the First Affiliated Hospital of Xinjiang Medical University from March 2012 to March 2014, and the injury time was 2 hours to 12 days. Preoperative X-ray films revealed that, the involved patients had no wrist scaphoid bone colapses, lunate bone dislocation, ischemic necrosis of bone and osseous changes. Al the cases showed shift, unstable fractures. According to the patient’s wiling and the surgical method, the involved patients were divided into two groups, receiving plaster fixation and cannulated screw internal fixation respectively. Each group contained 11 cases. Wrist joint function was evaluated using Cooney score system. There was no significant difference in the age distribution and gender between the two groups (P > 0.05). RESULTS AND CONCLUSION: At 3-6 months of folow-up, wrist joint function of patients in the two groups was compared and analyzed with Cooney scores. According to the Cooney scores, nine cases in internal fixation group were excelent, 1 good, 1 fair and none poor; one case in plaster fixation group was excelent, 5 good, 3 fair, and 2 poor. The excelent and good rate in the internal fixation group was significantly higher than that in the plaster fixation group (91%, 55%,t=4.817,P < 0.05). Although plaster fixation has certain effects on wrist scaphoid bone fresh fracture, open reduction and canulated screw fixation has obvious effect and promotes the

  11. Bone

    International Nuclear Information System (INIS)

    Bone scanning provides information on the extent of primary bone tumors, on possible metastatic disease, on the presence of osteomyelitis prior to observation of roentgenographic changes so that earlier therapy is possible, on the presence of collagen diseases, on the presence of fractures not disclosed by x-ray films, and on the evaluation of aseptic necrosis. However, the total effect and contribution of bone scanning to the diagnosis, treatment, and ultimate prognosis of pediatric skeletal diseases is, as yet, unknown. (auth)

  12. Fabrication of a screw-retained restoration avoiding the facial access hole: a clinical report.

    Science.gov (United States)

    Garcia-Gazaui, Sabrina; Razzoog, Michael; Sierraalta, Marianella; Saglik, Berna

    2015-11-01

    Dental implant restorations may be either screw-retained or cemented onto an abutment. While each method has its advantages and disadvantages, cemented restorations are commonly used in the maxillary arch, usually because of esthetic concerns. Available bone in the anterior maxilla dictates the placement of the implant, which may result in a facially positioned screw-access opening. Still, a growing volume of literature states that periimplant soft tissues respond more favorably to screw-retained crowns than cement-retained crowns. This clinical report outlines a treatment with a new method of fabricating a custom abutment-crown combination for a screw-retained restoration. The technique allows the channel for the screw to be placed at an angle other than parallel to the implant body. In this case, the practitioner may choose either a screw-retained or cement-retained implant restoration, where previously only a cemented restoration was possible. PMID:26344192

  13. Effect of different radial hole designs on pullout and structural strength of cannulated pedicle screws.

    Science.gov (United States)

    Chen, Hsin-Chang; Lai, Yu-Shu; Chen, Wen-Chuan; Chen, Jou-Wen; Chang, Chia-Ming; Chen, Yi-Long; Wang, Shih-Tien; Cheng, Cheng-Kung

    2015-08-01

    Cannulated pedicle screws are designed for bone cement injection to enhance fixation strength in severely osteoporotic spines. However, the screws commonly fracture during insertion. This study aims to evaluate how different positions/designs of radial holes may affect the pullout and structural strength of cannulated pedicle screws using finite element analysis. Three different screw hole designs were evaluated under torsion and bending conditions. The pullout strength for each screw was determined by axial pullout failure testing. The results showed that when the Von Mises stress reached the yield stress of titanium alloy the screw with four radial holes required a greater torque or bending moment than the nine and twelve hole screws. In the pullout test, the strength and stiffness of each screw with cement augmentation showed no significant differences, but the screw with four radial holes had a greater average pullout strength, which probably resulted from the significantly greater mean maximum lengths of cement augmentation. Superior biomechanical responses, with lower stress around the radial holes and greater pullout strength, represented by cannulated pedicle screw with four radial holes may worth recommending for clinical application. PMID:26054806

  14. BIOMECHANICAL EVALUATION OF DYNAMIC HIP SCREW WITH BONE CEMENT AUGMENTATION IN NORMAL BONE%骨水泥强化正常骨质动力髋螺钉固定的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    黎宁; 彭阿钦; 柴仪; 曹晶; 刘勇; 郭锐; 韩长伶

    2007-01-01

    目的 选取正常骨密度的股骨转子间骨折标本,研究骨水泥强化对动力髋螺钉(dynamic hip screw,DHS)固定的生物力学影响.方法 取成年男性防腐尸体双侧股骨上段标本24对48侧,制备A2型股骨转子间骨折DHS固定模型.右侧标本行骨水泥强化DHS固定,为强化组;左侧行DHS常规固定,为对照组.两组标本进行弯曲强度实验及扭转强度实验.结果 强化组最大负荷及最大扭矩分别为3 852.160 2±143.603 1 N、15.5±2.6 Nm,对照组为3 702.966 7±133.860 1 N、14.7±3.4 Nm;两组比较生物力学差异均无统计学意义(P>0.05).结论 正常骨密度的股骨转子间骨折行骨水泥强化,对DHS固定强度及骨折整体稳定性无显著影响.

  15. NUT SCREW MECHANISMS

    Science.gov (United States)

    Glass, J.A.F.

    1958-07-01

    A reactor control mechanism is described wherein the control is achieved by the partial or total withdrawal of the fissile material which is in the form of a fuel rod. The fuel rod is designed to be raised and lowered from the reactor core area by means of two concentric ball nut and screw assemblies that may telescope one within the other. These screw mechanisms are connected through a magnetic clutch to a speed reduction gear and an accurately controllable prime motive source. With the clutch energized, the fuel rod may be moved into the reactor core area, and fine adjustments may be made through the reduction gearing. However, in the event of a power failure or an emergency signal, the magnetic clutch will become deenergized, and the fuel rod will drop out of the core area by the force of gravity, thus shutting down the operation of the reactor.

  16. 老年肱骨髁间骨折患者螺钉植入区域骨量变化的定量分析%A quantitative analysis of bone density in the screw area of the elderly intercondylar fractures of humerus Zhang Yanhui1, Zhang Zhuqiu2, Wang

    Institute of Scientific and Technical Information of China (English)

    张衍辉; 张祝秋; 王烨; 孙晟轩; 周海斌

    2016-01-01

    目的:通过对比肱骨髁间骨折合并骨质疏松的患者不同随访时间 X 线片螺钉周围灰度的变化,定量分析螺钉置于肱骨髁后外侧及肱骨髁两侧的安全性。方法回顾性收集苏州大学附属第二医院2009年9月至2012年11月肱骨髁间骨折合并骨质疏松的患者30例,其中螺钉置于肱骨髁后外侧区域的15例患者为肱骨髁后外侧组,螺钉置于肱骨髁两侧或单侧区域的15例患者为肱骨髁两侧组。两组患者在年龄、性别、术前诊断方面均匹配。用 Photoshop 及 Image J 软件测两组患者 X线片灰度值,取相对值。结果两组患者全部得到随访,随访时间9~26个月,平均17.8个月。两组肱骨髁远端处灰度值均较术后3d 有不同程度的升高,说明术后肱骨远端区域骨量存在丢失。术后3 d肱骨髁后外侧组灰度值为81.93±10.43,肱骨髁两侧组灰度值为110.35±14.48,两组比较差异有统计学意义(F=10.52,P0.05)。结论由于肱骨髁后外侧骨量的不足,螺钉置于此区域,会增加松动、断钉的风险;肱骨髁两侧骨量相对丢失不大,可以作为理想的置钉区域。因此,临床上对于肱骨髁间骨折合并骨质疏松的患者,更建议选择使用平行钢板固定。%Background The treatment of humeral intercondylar fracture is often very difficult and technical demanding because of its intra-articular involvement.Especially in the elderly patients and those with osteoporosis, reduced bone mass lets the patients suffer from more seriously comminuted fractures while internal fixation is less stable since screws gets loose easily and a firm fixation is hard to achieve.Therefore,choosing a proper fixation location is one of the key factors for successful fixation of distal humeral fractures in the elderly patients.Park et al performed morphological measurements (the number of bone trabeculae and cortical bone thickness)of the distal humeral region in deceased elderly (with a mean

  17. ROTARY SCREW SYSTEMS IN CEMENT

    OpenAIRE

    Taratuta V. D.; Belokur K. A.; Serga G. V.

    2016-01-01

    The article presents results of research of rotary-screw systems in relation to the creation of rotary kilns for the annealing of-cuttings in the preparation of cement clinker. Using the proposed design, in comparison with known designs of similar purpose, it significantly improves performance, reduces size and power consumption through the use of rotary screw systems in the form of screw rotors and drums made hollow with sidewalls assembled from separate strips or plates of different geometr...

  18. Mechanics research of bone cement augmentation on pedicle screw in revision of internal lumbar fixation%椎弓根螺钉骨水泥强化技术在腰椎内固定翻修手术中的力学研究

    Institute of Scientific and Technical Information of China (English)

    陈路; 廖琦; 龚玉琴

    2014-01-01

    目的:评价骨水泥强化技术在钉道扩大时对椎弓根螺钉固定强度的影响,为腰椎内固定翻修选择可靠的补救技术提供依据。方法选用成人尸体腰椎标本40个,观察组进行骨水泥强化,对照组普通方法置钉,进行生物力学检测。结果两种固定方法的最大轴向拔出力及最大旋出扭矩具有显著性差异(P<0.001),并提示弱相关。结论(1)在腰椎内固定翻修手术中,对椎弓根螺钉进行骨水泥强化可以有效提高椎弓根螺钉的固定强度。(2)钉道本身的骨质量对进行强化后的椎弓根螺钉固定强度影响有限。%Objective To evaluate the effect of bone cement augmentation technique on fixation strength of pedicle screw dur-ing trajectory expansion,to provide the basis of reliable remedial technique selection for revision of internal lumbar fixation.Methods A total of 40 lumbar vertebrae and 80 pedicles were obtained to stimulate the trajectory of pedicle needing revision after internal lumbar fixation surgery. 40 lumbar vertebrae were randomly divided into Group A and Group B ,with 20 simple fixed sides and 20 augmented fixed sides in each group. In Group A,pedicles on both sides of all the specimens were determined for the maximum axial pullout of strength;while in Group B,pedicles on both sides of all the specimens were detected for the maximum rotary torque,and differences between the two sides were compared. Results (1) There was significant difference between the two fixations,indicating a weak correlation. Conclusion (1)It was confirmed that in revision of internal lumbar fixation,bone cement augmentation on pedicle screw can effectively improve the strength of pedicle screw. (2)Maximum axial pullout of strength and maximum rotary torque in reinforced group were weakly correlated with those in the control group ,suggesting the bone quality of the trajectory had limited influence on the strength of reinforced pedicle screw

  19. Influência do macheamento na interface do parafuso e do tecido ósseo na fase imediata pós-implante Influencia del taladramiento en la interfase del tornillo y del tejido óseo durante la fase inmediata post implante The influence of tapping techniques on the interface bone screw/bone tissue in immediate postoperative period

    Directory of Open Access Journals (Sweden)

    Fabiano Pinheiro de Lemos Masson

    2009-06-01

    el orificio proximal derecho fue realizado el taladramiento antes de la inserción del tornillo cortical de 3.5 mm (Grupo A, en el orificio proximal izquierdo el tornillo fue insertado sin taladramiento (Grupo B y los otros dos orificios distales fueron utilizados como controles (Grupo C. Las alteraciones de la interfase entre el hueso y el implante fueron analizadas por medio de un estudio histomorfométrico, teniendo en cuenta el número de trabéculas fracturadas entre los filetes de rosca; la mayor distancia de la fractura trabecular transversal provocada por la inserción del tornillo; la mayor extensión de la fractura trabecular longitudinal provocada por la inserción del tornillo y la línea de contacto en la interfase hueso-tornillo. RESULTADOS: taladrar el orificio piloto ha provocado alteraciones de la microestructura del tejido óseo alrededor del implante cuando comparado con las alteraciones producidas por la inserción del tornillo sin el taladramiento o el orificio piloto. La evaluación del contacto entre el hueso y el implante fue el parámetro que presentó diferencia estadística en la comparación entre la colocación del implante con o sin taladramiento. CONCLUSIÓN: al comparar con el orificio control, todos los parámetros presentaron diferencia estadística.OBJECTIVE: to analyze experimentally the early alterations of the bone-screw interface with tapping techniques in the cancellous bone of the cervical vertebrae. METHODS: five wooless sheep (Santa Inês were analyzed. Pilot holes of 2.5 mm were performed at both sides of the third cervical vertebrae in the proximal and distal portion. The tapping process was done in the right proximal hole before the 3.5 mm screw insertion (Group A, while the left proximal hole was not tapped (Group B and the two distal holes were used as control (Group C. The interface alterations between bone and screw were analyzed through histomorphometric study, considering the number of trabeculae fractures between

  20. Combining of small fragment screws and large fragment plates for open reduction and internal fixation of periprosthetic humeral fractures.

    Science.gov (United States)

    Seybold, Dominik; Citak, Mustafa; Königshausen, Matthias; Gessmann, Jan; Schildhauer, Thomas A

    2011-10-01

    Operative treatment of periprosthetic humeral fractures in elderly patients with osteoporotic bone requires a stable fixations technique. The combination of 3.5 cortical screws with washers in a 4.5 Arbeitsgemeinschaft für Osteosynthesefragen, Limited-contact dynamic compression plate or Locking plate, allows a stable periprosthetic fixation with the small 3.5 screws and 4.5 screws above and below the prosthesis, respectively. This combination is a cost-effective technique to treat periprosthetic humeral fractures.

  1. Preliminary experimental results of radiofrequency-cement-augmented and cannulated pedicle screws

    Directory of Open Access Journals (Sweden)

    Goost H

    2011-01-01

    Full Text Available The risk of cut-out of a pedicle screw is high in the presence of osteoporotic bone. In cadaver studies it was found that cement augmentation of pedicle screws markedly increases pullout forces. However, the use of conventional low viscosity vertebroplasty or kyphoplasty cement is associated with the risk of cement extravasation. The risk might be reduced by using high viscosity, radiofrequency-activated bone cement. After performing DEXA scans, six fresh-frozen vertebral bodies of different bone densities were obtained from cadavers. Two pedicle screws (WSI Expertise-Inject, Peter Brehm, Germany were placed in the pedicles. About 3 ml of radiofrequency-activated, ultra-high viscosity cement (ER2 Bone Cement, DFine Europe GmbH, Germany was injected through the right pedicle. The left pedicle screw was left uncemented and served as control. Axial pullout tests were performed using a material testing device (Zwick/Roell Zmartpro, Ulm, Germany. The tests revealed that cementaugmented pedicle screws were able to withstand markedly higher pullout forces. Extravasation of cement did not occur. The value of the study is limited by the fact that only six samples were investigated. Further cadaver studies and clinical evaluation will be needed in the future. However, this pilot study showed that combining cannulated pedicle screws with ultra-high viscosity bone cement is a successful approach. Revision due to cut-out and complications secondary to cement extravasation can be reduced by this method.

  2. Cement embolism into the venous system after pedicle screw fixation: case report, literature review, and prevention tips

    Directory of Open Access Journals (Sweden)

    Ghassan Kerry

    2013-09-01

    Full Text Available The strength of pedicle screws attachment to the vertebrae is an important factor affecting their motion resistance and long term performance. Low bone quality, e.g. in osteopenic patients, keeps the screw bone interface at risk for subsidence and dislocation. In such cases, bone cement could be used to augment pedicle screw fixation. But its use is not free of risk. Therefore, clinicians, especially spine surgeons, radiologists, and internists should become increasingly aware of cement migration and embolism as possible complications. Here, we present an instructive case of cement embolism into the venous system after augmented screw fixation with fortunately asymptomatic clinical course. In addition we discuss pathophysiology and prevention methods as well as therapeutic management of this potentially life-threatening complication in a comprehensive review of the literature. However, only a few case reports of cement embolism into the venous system were published after augmented screw fixation.

  3. A screwing device for handling and assembly of micro screws

    DEFF Research Database (Denmark)

    Gegeckaite, Asta; Hansen, Hans Nørgaard; Eriksson, Torbjörn Gerhard

    2007-01-01

    Nowadays, the application of specially designed handling devices in micro technology is an important topic and a necessity for the industry. Conventional methods for screwing can not be applied directly to micro screws. This is caused by the 3D micro object geometry and dimensions which inducing ...

  4. A new alternative to expandable pedicle screws: Expandable poly-ether-ether-ketone shell.

    Science.gov (United States)

    Demir, Teyfik

    2015-05-01

    Screw pullout is a very common problem in the fixation of sacrum with pedicle screws. The principal cause of this problem is that the cyclic micro motions in the fixation of sacrum are higher than the other regions of the vertebrae that limit the osteo-integration between bone and screw. In addition to that, the bone quality is very poor at sacrum region. This study investigated a possible solution to the pullout problem without the expandable screws' handicaps. Newly designed poly-ether-ether-ketone expandable shell and classical pedicle screws were biomechanically compared. Torsion test, pullout tests, fatigue tests, flexion/extension moment test, axial gripping capacity tests and torsional gripping capacity tests were conducted in accordance with ASTM F543, F1798 and F1717. Standard polyurethane foam and calf vertebrae were used as embedding medium for pullout tests. Classical pedicle screw pullout load on polyurethane foam was 564.8 N compared to the failure load for calf vertebrae's 1264 N. Under the same test conditions, expandable poly-ether-ether-ketone shell system's pullout loads from polyurethane foam and calf vertebrae were 1196.3 and 1890 N, respectively. The pullout values for expandable poly-ether-ether-ketone shell were 33% and 53% higher than classical pedicle screw on polyurethane foam and calf vertebrae, respectively. The expandable poly-ether-ether-ketone shell exhibited endurance on its 90% of yield load. Contrary to poly-ether-ether-ketone shell, classical pedicle screw exhibited endurance on 70% of its yield load. Expandable poly-ether-ether-ketone shell exhibited much higher pullout performance than classical pedicle screw. Fatigue performance of expandable poly-ether-ether-ketone shell is also higher than classical pedicle screw due to damping the micro motion capacity of the poly-ether-ether-ketone. Expandable poly-ether-ether-ketone shell is a safe alternative to all other expandable pedicle screw systems on mechanical perspective

  5. Biomechanical effects of kyphoplasty-assisted versus traditional bone cement augmentation on the loosened sacral screws%后凸成形和传统钉道骨水泥强化对骶骨钉松动的生物力学作用

    Institute of Scientific and Technical Information of China (English)

    周冬长; 王丽冰; 曾丽雯; 黄阳亮; 于滨生

    2011-01-01

    BACKGROUND: Kyphoplasty-assisted bone cement augmentation can be used in lumbar pedicle screw fixation of osteoporotic patients.OBJECTIVE: To assess the fixation strengths of loosened sacral screws augmented with kyphoplasty-assisted and traditional bone cement techniques.METHODS: Fresh sacra were harvested from nine osteoporotic cadavers. After testing bilaterally placed unicortical and bicortical pedicle screws, two unicortical pedicle screws with the traditional and kyphoplasty-assisted cement augmentations were established on the same sacrum. Following 2000 cyclic compression loading to screw head on a MTS machine, their maximum pull-out forces were recorded and compared. RESULTS AND CONCLUSION: The bone mineral densities of nine specimens were ranged from 0.61 to 0.77 g/cm2 (0.71 g/cm2 in average). The mean maximum pull-out forces of unicortical and bicortical screws, and traditional and kyphoplasty-assisted cement screws were 203, 325, 437, and 565 N, respectively. The pull-out force was significantly higher in bicortical screw compared with unicortical (P < 0.05); however, these two fixations exhibited markedly lower pull-out strength compared with two cement augmentation techniques (P < 0.05). The pull-out strength was significantly higher in kyphoplasty-assisted cement augmentation group compared with traditional bone cement technique (P < 0.05). In addition, a significant positive correlation was exhibited between bone mineral density and pull-out force for the four fixations (P < 0.05). Results demonstrated that traditional and kyphoplasty-assisted cement augmentations can serve as the salvage technique for loosening sacral screw. However, kyphoplasty-assisted augmentation can provide higher stability.%背景:后凸成形骨水泥强化可应用于骨质疏松患者的腰椎椎弓根钉固定.目的:评价松动的骶骨钉经后凸成形和传统钉道骨水泥强化后的固定强度.方法:纳入9具骨质疏松症患者的新鲜尸体标本.在同

  6. Comparison of the bending performance of solid and cannulated spinal pedicle screws using finite element analyses and biomechanical tests.

    Science.gov (United States)

    Shih, Kao-Shang; Hsu, Ching-Chi; Hou, Sheng-Mou; Yu, Shan-Chuen; Liaw, Chen-Kun

    2015-09-01

    Spinal pedicle screw fixations have been used extensively to treat fracture, tumor, infection, or degeneration of the spine. Cannulated spinal pedicle screws with bone cement augmentation might be a useful method to ameliorate screw loosening. However, cannulated spinal pedicle screws might also increase the risk of screw breakage. Thus, the purpose of this study was to investigate the bending performance of different spinal pedicle screws with either solid design or cannulated design. Three-dimensional finite element models, which consisted of the spinal pedicle screw and the screw's hosting material, were first constructed. Next, monotonic and cyclic cantilever bending tests were both applied to validate the results of the finite element analyses. Finally, both the numerical and experimental approaches were evaluated and compared. The results indicated that the cylindrical spinal pedicle screws with a cannulated design had significantly poorer bending performance. In addition, conical spinal pedicle screws maintained the original bending performance, whether they were solid or of cannulated design. This study may provide useful recommendations to orthopedic surgeons before surgery, and it may also provide design rationales to biomechanical engineers during the development of spinal pedicle screws. PMID:26208430

  7. Screw/stud removal tool

    Science.gov (United States)

    Daniels, K.; Herrick, D. E.; Rothermel, L.

    1980-01-01

    Tool removes stubborn panheaded screws or studs where conventional tools would be either too weak or inconvenient to use. Screws with damaged heads or slots can also be removed this way. Tool can be worked with one hand and easily fits limited-access and blind areas. It can be made in various sizes to fit different screwheads.

  8. Clinical effect of posterior pedicle screw ifxation and bone graft surgery for thoracolumbar spine fracture%脊柱胸腰段骨折行后路椎弓根螺钉固定联合植骨手术的临床效果

    Institute of Scientific and Technical Information of China (English)

    官丙刚; 韩燕; 邓树才

    2016-01-01

    Objective to observe and analyze clinical effect of posterior pedicle screw fixation and bone graft surgery for thoracolumbar spine fracture.Methods choose 64 cases thoracolumbar fracture patients treated in our hospital from May 2013 to October 2015 as research objects and randomly divide them into control and observation group, 32 cases in each. Observation group was treated with posterior pedicle screw fixation and bone graft surgery, and control group with combined lateral bone grafting. Compare treatment effect of two groups.Results after operation, VAS scores, Worter index, Cobb angle and complication incidence of observation group were significantly better than control group, difference showed statistical significance (P<0.05).Conclusion posterior pedicle screw fixation and bone graft surgery has significant clinical effect for thoracolumbar spine fracture, which can effectively improve patient’s life quality,and is worthy of clinical application and promotion.%目的:观察分析脊柱胸腰段骨折行后路椎弓根螺钉固定联合植骨手术的临床效果。方法选取我院2013年5月至2015年10月收治的64例脊柱胸腰段骨折患者为研究对象,随机分为对照组与观察组,各32例。观察组行后路椎弓根螺钉固定联合植骨术治疗,对照组行联合外侧植骨治疗,比较两组治疗效果。结果术后,观察组VAS评分、Worter指数、Cobb角及并发症发生率均显著优于对照组,(P<0.05)差异具有统计学意义。结论对脊柱胸腰段骨折患者行后路椎弓根螺钉固定联合植骨术的临床疗效显著,可有效提高患者生活质量,值得临床广泛应用及推广。

  9. Stability and interbody fusion of augmented pedicle screws with bone cement for lumbar spondylolisthesis accompanied with osteoporosis%骨水泥螺钉强化固定伴骨质疏松腰椎滑脱症的稳定性及椎间融合

    Institute of Scientific and Technical Information of China (English)

    姚珍松; 丁金勇; 唐永超; 陈康; 江晓兵; 梁德; 晋大祥; 庄洪; 张顺聪; 杨志东

    2016-01-01

    背景:对于骨质疏松严重的腰椎滑脱症患者,复位时易发生螺钉松动、拔出,或者修复后容易出现复位丢失及内固定失败,因此修复过程中提高椎弓根螺钉固定强度非常重要。目前有关骨水泥螺钉强化技术应用于伴骨质疏松腰椎滑脱症患者的报道较少。目的:探讨聚甲基丙烯酸甲酯骨水泥强化椎弓根螺钉置入内固定在伴骨质疏松腰椎滑脱症中的应用价值。方法:将2009年6月至2011年6月收治的27例伴骨质疏松的腰椎滑脱症患者纳入回顾性分析,均行聚甲基丙烯酸甲酯骨水泥强化椎弓根螺钉置入内固定治疗。采用 Oswestry 功能障碍指数、目测类比评分评价功能障碍与疼痛程度,治疗后以影像学检查评估内固定与融合情况,记录并发症。结果与结论:患者获得15-37个月随访。末次随访 Oswestry 功能障碍指数、目测类比评分均显著优于治疗前,差异有显著性意义(P <0.05)。治疗后影像学结果显示所有患者的骨水泥与骨质界面结合紧密,螺钉及骨水泥位置良好,未发生有症状的骨水泥渗漏,末次随访无内固定失败,患者均获椎间融合。提示聚甲基丙烯酸甲酯骨水泥可增加骨质疏松椎体中椎弓根螺钉的把持力,骨水泥钉道强化固定伴骨质疏松的腰椎滑脱症安全有效,可得到满意的固定稳定性及椎间融合。%BACKGROUND: In lumbar spondylolisthesis patients with severe osteoporosis, screw is easily loose and pul s out during reposition, or loss of reduction and internal fixation failure easily occur after repair. Therefore, it is very important to elevate the intensity of pedicle screw fixation during repair. At present, few studies concern application of bone cement screw enhancement technology in lumbar spondylolisthesis patients with osteoporosis. OBJECTIVE: To investigate the clinical value of augmented pedicle screw with

  10. Intra-operative computer navigation guided cervical pedicle screw insertion in thirty-three complex cervical spine deformities

    Directory of Open Access Journals (Sweden)

    S Rajasekaran

    2010-01-01

    Full Text Available Background: Cervical pedicle screw fixation is challenging due to the small osseous morphometrics and the close proximity of neurovascular elements. Computer navigation has been reported to improve the accuracy of pedicle screw placement. There are very few studies assessing its efficacy in the presence of deformity. Also cervical pedicle screw insertion in children has not been described before. We evaluated the safety and accuracy of Iso-C 3D-navigated pedicle screws in the deformed cervical spine. Materials and Methods: Thirty-three patients including 15 children formed the study group. One hundred and forty-five cervical pedicle screws were inserted using Iso-C 3D-based computer navigation in patients undergoing cervical spine stabilization for craniovertebral junction anomalies, cervico-thoracic deformities and cervical instabilities due to trauma, post-surgery and degenerative disorders. The accuracy and containment of screw placement was assessed from postoperative computerized tomography scans. Results: One hundred and thirty (89.7% screws were well contained inside the pedicles. Nine (6.1% Type A and six (4.2% Type B pedicle breaches were observed. In 136 levels, the screws were inserted in the classical description of pedicle screw application and in nine deformed vertebra, the screws were inserted in a non-classical fashion, taking purchase of the best bone stock. None of them had a critical breach. No patient had any neurovascular complications. Conclusion: Iso-C navigation improves the safety and accuracy of pedicle screw insertion and is not only successful in achieving secure pedicle fixation but also in identifying the best available bone stock for three-column bone fixation in altered anatomy. The advantages conferred by cervical pedicle screws can be extended to the pediatric population also.

  11. Posterior atlantoaxial transpedicle screw fixation for traumatic atlatoaxial instability

    Directory of Open Access Journals (Sweden)

    Zheng-lei WANG

    2015-10-01

    Full Text Available Objective To explore the clinical efficacy of posterior atlantoaxial pedicle screw fixation for traumatic atlantoaxial instability. Methods From September 2009 to March 2013, 17 patients with atlantoaxial instability received posterior atlantoaxial pedicle screw fixation. There were 12 males and 5 females, with a mean age of 42 years old (ranged from 19 to 63 years old. Transpedicle screw fixation was employed in 8 patients with atlantoaxial fracture and dislocation, in 2 with traumatic disruption of transverse atlantal ligament, and in 7 with odontoid fracture. The Japanese Orthopaedic Association (JOA score before operation was from 5 to 14, with a mean of 11.2. Preoperative CT, MRI and radiographs, as well as intraoperative screw placement and bone graft were administered in all the patients. Results In all the patients, complete reduction was achieved without injury to the vertebral artery, spinal cord or never root, and they started to be ambulatory on the first day after the operation. The patients were followed up for 6-36 months (mean 21 months, and clinical symptoms were seen to be improved significantly. Imaging reexamination 6 months after the surgery showed satisfactory healing of implanted bone and position of all the screws without loosening of the implant. The mean JOA scores was 15.5(11.0-17.0 twelve months after the operation. Conclusion Atlantoaxial pedicle screw fixation for traumatic atlantoaxial instability is safe and reliable with a favorable clinical result. DOI: 10.11855/j.issn.0577-7402.2015.09.14

  12. The Biocompatibility of Degradable Magnesium Interference Screws: An Experimental Study with Sheep

    Directory of Open Access Journals (Sweden)

    Ulrich Thormann

    2015-01-01

    Full Text Available Screws for ligament reconstruction are nowadays mostly made of poly-L-lactide (PLLA. However, magnesium-based biomaterials are gathering increased interest in this research field because of their good mechanical property and osteoanabolic influence on bone metabolism. The aim of this pilot study was to evaluate the biocompatibility of an interference screw for ligament reconstruction made of magnesium alloy W4 by diecasting and milling and using different PEO-coatings with calcium phosphates. PLLA and titanium screws were used as control samples. The screws were implanted in the femur condyle of the hind leg of a merino sheep. The observation period was six and twelve weeks and one year. Histomorphometric, immunohistochemical, immunofluorescence, and molecular biological evaluation were conducted. Further TEM analysis was done. In all magnesium screws a clinically relevant gas formation in the vicinity of the biomaterial was observed. Except for the PLLA and titanium control samples, no screw was fully integrated in the surrounding bone tissue. Regarding the fabrication process, milling seems to produce less gas liberation and has a better influence on bone metabolism than diecasting. Coating by PEO with calcium phosphates could not reduce the initial gas liberation but rather reduced the bone metabolism in the vicinity of the biomaterial.

  13. Influence of screw length and diameter on tibial strain energy density distribution after anterior cruciate ligament reconstruction

    Science.gov (United States)

    Yao, Jie; Kuang, Guan-Ming; Wong, Duo Wai-Chi; Niu, Wen-Xin; Zhang, Ming; Fan, Yu-Bo

    2014-04-01

    Postoperative tunnel enlargement has been frequently reported after anterior cruciate ligament (ACL) reconstruction. Interference screw, as a surgical implant in ACL reconstruction, may influence natural loading transmission and contribute to tunnel enlargement. The aims of this study are (1) to quantify the alteration of strain energy den sity (SED) distribution after the anatomic single-bundle ACL reconstruction; and (2) to characterize the influence of screw length and diameter on the degree of the SED alteration. A validated finite element model of human knee joint was used. The screw length ranging from 20 to 30mm with screw diameter ranging from 7 to 9 mm were investigated. In the post-operative knee, the SED increased steeply at the extra-articular tunnel aperture under compressive and complex loadings, whereas the SED decreased beneath the screw shaft and nearby the intra-articular tunnel aperture. Increasing the screw length could lower the SED deprivation in the proximal part of the bone tunnel; whereas increasing either screw length or diameter could aggravate the SED deprivation in the distal part of the bone tunnel. Decreasing the elastic modulus of the screw could lower the bone SED deprivation around the screw. In consideration of both graft stability and SED alteration, a biodegradable interference screw with a long length is recommended, which could provide a beneficial mechanical environment at the distal part of the tunnel, and meanwhile decrease the bone-graft motion and synovial fluid propagation at the proximal part of the tunnel. These findings together with the clinical and histological factors could help to improve surgical outcome, and serve as a preliminary knowledge for the following study of biodegradable interference screw. [Figure not available: see fulltext.

  14. Distal Locking Screws for Intramedullary Nailing of Tibial Fractures.

    Science.gov (United States)

    Agathangelidis, Filon; Petsatodis, Georgios; Kirkos, John; Papadopoulos, Pericles; Karataglis, Dimitrios; Christodoulou, Anastasios

    2016-01-01

    Recently introduced tibial intramedullary nails allow a number of distal screws to be used to reduce the incidence of malalignment and loss of fixation of distal metaphyseal fractures. However, the number of screws and the type of screw configuration to be used remains obscure. This biomechanical study was performed to address this question. Thirty-six Expert tibial nails (Synthes, Oberdorf, Switzerland) were introduced in composite bone models. The models were divided into 4 groups with different distal locking configurations ranging from 2 to 4 screws. A 7-mm gap osteotomy was performed 72 mm from the tibial plafond to simulate a 42-C3 unstable distal tibial fracture. Each group was divided in 3 subgroups and underwent nondestructive biomechanical testing in axial compression, coronal bending, and axial torsion. The passive construct stiffness was measured and statistically analyzed with one-way analysis of variance. Although some differences were noted between the stiffness of each group, these were not statistically significant in compression (P=.105), bending (P=.801), external rotation (P=.246), and internal rotation (P=.370). This in vitro study showed that, when using the Expert tibial nail for unstable distal tibial fractures, the classic configuration of 2 parallel distal screws could provide the necessary stability under partial weight-bearing conditions. PMID:26840700

  15. 骨水泥强化椎弓根螺钉固定治疗伴骨质疏松腰椎管狭窄症临床应用%Clinical application of bone cement augmentation of pedicle screws in lumbar spinal canal stenosis with osteoporosis

    Institute of Scientific and Technical Information of China (English)

    孙治国; 王浩; 赵喜滨; 袁宏

    2015-01-01

    Objective To investigate the clinical application of bone cement augmentation of pedicle screws in lumbar spinal canal stenosis with osteoporosis.Methods From June 2010 to June 2013,13 patients ( 4 males,9 females ) of lumbar spinal canal stenosis with osteoporosis were recruited,with an average age of 68 years old ( range: 61-77 years ).Nine cases were in stage two.Four cases were in stage three.Assessing osteoporosis according to Jikei,there were 4 cases of stage Ⅱ and 9 cases of Ⅲ.Bone cement augmentation of the screw channel was conducted before pedicle screw ifxation.Thirty-six bone cement augmented pedicle screws were implanted.Using X-ray during and after the operation to compare pedicle screw positions and observe the stability.Visual analogue scores ( VAS ) was applied to evaluate low back pain and leg pain 1 day before surgery,7 days and 3 months postoperatively.Results Complications due to the bone cement leakage,heat-induced effects and toxicity in the screw implantation process did not occur.The low back pain and leg pain symptoms were improved signiifcantly 1 week postoperatively.VAS were ( 2.20 ± 1.18 ) points and ( 2.32 ± 0.35 ) points respectively,with statistical signiifcance comparing with preoperative condition (P<0.05 ).VAS were ( 1.82 ± 0.15 ) points and ( 1.14 ± 0.44 ) points in 3 months postoperatively,with no statistical significance comparing with the condition 1 week postoperatively (P>0.05 ).Thirteen patients were followed up.The average followed up time was 14 months ( range: 8-16 months ).Thirteen cases obtained bony fusion.X-ray showed no loosening,fracture or falling of the internal fixation.No radiolucent lines appeared around the screws.Conclusions Application of bone cement augmentation of pedicle screws in lumbar spinal canal stenosis with osteoporosis can receive satisfactory short-term clinical outcomes.%目的 探讨骨水泥强化椎弓根螺钉在腰椎管狭窄伴骨质疏松患者的临床疗效.方法 2010年6

  16. ROTARY SCREW SYSTEMS IN CEMENT

    Directory of Open Access Journals (Sweden)

    Taratuta V. D.

    2016-01-01

    Full Text Available The article presents results of research of rotary-screw systems in relation to the creation of rotary kilns for the annealing of-cuttings in the preparation of cement clinker. Using the proposed design, in comparison with known designs of similar purpose, it significantly improves performance, reduces size and power consumption through the use of rotary screw systems in the form of screw rotors and drums made hollow with sidewalls assembled from separate strips or plates of different geometrical shapes with form inside the screw breaks or smooth edges, screw surfaces and screw grooves. It is shown that the housing of the rotary kiln is expedient to produce helical surfaces whose centers of curvature are located within the housing. Using the proposed constructions rotary kiln during the firing when preparing cement wedge can increase the speed of rotation of the housing, furnaces 5-10 times due to changes in the rotary-screw systems increase efficiency and reduce the size of furnaces

  17. Percutaneous Sacroiliac Screw Technique.

    Science.gov (United States)

    Tidwell, John; Cho, Rosa; Reid, J Spence; Boateng, Henry; Copeland, Carol; Sirlin, Edward

    2016-08-01

    Remembering that preoperative planning, surgical indications, and fracture reduction are paramount for this procedure, presented here is our technique for performing percutaneous sacroiliac screws, both transiliac-transsacral and sacral style. A combination of video, still pictures, and fluoroscopy images will guide the viewer through the process we routinely use highlighting specific details. Patient positioning and intraoperative fluoroscopy imaging are critical to a successful procedure. Although inlet and outlet films remain important, we find the procedure best started on the lateral sacral view to reduce the need for start site, trajectory, and imaging position changes during the case. A cannulated pig sticker (drill guide) used with long drill tip guide wires provide improved manual control to both finding a good start site and directing the trajectory. For patient safety, sacral anatomy and safe zones are discussed as well. Using these technical points will help make this a successful procedure. PMID:27441927

  18. The meniscus Arrow or metal screw for treatment of osteochondritis dissecans? In vitro comparison of their effectiveness

    NARCIS (Netherlands)

    Wouters, DB; Bos, RRM; Mouton, LJ; van Horn, [No Value

    2004-01-01

    Three draw bench tests in axial direction were conducted of the pull out forces in predrilled human condylar bone of one single meniscus Arrow, one single metal screw, and three Meniscus Arrows in one bone block, the Arrows being inserted using the standard hand instruments. Bone blocks with three m

  19. The pullout performance of pedicle screws

    CERN Document Server

    Demir, Teyfik

    2015-01-01

    This brief book systematically discusses all subjects that affect the pullout strength of pedicle screws. These screws are used in spinal surgeries to stabilize the spine. The holding strength of the pedicle screw is vital since loosening of the pedicle screws can cause revision surgeries. Once the pedicle screw is pulled out, it is harder to obtain same stabilization for the fused vertebrae. The book reviews the effect of screw designs, application techniques, cement augmentation, coating of the screw and test conditions on the pullout strength. The studies with finite element analysis were also included.

  20. Geothermal ORC Systems Using Large Screw Expanders

    OpenAIRE

    Biederman, Tim R.; Brasz, Joost J.

    2014-01-01

    Geothermal ORC Systems using Large Screw Expanders Tim Biederman Cyrq Energy Abstract This paper describes a low-temperature Organic Rankine Cycle Power Recovery system with a screw expander a derivative of developed of Kaishan's line of screw compressors, as its power unit. The screw expander design is a modified version of its existing refrigeration compressor used on water-cooled chillers. Starting the ORC development program with existing refrigeration screw compre...

  1. Comparison of interfaces of different pedicle screws with micro-CT technique in lumbar vertebrae with osteoporosis of sheep

    Directory of Open Access Journals (Sweden)

    Da LIU

    2015-07-01

    Full Text Available Objective To compare the changes in interfaces of expandable pedicle screw (EPS and polymethylmethacrylateenhanced pedicle screw (PMMA-PS after being used in osteoporotic sheep lumbar vertebrae with micro-CT technique. Methods Six lumbar vertebrae (L1-L6 in each sheep were randomly divided into three different screw-insertion groups (two vertebrae with four pedicles in each group after reproduction of osteoporosis in sheep. After making the pilot hole using the same method, CPS was inserted through the pilot hole into vertebral body in CPS group, while PMMA (1.0ml was injected into the pilot hole prior to the insertion of CPS in PMMA-PS group, and EPS was inserted through pedicle into vertebral body in EPS group. All the sheep were sacrificed, and lumbar vertebrae (L1-L6 were harvested respectively at the 6- and 12-week postoperatively. The micro-CT three dimensional reconstruction and histomorphometric analysis were performed to evaluate the interfacial conditions. Results  It was clearly demonstrated that interface was formed where the bone trabeculae was directly in contact with the screw to form "screw-bone" interface in both CPS and EPS groups both 6 weeks and 12 weeks after the operation. The screw was fully surrounded by PMMA and formed "screw-PMMA-bone" interface in PMMA-PS group. The anterior part of EPS expanded in vertebral body to form a clawlike structure, pressing against the surrounding bone trabeculae, thus significantly improved the local bone quality (amount and density of bone trabeculae. From 6 weeks to 12 weeks after the operation, there was no visual difference in bone quality around the screw in both CPS and PMMA-PS groups. There was no degradation and absorption of PMMA, and it led to form the second non-biological interface in PMMA-PS group. Nevertheless, bone quality around expanding part of EPS at 12-week post-operation was significantly improved compared with that at 6-week post-operation, thus forming a good

  2. Biomechanical testing of implant free wedge shaped bone block fixation for bone patellar tendon bone anterior cruciate ligament reconstruction in a bovine model

    Directory of Open Access Journals (Sweden)

    Willis-Owen Charles A

    2010-09-01

    Full Text Available Abstract Background The use of an interference fit wedged bone plug to provide fixation in the tibial tunnel when using bone-patellar tendon-bone autograft for anterior cruciate ligament reconstruction offers many theoretic advantages including the potential to offer a more economical and biological alternative to screw fixation. This technique has not been subjected to biomechanical testing. We hypothesised that a wedged bone plug fixation technique provides equivalent tensile load to failure as titanium interference screw fixation. Methods In a controlled laboratory setting, anterior cruciate ligament reconstruction was performed in 36 bovine knees using bone-patella-bone autograft. In 20 knees tibial fixation relied upon a standard cuboid bone block and interference screw. In eight knees a wedge shaped bone block with an 11 mm by 10 mm base without a screw was used. In a further eight knees a similar wedge with a 13 mm by 10 mm base was used. Each specimen used a standard 10 mm tibial tunnel. The reconstructions were tested biomechanically in a physiological environment using an Instron machine to compare ultimate failure loads and modes of failure. Results Statistical analysis revealed no significant difference between wedge fixation and screw fixation (p = 0.16, or between individual groups (interference screw versus 11 mm versus 13 mm wedge fixation (P = 0.35. Conclusions Tibial tunnel fixation using an impacted wedge shaped bone block in anterior cruciate ligament reconstruction has comparable ultimate tensile strength to titanium interference screw fixation.

  3. Pedicle screw rupture: A case study

    Directory of Open Access Journals (Sweden)

    Giorgio E.O. Giacaglia

    2015-10-01

    Full Text Available In this work we present a technical description related to the rupture of a titanium alloy pedicle screw and connecting bar implanted in dorsal vertebras of a patient. Only metallurgical facts are described, with no attempt to identify any imperfections in the clinical aspects related to the rupture. The results described here are based on extensive analysis of the broken materials in a material sciences specialized laboratory. Excluding an incorrect prosthesis implantation in the surgical procedure and a possible low bone density, an information not available to the research team, with high probability the rupture of metallic pieces used in the prosthetic implant, was produced by the low fatigue resistance resulting by an improper machining process and excessive bending of the connecting bar prior to implant.

  4. Tibial Tunnel Cyst Formation after Anterior Cruciate Ligament Reconstruction Using a Non-Bioabsorbable Interference Screw.

    Science.gov (United States)

    Joshi, Yogesh V; Bhaskar, Deepu; Phaltankar, Padmanabh M; Charalambous, Charalambos P

    2015-12-01

    Tibial cyst formation following the use of bioabsorbable interference screws in anterior cruciate ligament (ACL) reconstruction is well-described; however, cyst formation after the use of metallic interference screws is not well-documented. We describe a case of osteolytic lesion of the proximal tibia presenting to us 20 years after ACL reconstruction using an autologous bone-tendon-bone graft. The original graft fixation technique was interference fixation with a metal screw in the tibial and femoral tunnels. A two-stage revision reconstruction of the ACL was undertaken with curettage and bone grafting of the tibial lesion in the first stage and reconstruction using a four-strand hamstring tendon in the second stage. The patient recovered satisfactorily with complete healing of the cyst and returned to pre-injury level of activities. We have reviewed case reports and case series that describe the aetiology of intra-osseous cyst formation following ACL reconstruction. PMID:26673117

  5. GSS pedicle screw fixation combined with two-stage bone cement perfusion for thoracolumbar fractures%GSS椎弓根螺钉内固定并二期伤椎骨水泥灌注治疗胸腰椎骨折

    Institute of Scientific and Technical Information of China (English)

    宋洁富; 李利军; 常峰; 荆志振

    2012-01-01

    Objective To explore the efficacy and safety of surgical treatment of thoracolumbar fractures by GSS pedicle screw fixation combined with two-stage bone cement perfusion. Methods From March 2005 to October 2010, 31 patients with thoracolumbar bursting fractures were treated with posterior GSS pedicle screw fixation. The patients were reviewed by X-ray and CT scan 3-18 months postoperatively. Once "eggshell phenomenon" appeared, bone cement was used in the injured vertebral body before removing the fixators. Injured vertebral height and Cobb' s angle were measured preoperatively, postoperatively and at the final follow-up. Results No leakage of bone cement happened in all the patients. The internal fixators were removed 12-18 months postoperatively. Then the patients were followed up for 1-3 years. Fractured vertebral height and Cobb' s angle were significantly improved after surgery. Conclusion GSS combined with two-stage bone cement perfusion for thoracolumbar fractures can achieve a good therapeutic effect. It can be taken as an attempt at the treatment of thoracolumbar fractures.%目的 探讨GSS椎弓根螺钉内固定结合二期伤椎骨水泥灌注治疗胸腰椎骨折的有效性和安全性.方法 2005年3月~2010年10月共31例胸腰椎爆裂性骨折患者行后路GSS椎弓根螺钉内固定治疗,术后3~18个月根据X线及CT复查情况,出现"蛋壳现象"的患者在取出内固定前行伤椎骨水泥灌注,记录术前、术后及末次随访时的伤椎高度及X线片测量的Cobb角角度.结果 本组患者均未出现骨水泥渗漏,术后12~18个月取出内固定后再随访1~3年.术后伤椎椎体高度及Cobb角与术前相比有明显改善.结论 GSS椎弓根螺钉内固定结合二期伤椎骨水泥灌注治疗胸腰椎骨折可达到良好的治疗效果,可作为治疗胸腰椎骨折的新的尝试.

  6. Can experimental data in humans verify the finite element-based bone remodeling algorithm?

    DEFF Research Database (Denmark)

    Wong, Christian; Gehrchen, P Martin; Kiaer, Thomas

    2008-01-01

    A finite element analysis-based bone remodeling study in human was conducted in the lumbar spine operated on with pedicle screws. Bone remodeling results were compared to prospective experimental bone mineral content data of patients operated on with pedicle screws....

  7. Simple coating with fibronectin fragment enhances stainless steel screw osseointegration in healthy and osteoporotic rats.

    Science.gov (United States)

    Agarwal, Rachit; González-García, Cristina; Torstrick, Brennan; Guldberg, Robert E; Salmerón-Sánchez, Manuel; García, Andrés J

    2015-09-01

    Metal implants are widely used to provide structural support and stability in current surgical treatments for bone fractures, spinal fusions, and joint arthroplasties as well as craniofacial and dental applications. Early implant-bone mechanical fixation is an important requirement for the successful performance of such implants. However, adequate osseointegration has been difficult to achieve especially in challenging disease states like osteoporosis due to reduced bone mass and strength. Here, we present a simple coating strategy based on passive adsorption of FN7-10, a recombinant fragment of human fibronectin encompassing the major cell adhesive, integrin-binding site, onto 316-grade stainless steel (SS). FN7-10 coating on SS surfaces promoted α5β1 integrin-dependent adhesion and osteogenic differentiation of human mesenchymal stem cells. FN7-10-coated SS screws increased bone-implant mechanical fixation compared to uncoated screws by 30% and 45% at 1 and 3 months, respectively, in healthy rats. Importantly, FN7-10 coating significantly enhanced bone-screw fixation by 57% and 32% at 1 and 3 months, respectively, and bone-implant ingrowth by 30% at 3 months compared to uncoated screws in osteoporotic rats. These coatings are easy to apply intra-operatively, even to implants with complex geometries and structures, facilitating the potential for rapid translation to clinical settings. PMID:26100343

  8. Novel free-hand T1 pedicle screw method: Review of 44 consecutive cases

    Directory of Open Access Journals (Sweden)

    Mark A Rivkin

    2014-01-01

    Full Text Available Summary of Background Data: Multilevel posterior cervical instrumented fusions are becoming more prevalent in current practice. Biomechanical characteristics of the cervicothoracic junction may necessitate extending the construct to upper thoracic segments. However, fixation in upper thoracic spine can be technically demanding owing to transitional anatomy while suboptimal placement facilitates vascular and neurologic complications. Thoracic instrumentation methods include free-hand, fluoroscopic guidance, and CT-based image guidance. However, fluoroscopy of upper thoracic spine is challenging secondary to vertebral geometry and patient positioning, while image-guided systems present substantial financial commitment and are not readily available at most centers. Additionally, imaging modalities increase radiation exposure to the patient and surgeon while potentially lengthening surgical time. Materials and Methods: Retrospective review of 44 consecutive patients undergoing a cervicothoracic fusion by a single surgeon using the novel free-hand T1 pedicle screw technique between June 2009 and November 2012. A starting point medial and cephalad to classic entry as well as new trajectory were utilized. No imaging modalities were employed during screw insertion. Postoperative CT scans were obtained on day 1. Screw accuracy was independently evaluated according to the Heary classification. Results: In total, 87 pedicle screws placed were at T1. Grade 1 placement occurred in 72 (82.8% screws, Grade 2 in 4 (4.6% screws and Grade 3 in 9 (10.3% screws. All Grade 2 and 3 breaches were <2 mm except one Grade 3 screw breaching 2-4 mm laterally. Only two screws (2.3% were noted to be Grade 4, both breaching medially by less than 2 mm. No new neurological deficits or returns to operating room took place postoperatively. Conclusions: This modification of the traditional starting point and trajectory at T1 is safe and effective. It attenuates additional bone

  9. Effect of immersion in simulated body environment on mechanical properties of twist-oriented poly(lactic acid) screws

    Science.gov (United States)

    Sakaguchi, Masato; Kobayashi, Satoshi; composite engineering lab Collaboration

    Poly(lactic acid) (PLA) has been applied to bone fixation devices, since it has high biocompatibility. In order to apply PLA device to a higher loaded part, mechanical properties of PLA have been improved by uniaxial drawing. However, mechanical properties along the other loading direction than the drawing direction such as torsion were not improved. Therefore, surgeon should be carefully conducted not to brake the reinforced PLA screw when tightening. In this study, screw is focused on as a bone fixation device. In order to improve torsional strength of a PLA screw, twist-orientation method was developed. PLA screw is prepared through a series of routes including casting, extrusion drawing, twist-orientation and forging. This screw was immersed in the phosphate buffered solution for 0, 8, 16 and 24 weeks, then shear strength, orientation function, crystallinity and molecular weight were measured. As a result, twist-orientation improves the initial torsional strength of PLA screw without the decrease in initial shear strength. In addition, the shear strength on twist-oriented screw is equivalent that of non-twist oriented screw during immersion until 24 weeks. This result shown that the twist-orientation does not decrease shear strength after immersion.

  10. Anterior transarticular screw fixation as a conventional operation for rigid stabilization

    Directory of Open Access Journals (Sweden)

    Manabu Sasaki

    2014-01-01

    Full Text Available Background: Anterior transarticular screw (ATS fixation is a useful surgical option for atlantoaxial (AA stabilization. This report presents a revised ATS method for AA fusion. Methods: A 79-year-old male presented with AA instability attributed both to an old odontoid fracture and severe degeneration of the lateral atlantoaxial joints (LAAJs. ATS fixation was performed through the conventional anterior cervical approach. The longest screw trajectories were planned preoperatively using multiplanar reconstruction computed tomography (CT scans, with entry points of the screws situated at the midpoint on the inferior border of the axial body. The surgical exposure was limited to opening at the entry points alone. Our retractor of choice was the Cusco speculum; it sufficiently secured space for utilizing the required instruments for screw placement while offering sufficient protection of soft tissues. Cannulated full-threaded bicortical screws stabilized the LAAJs. Screw insertion required a significant amount of coronal angulation up to the superior articular process of the atlas under open-mouth and lateral fluoroscopy image guidance. After ATS fixation, bone grafting was performed between the posterior laminae of the axis and the atlas through a conventional posterior approach. Results: Bony fusion between the atlas and the axis was confirmed radiographically. Arthrodesis of the LAAJs occurred despite no bone grafting. Conclusions: Rigid fixation of the LAAJs was obtained by our ATS technique, indicating that it is an alternative method for AA fixation when posterior rigid internal fixation is not applicable.

  11. Periprosthetic fracture fixation in osteoporotic bone.

    Science.gov (United States)

    Lenz, Mark; Lehmann, Wolfgang; Wähnert, Dirk

    2016-06-01

    Fixation techniques of periprosthetic fractures are far from ideal although the number of this entity is rising. The presence of an intramedullary implant generates its own fracture characteristics since stiffness is altered along the bone shaft and certain implant combinations affect load resistance of the bone. Influencing factors are cement fixation of the implant, intramedullary locking and extramedullary or intramedullary localization of the implant and the cortical thickness of the surrounding bone. Cerclage wires are ideally suited to fix radially displaced fragments around an intramedullary implant but they are susceptible to axial and torsional load. Screws should be added if these forces have to be neutralized. Stability of the screw fixation itself can be enhanced by embracement configuration around the intramedullary implant. Poor bone stock quality, often being present in metaphyseal areas limits screw fixation. Cement augmentation is an attractive option in this field to enhance screw purchase. PMID:27338227

  12. 椎弓根螺钉系统加自固化磷酸钙人工骨灌注治疗胸腰椎骨折%Treatment of thoracolumbar vertebrae fractures with vertebral pedicle screw system and artificial bones filled with autosolidification calcium phosphate cement

    Institute of Scientific and Technical Information of China (English)

    曾忠友; 金才益; 陆金荣; 王斌; 徐阿炳

    2001-01-01

    目的探讨应用椎弓根螺钉系统及自固化磷酸钙人工骨(ACPC)灌注治疗胸腰椎骨折的效果。方法 1999年4月始,选择18例胸腰椎骨折患者,其中压缩型12例,爆裂型6例。伤后6 h~7 d行椎弓根螺钉系统固定、复位,同时加ACPC灌注伤椎。结果 18例患者除2例神经功能A级脊髓神经症状无改善外,其余均有Ⅰ~Ⅲ级的恢复,脊柱后凸角平均恢复21°,伤椎前缘高度平均恢复至98%,伤椎后缘侵入椎管骨块明显回纳。随访10~16个月,平均11.6个月。随访期间无内固定松动及断裂现象,无慢性腰背痛,伤椎高度及脊柱生理弧度无丢失。结论胸腰椎压缩型骨折是使用ACPC的最佳适应证。如术前影像检查明确有双侧椎弓根骨折,则为禁忌。只要手术适应证选择适当,术中操作仔细,椎弓根螺钉系统加ACPC灌注治疗胸腰椎骨折是一有效而又安全的方法,特别是后期伤椎高度和脊柱生理弧度得到很好的维持。%Objective To study the effect of vertebral pedicle screw system and artificial bones filled with autosolidification calcium phosphate cement(ACPC) on thoracolumbar vertebrae fractures.  Methods A total of 18 patients with thoracolumbar vertebrae fractures and with operative indications were treated with vertebral pedicle screw system and artificial bones filled with ACPC.  Results  Except 2 patients with the spinal cord function for Grade A, all the patients had the average improvement of Degree I to Degree Ⅲ on the aspect of spinal cord function. The kyphotic angle recovered averagely for 21°, the anterior height of the injured vertebral body was averagely restored to 98% of the normal, and the bone fragments that invaded into the spinal canal were obviously restored. During the following-up, loose or breakage of the internal fixation was not found, and there was no chronic lumbar back pain or loss of the normal spine curve and the

  13. 聚甲基丙烯酸甲酯和自体骨加强的椎弓根螺钉技术治疗退变性脊柱侧凸的临床疗效比较%Autogenous bone and polymethylmethacrylate augmentation of screw fixation for degenerative scoliosis

    Institute of Scientific and Technical Information of China (English)

    谢杨; 傅强; 陈自强; 石志才; 朱晓东; 孙晓飞; 李明

    2012-01-01

    Objective To compare the clinical effect of autogenous bone and polymethylmethacrylate (PMMA) augmentation of screw fixation in degenerative scoliosis with osteoporosis. Methods A retrospective analysis was conducted on 31 consecutive patients with degenerative scoliosis combined with osteoporosis who accepted pedicle screw fixation from December 2000 to December 2006. Fourteen of them underwent fixation with pedicle screw by augmentation with PMMA and the other 17 patients with autogenous bone. Peri-operative data were recorded. Preoperative, postoperative and final follow up corrective effects were compared. Results No significant difference was found in clinical data except for administration time of oral pain relief medicines and surgery cost between the two surgical strategies. Cement leakage was observed in 2 patients in PMMA augmentation group, but there was no evidence of nerve damage. Conclusion There is no difference in surgical effect between two surgery strategies on degenerative scoliosis combined with osteoporosis. Less oral pain medicines are taken in the polymethylmethacrylate-augmented pedicle screw fixation and fusion, but with much more cost and danger of cement leakage.%目的 比较应用聚甲基丙烯酸甲酯( PMMA)和自体骨加强的椎弓根螺钉技术治疗合并骨质疏松的退变性脊柱侧凸的临床疗效.方法 回顾性分析2000年12月至2006年12月手术治疗的31例伴骨质疏松的退变性脊柱侧凸患者,其中14例采用PMMA加强钉道,17例采用自体骨加强钉道.记录并发症等围手术期情况,比较手术前后及随访期间侧凸的矫正效果.结果 两种手术除口服止痛药使用时间和手术费用外,其他临床数据差异无统计学意义,PMMA加强组中2例出现骨水泥渗漏,但未出现神经损伤的症状.结论 两种手术对伴骨质疏松的退变性脊柱侧凸的临床疗效无明显差异,PMMA加强的椎弓根螺钉内固定融合术可减少口服止痛药的用量,

  14. 骨水泥强化与常规椎弓根螺钉固定治疗老年退行性腰椎疾病的比较%Comparison of bone cement augmented with traditional pedicle screw in the treatment of degenerative lumbar disease

    Institute of Scientific and Technical Information of China (English)

    吴志彬; 刘宏建; 尚国伟; 贾杰; 魏琛; 王俊魁; 周权发; 皮国富; 王义生

    2015-01-01

    目的 比较骨水泥强化与常规椎弓根螺钉固定治疗老年退行性腰椎疾病的疗效.方法 回顾性分析2013年5月至2015年5月采用腰椎融合术治疗40例老年退行性腰椎疾病患者资料,根据置入椎弓根螺钉的椎体内是否注入骨水泥分为常规组(未置入骨水泥,20例,男5例,女15例;年龄平均73.2岁;腰椎间盘突出 12例,腰椎管狭窄8例)和骨水泥强化组(置入骨水泥,20例,男6例,女14例;年龄平均73.7岁;腰椎间盘突出12例,腰椎管狭窄8例),螺钉分别置入L3、L4、L5及S1共170个椎体.分别评估术前、术后30天及末次随访的Oswestry功能障碍指数、固定节段上位相邻椎间隙高度、固定节段上位相邻椎体变形指数、固定节段Cobb角、固定节段椎体上缘终板及相邻上位椎体下缘终板凹陷角度.结果 40例患者经3~24个月随访,平均随访12.2个月.末次随访Oswestry功能障碍指数常规组及骨水泥强化组评分分别为13.0%±4.9%和11.0%±8.0%,两组比较差异无统计学意义.末次随访与术后30 d的平均Cobb角的变化值常规组及骨水泥强化组分别为5.53°±1.64°、2.15°±0.97°.骨水泥强化组术后30 d出现上终板凹陷角度增大,末次随访时相邻上位椎体下终板凹陷角度、椎体变形指数及相邻椎间隙均减小,且前两项指标的改变程度明显大于常规组.结论 骨水泥强化与常规椎弓根螺钉固定均能缓解患者症状,但骨水泥强化椎弓根螺钉能明显提高老年患者内固定术后椎体的稳定性.%Objective To compare post-operative clinical outcomes between bone cement augmented pedicle screw and traditional pedicle screw in treatment of degenerative lumbar disease.Methods Data of 40 cases with lumbar degenerative disease who had surgery from May 2013 to May 2015 were retrospectively analyzed.They were divided into two groups according to whether the bone cement was injected in the vertebral body with pedicle

  15. Designs and Techniques That Improve the Pullout Strength of Pedicle Screws in Osteoporotic Vertebrae: Current Status

    Directory of Open Access Journals (Sweden)

    Thomas M. Shea

    2014-01-01

    Full Text Available Osteoporosis is a medical condition affecting men and women of different age groups and populations. The compromised bone quality caused by this disease represents an important challenge when a surgical procedure (e.g., spinal fusion is needed after failure of conservative treatments. Different pedicle screw designs and instrumentation techniques have been explored to enhance spinal device fixation in bone of compromised quality. These include alterations of screw thread design, optimization of pilot hole size for non-self-tapping screws, modification of the implant’s trajectory, and bone cement augmentation. While the true benefits and limitations of any procedure may not be realized until they are observed in a clinical setting, axial pullout tests, due in large part to their reproducibility and ease of execution, are commonly used to estimate the device’s effectiveness by quantifying the change in force required to remove the screw from the body. The objective of this investigation is to provide an overview of the different pedicle screw designs and the associated surgical techniques either currently utilized or proposed to improve pullout strength in osteoporotic patients. Mechanical comparisons as well as potential advantages and disadvantages of each consideration are provided herein.

  16. Pull-out strength comparison of a novel expanding fastener against an orthopaedic screw in an ovine vertebral body: an ex-vivo study.

    Science.gov (United States)

    Oldakowski, Matthew; Oldakowska, Intan; Kirk, Thomas B; Ford, Chris T; Sercombe, Tim B; Hardcastle, Philip; Day, Robert E

    2016-01-01

    The purpose of this study was to mechanically test a novel Unthreaded Expandable Fastener (UEF), manufactured using Selective Laser Melting, which was designed for fixation in the cervical lateral mass. The pull-out strength and stiffness of the prototype UEFs was evaluated in a non-osteoporotic ovine bone model against equivalent screws. The prototype UEF demonstrated a 41% increase in failure force and a 60% reduction in failure force standard deviation compared to the screws. All bone samples were micro CT-scanned and no significant differences in bone microstructural properties was found between the screw and UEF sample sets, indicating that the UEFs may be less sensitive to bone quality variation. This increased performance can potentially translate into improved surgical outcome and reduced surgical risk for lateral mass fixation. With further design optimisation, additional improvement in performance over screws may be possible in future studies.

  17. 骨水泥强化椎弓根钉固定联合椎体成形术治疗重度骨质疏松性脊柱骨折%Pedicle screw fixation strengthened with bone cement combined with vertebroplasty for the treatment of severe osteoporotic fractures

    Institute of Scientific and Technical Information of China (English)

    胡明; 李大伟; 黄凤山; 刘玉川; 杨达宇; 马远征

    2011-01-01

    Objective To explore the peri-operative treatment and clinical efficacy of pedicle screw fixation strengthened with bone cement combined with vertebroplasty for the treatment of severe osteoporotic fractures. Methods The clinical data of 15 patients with severe vertebral osteoporotic compression fractures were retrospectively analyzed from August 2005 to April 2009. The average age of the patients was 63. 1 years old. They had no severe basal diseases. They were all treated with posterior pedicle screw fixation strengthened with bone cement combined with vertebroplasty. All patients were followed up for 10-38 months (21 months in average) after the operation. Results All patients could tolerate the surgery and the average operating time was 106. 7 ±5. 3 min. The average bleeding volume was 370 ± 6. 1 ml. The twist and back pain were significantly ameliorated after the surgery. The height of vertebral body recovered back to 90% after operation. The height loss was not obvious during the following up. Conclusion The efficacy of pedicle screw fixation strengthened with bone cement combined with vertebroplasty for the treatment of severe osteoporotic fractures is good at correcting fracture and maintaining the recovering effect of the vertebra. The key point of this therapy is the surgical indication and osteoporotic medicine treatment.%目的 探讨骨水泥强化椎弓根钉固定联合椎体成形术治疗严重骨质疏松性椎体压缩骨折的围术期处理和临床疗效.方法 回顾分析2005年8月~ 2009年4月收治的15例严重骨质疏松性椎体压缩骨折患者的临床资料,平均63.1岁,无重大基础病存在,经脊柱后入路椎弓根钉撑开复位,钉道采用骨水泥灌注加强并行经伤椎椎体成形术.术后随访10~ 38个月,平均21月.结果 均耐受手术,平均手术时间为106.7±5.3min;平均失血量为370±6.1ml,术后腰背痛明显改善,椎体高度恢复至90%左右,随访椎体高度

  18. 伤椎椎弓根植骨加短节段椎弓根螺钉置入内固定治疗老年人胸腰椎骨折%Transpedicular bone graft combined with short-segment pedicle screw internal fixation for senile thoracolumbar fracture

    Institute of Scientific and Technical Information of China (English)

    王宏伟; 王宇; 王军辉; 穆尚强; 姜波; 潘锋

    2011-01-01

    BACKGROUND: Traditional pedicle screw internal fixation combined with posterolateral lumbar fusion in the treatment of senilethoracolumbar burst fracture are easily to occur reset angle, high loss, delayed nerve damage and internal fixation loosening.OBJECTIVE: To investigate the method and effect of transpedicular bone graft combined with pedicle screw internal fixation onthe treatment of senile thoracolumbar fracture.METHODS: Totally 32 patients who were more than 60 years old with thoracolumbar burst fracture were treated by posteriorpedicle fixation combined with grafting through the injured pedicle. Height of fractured vertebrae, Cobb angle, occupying of spinalcanal, neuropathic function, lumbar and back pain were measured and analyzed preoperatively, postoperatively and during thefollow up period.RESULTS AND CONCLUSION: All the patients were followed-up over 6 months. The internal fixation was not break or loose, theheight of fractured vertebrae, the Cobb angle, the occupying of spinal canal, the neuropathic function, lumbar and back painimproved obviously, and the height of fractured vertebrae, the Cobb angle and the occupying of spinal canal were not obviouslylose. It is indicated that application of transpedicular bone graft combined with posterior pedicle screw internal fixation is aneffective method in treatment of senile thoracolumbar burst fracture, it can restore the height and strength of the vertebral body,and immediately increase vertebral bone content and the stability of the spine, and reduce the possibility of breaking nail, breakingrod, the loss of height and other complications, which are caused by stress.%背景:传统椎弓根内固定系统加后外侧植骨融合治疗老年胸腰椎爆裂性骨折易发生复位角度、高度丢失,迟发性神经损伤,内固定松动.目的:观察经骨折椎椎弓根植骨联合椎弓根内固定治疗老年胸腰椎爆裂性骨折的方法和效果.方法:采用经骨折椎椎弓根植骨结合短

  19. Fibular grafting with cannulated hip screw fixation in late femoral neck fracture in young adults

    Directory of Open Access Journals (Sweden)

    Goyal R

    2006-01-01

    Full Text Available Background: We reviewed the operative results of fibular bone graft with cannulated hip screw fixation in femoral neck fracture in young adults. Method: Sixteen young adults with femoral neck fracture were treated by fibular bone graft with cannulated hip screw fixation. All the fractures were more than 3 weeks old. Results: Results were assessed in 15 patients while one patient died due to complications not related to surgery. Union occurred in all 15 patients. One patient had intra-operative complication in the form of screw cut out with graft in the joint space. The average fallow up was 24.4 months. Out of 15 patients assessed clinico-radiologically 11 showed good results, 3 had fair while 1 had poor result. Conclusion: We conclude that this is a simple and cost effective procedure for late femoral fleck fracture in young adults with good results.

  20. Metallurgical examination of gun barrel screws

    Energy Technology Data Exchange (ETDEWEB)

    Bird, E.L.; Clift, T.L.

    1996-06-01

    The examination was conducted to determine the extent of degradation that had occurred after a series of firings; these screws prevent live rounds of ammunition from being loaded into the firing chamber. One concern is that if the screw tip fails and a live round is accidentally loaded into the chamber, a live round could be fired. Another concern is that if the blunt end of the screw begins to degrade by cracking, pieces could become small projectiles during firing. All screws used in firing 100 rounds or more exhibited some degree degradation, which progressively worsened as the number of rounds fired increased. (SEM, metallography, x-ray analysis, and microhardness were used.) Presence of cracks in these screws after 100 fired rounds is a serious concern that warrants the discontinued use of these screws. The screw could be improved by selecting an alloy more resistant to thermal and chemical degradation.

  1. Intervertebral bone graft and posterior pedicle screw in treatment of serious thoracolumbar vertebral burst fractures%伤椎内植骨成形联合后路植骨椎弓根螺钉复位固定治疗重度胸腰椎爆裂性骨折

    Institute of Scientific and Technical Information of China (English)

    丁建忠; 罗建; 胡广; 徐为刚; 臧峰

    2014-01-01

    Objective To evaluate the clinical effect of serious thoracolumbar vertebral burst fractures treated by transpedicular bone graft and posterior fixation with pedicle screws system and posterolateral bone graft. Methods A total of 36 patients with serious thoracolumbar burst fractures from Oct 2007 to May 2013 were treated by transpedicular bone graft with au_tologous and allogeneic bone chips combined with posterior fixation with pedicle screws system and posterolateral bone graft. For osteoporosis patients,bone cement was applied to reinforce screw fixation. The clinical outcome and imaging examination results before surgery,at the 3rd,6th,12th month after surgery and at the last follow up were studied. The condition of the bone graft and posterior cervical fusion was evaluated. The canalis vertebralis stenosis ,the Cobb′s angle and vertebral compression ratio were measured. The lumbago degree and neural functional recovery were assessed. Results All the patients were followed up to 3 years and 2 months in average(ranged from 13 months to 5 years). The canalis vertebralis stenosis,the Cobb′s angle and vertebral compression ratio[(3.4±1.2)%,(5.2±3.1)°,(4.4±3.1)%] were all significantly improved immediately after surgery with statistically significant difference(P0.05). CT and X ray results showed the stable bone graft,no"shell"phenomenon,no vertebral body height lost,and an average healing time of 3.5 months. The average healing time for posterior cervical fusion was 5.0 months , and pseudarthrosis formation was not observed. Fixation failure did not occur in any of the studied cases. Nerve injuries were all improved to a certain degree after surgery. Conclusion Transpedicular bone graft combined with posterior fixation with pedicle screws system and posterolateral bone graft can solve the problem of bone defect of anterior and middle column in serious thora_columbar burst fractures,and in addition,it can reinforce the fusion and fixation between the

  2. Comparison between two pedicle screw augmentation instrumentations in adult degenerative scoliosis with osteoporosis

    Directory of Open Access Journals (Sweden)

    Xie Yang

    2011-12-01

    Full Text Available Abstract Background The operative treatment of adult degenerative scoliosis combined with osteoporosis increase following the epidemiological development. Studies have confirmed that screws in osteoporotic spines have significant lower-screw strength with more frequent screw movements within the vertebra than normal spines. Screws augmented with Polymethylmethacrylate (PMMA or with autogenous bone can offer more powerful corrective force and significant advantages. Methods A retrospective analysis was conducted on 31 consecutive patients with degenerative lumbar scoliosis combined with osteoporosis who had surgery from December 2000. All had a minimum of 2-year follow-up. All patients had posterior approach surgery. 14 of them were fixed with pedicle screw by augmentation with Polymethylmethacrylate (PMMA and the other 17 patients with autogenous bone. Age, sex and whether smoking were similar between the two groups. Surgical time, blood loss, blood transfusion, medical cost, post surgery ICU time, hospital day, length of oral pain medicines taken, Pre-and postoperative Oswestry disability index questionnaire and surgical revision were documented and compared. Preoperative, postoperative and final follow up Cobb angle, sagittal lumbar curve, correction rate, and Follow up Cobb loss were also compared. Results No significant differences were found between the autogenous bone group and Polymethylmethacrylate group with regards to all the targets above except for length of oral pain medicines taken and surgery cost. 2 patients were seen leakage during operation, but there is neither damage of nerve nor symptom after operation. No revision was needed. Conclusion Both augmentation pedicle screw with Polymethylmethacrylate (PMMA and autogenous bone treating degenerative lumbar scoliosis combined with osteoporosis can achieve a good surgical result. Less oral pain medicines taken are the potential benefits of Polymethylmethacrylate augmentation, but

  3. 硫酸钙骨水泥增强骨质疏松股骨粗隆间骨折内固定的有限元分析%Finite-Element Analysis of Injectable Calcium Sulfate Bone Cement Augmentation with Dynamic Hip Screw System for the Treatment of Osteoporotic Intertrochanteric Fractures

    Institute of Scientific and Technical Information of China (English)

    于晓巍; 王楠; 汤亭亭

    2009-01-01

    通过有限元分析,研究硫酸钙对稳定型骨质疏松股骨粗隆间骨折内固定增强的影响.建立骨质疏松股骨稳定型粗隆阅骨折有限元模型,模拟动力髋螺钉(DHS)固定及硫酸钙增强的DHS固定,分析硫酸钙对DHS固定的增强效果.有限元分析显示,硫酸钙增强后,股骨头部的松质骨最大应力减少了35%,提示螺钉切割出股骨头的可能性减小;而股骨骨折面最大应力从3.7 MPa减少到1.8 MPa,提示硫酸钙增强提高了DHS固定的稳定性.研究结果表明,硫酸钙骨水泥能有效增强骨质疏松性骨折内固定的稳定性,具有较好的临床应用前景.%The mechanical performance of the dynamic hip screw (DHS) system augmented with calcium sulfate bone cement (CSC) for the fixation of stable osteoporotic intertrochanteric fracture was evaluated by means of finite element analysis (FEA). Finite element model was used to simulate the stable osteoporotic intertrochanteric fracture with DHS fixation or DHS fixation plus CSC augmentation and the stress distribution was analyzed. With cement augmentation, 35% reduction of the maximum stress was found in the femur head, suggesting reduced possibility of screw cut-outs. Maximum stress at the fracture plane was also decreased from 3.7 MPa to 1.8 MPa, which indicates improved fixation after CSC augmentation. These results indicate that calcium sulfate cement is effective in augmenting fixation in osteoporotic bone. Calcium sulfate cement has potential application in the treatment of osteoporotic fractures.

  4. Biopolymer augmentation of the lag screw in the treatment of femoral neck fractures - a biomechanical in-vitro study

    OpenAIRE

    Paech A; Wilde E; Schulz AP; Heinrichs G; Wendlandt R; Queitsch C; Kienast B; Jürgens Ch

    2010-01-01

    Abstract The cut-out of the sliding screw is one of the most common complications in the treatment of intertrochanteric fractures. The reasons for the cut-out are: a suboptimal position of the hip-screw in the femoral head, the type of fracture and poor bone quality. The aim of this study was to reproduce the cut-out event biomechanically and to evaluate the possible prevention of this event by the use of a biopolymer augmentation of the hip screw. Concerning the density and compression force...

  5. Combining of small fragment screws and large fragment plates for open reduction and internal fixation of periprosthetic humeral fractures

    Directory of Open Access Journals (Sweden)

    Dominik Seybold

    2011-01-01

    Full Text Available Operative treatment of periprosthetic humeral fractures in elderly patients with osteoporotic bone requires a stable fixations technique. The combination of 3.5 cortical screws with washers in a 4.5 Arbeitsgemeinschaft fόr Osteosynthesefragen, Limited-contact dynamic compression plate or Locking plate, allows a stable periprosthetic fixation with the small 3.5 screws and 4.5 screws above and below the prosthesis, respectively. This combination is a cost-effective technique to treat periprosthetic humeral fractures.

  6. Percutaneous Cement-Augmented Screws Fixation in the Fractures of the Aging Spine: Is It the Solution?

    Directory of Open Access Journals (Sweden)

    Sébastien Pesenti

    2014-01-01

    Full Text Available Introduction. Management of elderly patients with thoracolumbar fractures is still challenging due to frequent osteoporosis and risk of screws pull-out. The aim of this study was to evaluate results of a percutaneous-only procedure to treat these fragile patients using cement-augmented screws. Methods. 12 patients diagnosed with a thoracolumbar fracture associated with an important loss of bone stock were included in this prospective study. Surgical procedure included systematically a percutaneous osteosynthesis using cemented fenestrated screws. When necessary, additional anterior support was performed using a kyphoplasty procedure. Clinical and radiographic evaluations were performed using CT scan. Results. On the whole series, 15 fractures were diagnosed and 96 cemented screws were inserted. The difference between the pre- and postoperative vertebral kyphosis was statistically significant (12.9° versus 4.4°, P=0.0006. No extrapedicular screw was reported and one patient was diagnosed with a cement-related pulmonary embolism. During follow-up period, no infectious complications, implant failures, or pull-out screws were noticed. Discussion. Aging spine is becoming an increasing public health issue. Management of these patients requires specific attention due to the augmented risk of complications. Using percutaneous-only screws fixation with cemented screw provides satisfactory results. A rigorous technique is mandatory in order to achieve best outcomes.

  7. Magnesium inference screw supports early graft incorporation with inhibition of graft degradation in anterior cruciate ligament reconstruction

    Science.gov (United States)

    Cheng, Pengfei; Han, Pei; Zhao, Changli; Zhang, Shaoxiang; Zhang, Xiaonong; Chai, Yimin

    2016-05-01

    Patients after anterior cruciate ligament (ACL) reconstruction surgery commonly encounters graft failure in the initial phase of rehabilitation. The inhibition of graft degradation is crucial for the successful reconstruction of the ACL. Here, we used biodegradable high-purity magnesium (HP Mg) screws in the rabbit model of ACL reconstruction with titanium (Ti) screws as a control and analyzed the graft degradation and screw corrosion using direct pull-out tests, microCT scanning, and histological and immunohistochemical staining. The most noteworthy finding was that tendon graft fixed by HP Mg screws exhibited biomechanical properties substantially superior to that by Ti screws and the relative area of collagen fiber at the tendon-bone interface was much larger in the Mg group, when severe graft degradation was identified in the histological analysis at 3 weeks. Semi-quantitative immunohistochemical results further elucidated that the MMP-13 expression significantly decreased surrounding HP Mg screws with relatively higher Collagen II expression. And HP Mg screws exhibited uniform corrosion behavior without displacement or loosening in the femoral tunnel. Therefore, our results demonstrated that Mg screw inhibited graft degradation and improved biomechanical properties of tendon graft during the early phase of graft healing and highlighted its potential in ACL reconstruction.

  8. Treatment of Lumbar Degenerative Disease with Unilateral Decompression,Bone Graft Fusion and Unilateral Pedicle Screw Fixation%经单侧减压融合、单边椎弓根螺钉内固定治疗腰椎退变性疾病

    Institute of Scientific and Technical Information of China (English)

    宋晋刚; 崔易坤; 苗艳; 尹振宇; 羊刚毅; 黄海锋

    2016-01-01

    目的:探讨经单侧行病变节段椎管减压、椎间植骨融合、单边椎弓根螺钉内固定治疗腰椎退变性疾病的临床疗效。方法我院2010年1月~2013年12月对35例腰椎退变性疾病采用经单侧减压、椎间植骨融合、单边椎弓根螺钉固定手术治疗。根据 JOA 评分法评估术后腰椎功能改善情况,采用视觉模拟评分(visual analog scale,VAS)评估术后疼痛缓解情况,腰椎正侧位 X 线片及 CT 扫描了解植骨融合情况。结果随访12~18个月,平均15个月。术前 JOA 评分(8.2±2.1)分,显著低于术后3个月(20.8±3.8)分(q =22.123,P <0.05)和术后12个月(21.7±3.9)分(q =23.703,P <0.05);VAS 评分术前(7.9±2.1)分,显著高于术后3个月(2.4±0.4)分(q =26.107,P <0.05)和12个月(2.3±0.3)分(q =26.582,P <0.05);JOA 评分和 VAS 评分随访期间无显著变化(P >0.05)。1年后椎间植骨融合率100%,未发现椎弓根螺钉松动、断裂、拔钉等异常。结论经单侧减压、椎间植骨融合联合单边椎弓根螺钉内固定治疗腰椎退变性疾病疗效满意,可在合适病例中推广应用。%Objective To investigate the clinical effects of unilateral vertebral canal decompression,intervertebral bone graft fusion,and unilateral pedicle screw fixation in the treatment of lumbar degenerative disease. Methods From January 2010 to December 2013,a total of 35 cases of lumbar degenerative disease were treated with unilateral decompression,intervertebral bone graft fusion,and unilateral pedicle screw fixation.The postoperative spine functions were evaluated with the JOA scores,the postoperative pain relief was evaluated with the VAS scores,and bone graft fusion was reviewed with lumbar X-ray and CT scanning. Results The patients were followed up for 12 -18 months (mean,15 months).The preoperative JOA scores (8.2 ±2

  9. Revision characteristics of cement-augmented, cannulated-fenestrated pedicle screws in the osteoporotic vertebral body: a biomechanical in vitro investigation. Technical note.

    Science.gov (United States)

    Blattert, Thomas R; Glasmacher, Stefan; Riesner, Hans-Joachim; Josten, Christoph

    2009-07-01

    In generalized osteoporosis, instrumentation with cement-augmented pedicle screws is an amplification of the therapeutic spectrum. Early clinical results are promising for both solid and cannulated screws; however, there are concerns regarding the revision characteristics of these screws, especially for the cannulated-fenestrated type with its continuous cement interconnection from the core of the screw to surrounding bone tissue. In a human cadaver model, bone mineral density (BMD) was assessed radiographically. Spinal levels T9-L4 were instrumented left unilaterally, transpedicularly by using cannulated-fenestrated pedicle screws with the dimensions 6.5 x 45 mm. Polymethylmethacrylate cement (1.5 ml) was injected through the screws into each vertebra. After polymerization of the cement, the extraction torque was recorded. For both implantation and explantation of the screws, a fluoroscope was used to guarantee correct screw and cement positioning and to observe possible co-movements-that is, any movement of the cement mass within the vertebral body upon removal of the screw. For comparison, the extraction torque of same-dimension pedicle screws was recorded in a nonosteoporotic, non-cement-augmented instrumentation. The BMD was 0.60 g/cm2, a level that corresponds to a severe grade of osteoporosis. For removal of the screws, the median and mean extraction torques were 34 and 49 +/- 44 Ncm, respectively. No co-movements of the cement mass occurred within the vertebral body. In the nonosteoporotic control, BMD was 1.38 g/cm2. The median and mean extraction torques were 123 and 124 +/- 12 Ncm, respectively. Thus, the revision characteristics of cement-augmented, cannulated-fenestrated pedicle screws are not problematic, even in cases of severe osteoporosis. The winglike cement interconnection between the screw core and surrounding bone tissue is fragile enough to break off in the event of an extraction torque and to release the screw. There is no proof to support

  10. Polymethylmethacrylate-augmented screw fixation for stabilization in metastatic spinal tumors. Technical note.

    Science.gov (United States)

    Jang, Jee Soo; Lee, Sang Ho; Rhee, Chang Hun; Lee, Seung Hoon

    2002-01-01

    Screw fixation augmented with polymethylmethacrylate (PMMA) or some other biocompatible bone cement has been used in patients with osteoporosis requiring spinal fusion. No clinical studies have been conducted on PMMA-augmented screw fixation for stabilization of the vertebral column in patients with metastatic spinal tumors. The purpose of this study was to determine whether screw fixation augmented with PMMA might be suitable in patients treated for multilevel metastatic spinal tumors. Ten patients with metastatic spinal tumors involving multiple vertebral levels underwent stabilization procedures in which PMMA was used to augment screw fixation after decompression of the spinal cord. Within 15 days, partial or complete relief from pain was obtained in all patients postoperatively. Two of four patients in whom neurological deficits caused them to be nonambulatory before surgery were able to ambulate postoperatively. Neither collapse of the injected vertebral bodies nor failure of the screw fixation was observed during the mean follow-up period of 6.7 months. Screw fixation augmented with PMMA may offer stronger stabilization and facilitate the instrumentation across short segments in the treatment of multilevel metastatic spinal tumors. PMID:11795702

  11. Enhancement of pedicle screw stability using calcium phosphate cement in osteoporotic vertebrae: in vivo biomechanical study.

    Science.gov (United States)

    Taniwaki, Yoshimichi; Takemasa, Ryuichi; Tani, Toshikazu; Mizobuchi, Hiroo; Yamamoto, Hiroshi

    2003-01-01

    We conducted an experimental study using female beagles with and without ovariectomy-induced osteoporosis to determine the effect of calcium phosphate cement (CPC) on the mechanical stability of inserted pedicle screws. A drill hole was created from the base of the transverse process to the vertebral body; CPC was injected into the hole, and then a screw was inserted into the same hole. In the presence of osteoporosis evidenced by dual X-ray absorptiometry, the stability of the inserted screw augmented by CPC against pull-out and cephalocaudal forces were significantly greater by 28% and 54% at 1 week after operation, 48% and 71% at 2 weeks, and 56% and 68% at 4 weeks compared with those without CPC. The pull-out strength increased progressively with time after surgery, probably reflecting new-bone growth from the surrounding cancellous bone, which was in direct contact with the CPC, as shown in the histologic study. At each time point the cephalocaudal rigidity was similar and the pull-out strength greater than that for the screws inserted without CPC in nonporotic dogs. These findings suggest that CPC augments the stability of the inserted pedicle screws and increases the stiffness of fixed osteoporotic motion segments using instrumentation. PMID:12768486

  12. Modelling of the Heating Process in a Thermal Screw

    Science.gov (United States)

    Zhang, Xuan; Veje, Christian T.; Lassen, Benny; Willatzen, Morten

    2012-11-01

    The procedure of separating efficiently dry-stuff (proteins), fat, and water is an important process in the handling of waste products from industrial and commercial meat manufactures. One of the sub-processes in a separation facility is a thermal screw where the raw material (after proper mincing) is heated in order to melt fat, coagulate protein, and free water. This process is very energy consuming and the efficiency of the product is highly dependent on accurate temperature control of the process. A key quality parameter is the time that the product is maintained at temperatures within a certain threshold. A detailed mathematical model for the heating process in the thermal screw is developed and analysed. The model is formulated as a set of partial differential equations including the latent heat for the melting process of the fat and the boiling of water, respectively. The product is modelled by three components; water, fat and dry-stuff (bones and proteins). The melting of the fat component is captured as a plateau in the product temperature. The model effectively captures the product outlet temperature and the energy consumed. Depending on raw material composition, "soft" or "dry", the model outlines the heat injection and screw speeds necessary to obtain optimal output quality.

  13. Combined Percutaneous Iliosacral Screw Fixation With Sacroplasty Using Resorbable Calcium Phosphate Cement for Osteoporotic Pelvic Fractures Requiring Surgery.

    Science.gov (United States)

    Collinge, Cory A; Crist, Brett D

    2016-06-01

    Osteoporotic sacral fractures, including acute and chronic insufficiency fractures, are increasing in frequency and present a number of management problem. Many of these patients are treated nonoperatively with relative immobility (eg, bedrest, wheelchair, or weight-bearing restrictions) and analgesics, which likely make the osteoporotic component worse. Surgery in this patient population may be desirable in some cases with the goals of improving mobility, relieving pain, and healing in an aligned position while minimizing deformity progression. However, internal fixation of the osteoporotic pelvis can be difficult. Large unicortical lag screws are the workhorse of posterior pelvic fixation, and yet fixation in cancellous bone corridors of an osteoporotic sacrum seems unlikely to achieve optimal fixation. As a result, the operative management and clinical results of these difficult injuries may not be uniformly successful. The authors present a technique for treating osteoporotic patients with a sacral fracture when operative treatment is indicated using percutaneous screw fixation combined with screw augmentation using a resorbable calcium phosphate bone substitute or "cement." The guide wire for a 7.3-mm or other large cannulated lag screw is fully inserted along the desired bony sacral corridor as is standard. The lag screw is then inserted over the wire to the depth where cement is desired. The guide wire is removed, and the aqueous calcium phosphate is injected through the screw's cannulation. For acute fractures, cement was applied to the areas distant to the fracture; whereas in insufficiency fractures, the cement was inserted along most of the screw path. The guide wire then can be reinserted and the lag screw fully inserted. The rationale for using these 2 modalities is their synergistic effect: the cannulated screw provides typical screw fixation and also a conduit for cement application. The cement augments the lag screw's purchase in osteoporotic bone

  14. Evidence of bone formation in the nasal floor around polished surface bi-cortical screw implants after indirect nasal lift in an atrophied maxilla: Cone beam computed tomography-based case report.

    Science.gov (United States)

    Khairnar, Mayur; Gaur, Vivek

    2015-01-01

    Maxillary jaw is restricted superiorly with maxillary sinus in the posterior region and nasal cavity in the anterior region. Augmentation of distal maxilla with recessed maxillary sinus has been documented since, last few decades. Sinus lifts the procedure either through crestal or lateral approach proves to be an effective way for augmenting bone for the placement of dental implants in atrophied posterior maxilla. However, when it comes to vertically deficient anterior maxilla, lifting of the nasal membrane is not considered. Perhaps, recent studies have shown greater success of dental implant placed after augmentation of the nasal floor. This report emphasizes on an observation of significant bone formation after indirect lifting of the nasal membrane with smooth polished surface bi-cortical implants. PMID:26015681

  15. Evidence of bone formation in the nasal floor around polished surface bi-cortical screw implants after indirect nasal lift in an atrophied maxilla: Cone beam computed tomography-based case report

    OpenAIRE

    Khairnar, Mayur; Gaur, Vivek

    2015-01-01

    Maxillary jaw is restricted superiorly with maxillary sinus in the posterior region and nasal cavity in the anterior region. Augmentation of distal maxilla with recessed maxillary sinus has been documented since, last few decades. Sinus lifts the procedure either through crestal or lateral approach proves to be an effective way for augmenting bone for the placement of dental implants in atrophied posterior maxilla. However, when it comes to vertically deficient anterior maxilla, lifting of th...

  16. True anteroposterior view pedicle screw insertion technique

    Directory of Open Access Journals (Sweden)

    Bai JY

    2016-06-01

    Full Text Available Jia-yue Bai, Wei Zhang, Ji-long An, Ya-peng Sun, Wen-yuan Ding, Yong Shen Key Biomechanical Laboratory of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China Background: The wide use of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF surgery in the treatment of degenerative disc disease of lumbar spine in spinal surgery highlights the gradual decrease in the use of traditional pedicle screw insertion technology. This study aims to analyze the accuracy of the true anteroposterior view pedicle screw insertion technique in MIS-TLIF surgery, compare it with conventional pedicle screw insertion technology, and discuss its clinical application value. Methods: Fifty-two patients undergoing true anteroposterior view (group A and 87 patients undergoing conventional pedicle screw insertion (group B were diagnosed with lumbar disc herniation or lumbar spinal stenosis. Time for screw placement, intraoperative irradiation exposure, accuracy rate of pedicle screw insertion, and incidence of neurovascular injury were compared between the two groups. Results: The time for screw placement and intraoperative irradiation exposure was significantly less in group A. Penetration rates of the paries lateralis of vertebral pedicle, medial wall of vertebral pedicle, and anterior vertebral wall were 1.44%, 0%, and 2.40%, respectively, all of which were significantly lower than that in group B. No additional serious complications caused by the placement of screw were observed during the follow-up period in patients in group A, but two patients with medial penetration underwent revision for unbearable radicular pain. Conclusion: The application of true anteroposterior view pedicle screw insertion technique in MIS-TLIF surgery shortens time for screw placement and reduces the intraoperative irradiation exposure along with a higher accuracy rate of screw placement, which makes it a safe, accurate

  17. Minimally Invasive Pedicle Screw Fixation Combined with Vertebroplasty with Calcium Phosphate Bone Cement in the Treatment of Thoracolumbar Burst Fracture%微创椎弓根钉内固定联合磷酸钙骨水泥椎体成形术治疗胸腰椎爆裂性骨折

    Institute of Scientific and Technical Information of China (English)

    顾宇彤; 梁朝革; 张亮; 林红; 周健

    2015-01-01

    目的:评估微创椎弓根钉内固定(微小切口非空心椎弓根钉技术)联合磷酸钙骨水泥经皮穿刺椎体成形术(percutaneous vertebroplasty ,PVP)治疗胸腰椎爆裂性骨折的疗性和安全性。方法:采用微创椎弓根钉内固定联合磷酸钙骨水泥 PVP术治疗23例单节段胸腰椎新鲜爆裂性骨折且无神经症状的患者,伤椎位于 T11~L2,均属A3型骨折。记录手术时间、术中出血量、骨水泥注射量和住院天数。记录术前及术后即刻、1个月、2个月、3个月、6个月、1年、2年的腰背痛评分,计算并比较各时点的椎体高度压缩率、恢复率、椎体后凸角、椎体后凸矫正率。结果:磷酸钙骨水泥平均注射量为4.9(3.8~6.4)mL,平均手术时间92(75~120) min ,平均出血量52(40~75) mL ,平均住院5.6(4~7) d ,术后平均随访26(24~29)个月。VAS评分由术前的(8.8±1.2)分下降至术后即刻的(1.8±0.6)分及术后2年的(0.4±0.5)分,差异均有显著统计学意义(P<0.001)。高度压缩率由术前的(50.4±7.2)%显著下降至术后即刻的(6.2±1.5)%及术后2年的(6.9±1.4)%,差异均有显著统计学意义(P<0.001)。后凸角由术前的(22.6±1.8)°下降至术后即刻的(3.2±1.7)°及术后2年的(5.1±1.5)°,差异均有显著统计学意义( P<0.001)。随访过程中术后高度恢复率、后凸矫正率无明显减小;未出现螺钉松动、断钉或断棒。结论:微创椎弓根钉内固定联合磷酸钙骨水泥PV P术是治疗胸腰椎爆裂性骨折的安全、有效的方法。%Objective:To evaluate the efficacy and safety of minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty(PVP) with calcium phosphate bone cement in the treatment of acute thoracolumbar burst fracture . Methods:Twenty‐three patients

  18. Atlantoaxial arthrodesis using C1-C2 transarticular screw fixation in a case of Morquio syndrome

    Directory of Open Access Journals (Sweden)

    Arvind G Kulkarni

    2011-01-01

    Full Text Available Prophylactic or therapeutic arthrodesis is recommended for atlantoaxial instability in Morquio syndrome. Occipitocervical fusion, the common approach for upper cervical fusion in Morquio syndrome sacrifices the movements at the occipitoatlantal joints. The use of C1-C2 transarticular screws for achieving C1-C2 arthrodesis, without compromising mobility at the occipitoatlantal joint in Morquio syndrome has not been reported. We report a case of Morquio syndrome with atlantoaxial instability and odontoid hypoplasia, where we successfully achieved C1-C2 arthrodesis using transarticular screws and bone graft. The advantages of this method over other methods of atlantoaxial arthrodesis in Morquio syndrome have also been discussed.

  19. 微型种植体支抗-骨界面压力侧和非压力侧的组织学研究%A histological study on the bone-implant interface of the mini-screw implant anchorage

    Institute of Scientific and Technical Information of China (English)

    冯贻苗; 房兵; 娄新田; 吴勇; 江凌勇

    2011-01-01

    目的 研究在不同愈合时间和负载条件下微型种植体支抗-骨界面压力侧和非压力侧的组织学变化.方法 选用纯种Beagle犬8只,在其上颌根间牙槽骨中植入86颗微型种植体支抗,分别进行即刻负载、愈合2周、愈合4周、愈合12周后加载150 g和300 g牵引力,定期注射荧光标志物,加载2个月后处死动物.标记种植体的压力侧和非压力侧,两侧分别进行种植体颈部骨结合率(BIC)、骨充填率(BSA)和矿物沉积率(MAR)的测量以及HE染色组织形态观察,以BIC和BSA作为骨整合能力的观察指标.结果 即刻负载组和愈合2周负载300克组压力侧的骨整合能力、矿物沉积率和骨改建活跃程度均小于非压力侧,其余各组则相反.不同负载力值组间比较无显著性差异.结论 微型种植体支抗-骨界面颈部即刻负载时压力侧的骨整合和骨改建较非压力侧低,随着愈合时间的延长,压力侧相对增强,非压力侧相对降低,而负载力值对界面的影响较小.%Objective To investigate the histological difference at the bone-implant interface between pressure and non-pressure sides of the mini-screw implant anchorage (MIA) under the condition of different loading force and heeling time. Methods Eighty-six MIAs were inserted in the maxillary alveolar bone between the dental roots in 8 beagles. Healing after 0, 2, 4, 12 weeks, 150 g and 300 g forces were loaded perpendicularly to the implants and fluorochrome was injected. Two months later, all dogs were sacrificed. The slices of MIA on the pressure and non-pressure sides were labeled. Bone implant contact ratio(BIC), bone surface area(BSA) and mineral apposition rate (MAR) were measured and histological observations were carried out. Results BIC, BSA, MAR and bone remodeling on the pressure side were lower than those on the non-pressure side in the immediate loading group and the group healing after 2 weeks with 300 g force, while the reverse result

  20. 强化螺钉治疗老年腰椎管狭窄近中期疗效%The short and midterm clinical effect of pedicle screw fixation with bone cement augmentation in the treatment of senile lumbar spinal stenosis

    Institute of Scientific and Technical Information of China (English)

    瞿岱彪; 黄圣升; 吴华; 刘礼金

    2015-01-01

    目的:评价骨水泥强化椎弓根螺钉内固定治疗伴老年腰椎管狭窄症的近中期临床疗效。方法2012年6月至2014年6月间应用骨水泥强化椎弓根螺钉治疗老年性腰椎管狭窄患者24例,所有患者术前均行骨密度测定诊断为骨质疏松症。采用VAS、JOA下腰痛评分及Oswestry功能障碍指数问卷表(ODI)评分标准评价临床疗效。结果24例患者随访6-24个月,平均(11.50±2.11)个月,不适症状均得到一定改善。 VAS评分术前(7.55±1.30)、术后3个月为(3.65±0.87)、术后6个月为(3.15±0.71)、末次为(2.83±2.04);JOA评分术前为(8.66±7.01)、术后3个月为(14.09±2.07)、术后6个月为(16.88±1.95)、末次随访为(17.33±1.74);ODI评分术前为(0.71±0.31)、术后3个月为(0.44±0.12)、术后6个月为(0.31±0.11)、末次随访为(0.29±0.07)。术后3个月、6个月、末次随访所有评价指标分别与术前对比,差异均有统计学意义(P<0.05)。随访时复查相关影像学资料示只有1例因外伤出现椎弓根螺钉松动,末次随访椎间融合率高达87%。结论对于老年性合并骨质疏松的腰椎管狭窄症患者,应用骨水泥强化椎弓根螺钉技术临床疗效确切,有术后椎间融合率高、发生内固定松动率低、二次手术风险低等优势。%Objective To observe the short and midterm clinical effect of pedicle screw fixation with bone cement augmenta-tion in the treatment of senile lumbar spinal stenosis. Methods From June 2012 to June 2014,24 patients with Lumbar Spinal Stenosis and osteoporosis were treated by posterior decompression,intervertebral fusion with pedicle screw fixation with bone ce-ment augmentation. Osteoporosis was diagnosed by dual-energy X-ray absorptiometry (DEXA) examination in all cases preopera-tively. The clinical results were investigated by measuring VAS and JOA and ODI scoring. Results 24 patients were followed up from 6 to 24 months (average 11.50

  1. 持续闭式引流(VSD)结合骨水泥抗生素链珠治疗腰椎骨折椎弓根钉棒系统内固定术后早期感染%Treatment of early postoperative infection of lumbar fracture internal fixation of pedicle screw rod system with vacuum sealing drainage(VSD)combined with antibiotic bone cement chain

    Institute of Scientific and Technical Information of China (English)

    朱余龙; 朱海涛; 丁德刚; 徐亮

    2014-01-01

    目的:探讨持续闭式引流(VSD)结合骨水泥抗生素链珠治疗腰椎骨折椎弓根钉棒系统内固定术后早期感染的临床疗效。方法2010年3月一2014年3月,使用持续闭式引流(VSD)结合骨水泥抗生素链珠治疗腰椎骨折椎弓根钉棒系统内固定术后早期感染11例,随访其临床效果。结果11例患者均得到随访,随访时间8—12月,平均10.5月。手术后感染治愈,无一例需取出原内固定物重新或者更换固定材料。结论持续闭式引流(VSD)结合骨水泥抗生素链珠治疗腰椎骨折椎弓根钉棒系统内固定术后早期感染操作简单、安全有效,可以作为治疗腰椎骨折椎弓根钉棒系统内固定术后早期感染手段之一。%Objective: To investigate the efficacy of the treatment of early postoperative infection of umbar fracture internal fixation of pedicle screw rod system with VSD combined with antibiotic bone cement chain. Methods: from 2010 March to 2014 March, the use of continuous closed drainage (VSD) combined with antibiotic bone cement bead chain, lumbar fracture internal fixation of pedicle screw rod system treatment of early postoperative infection in 11 cases, folow-up clinical results. Results: 11 patients were folowed up from 8-12 months, with an average of 8.5 months. Cured of infection after surgery, no case of need to remove or replace the original re-fixed within the implant material. Conclusion: The continuous closed drainage (VSD) combined with antibiotic bone cement beads chain to treat early infection is simple, safe and effective treatment of lumbar fracture internal fixation of pedicle screw rod system can be used as a means of early postoperative infection.

  2. 后路一期病灶清除结合内固定治疗多节段脊柱结核%Surgical Treatment with Posterior Pedicle Screw Fixation,Focal Cleaning,Titanium Mesh and Bone Graft Fusion for Multi-segmental Spinal Tuberculosis

    Institute of Scientific and Technical Information of China (English)

    杨启远; 冯敬; 杨雯栋; 罗小丽; 李英博; 雷超; 冯志; 赖显金

    2016-01-01

    Objective To study the clinical effect of Surgical treatment with posterior pedicle screw fixation,focal clean-ing,titanium mesh and bone graft fusion for multi-segmental spinal tuberculosis. Methods The clinical data from 16 patients with multi-segmental spinal tuberculosis from January 2009 to December 2014 were retrospectively analyzed. There were 7 males and 9 females,ranging in age from 19 to 56 years with an average of 36. 5 years old. 2 vertebral bodies involved in 6 ca-ses,3 vertebral bodies in 7 cases,4 vertebral bodies in 2 eases,and 5 vertebral bodies in 1case. Among these cases,there were 9 cases of thoracic vertebra,5 cases of thoracolumbar vertebra,2 cases of lumbar vertebra. The kyphosis angel of diseased seg-ments was 28° to 53°,37. 6° in average. According to the Frankel classification before operation,there were Frankel A in 0 case,Frankel B in 1 cases,Frankel C in 2 cases,Frankel D in 6 cases,Frankel E in 7 cases. After intensive anti-tuberculosis medication(HRSZ)for 2 to 4 weeks before operation,all patients were treated with posterior pedicle screw fixation,focal clean-ing,titanium mesh and bone graft fusion. After operation,the anti-tuberculosis medication was continued for 12 ~ 18 months. Results The operation time ranged from 160 mins to 290 mins,215 mins in average. The blood loss ranged from 400 to 1 800 mL,780 mL in average. All the cases were followed up for 6 months to 2 years with the average of 1 year and 7 months. 1 cases was complicated with CSF leakage. No wound infection and sinus tract formation were noted. All the cases showed excellent bone graft fusion,all internal fixation had good position without looseness,displacement and breakage. The Mean kyphosis angle was 28. 2°(range,8°to 27°)after operation,with an average correction rate of 75% . Neurologic status of all patients with pre-opertative neurologic deficit was :1 with grade B recovered to grade C;2 with grade C,1 recovered to grade D and 1 recovered to grade E;6

  3. Effects of Lateral Mass Screw Rod Fixation to the Stability of Cervical Spine after Laminectomy

    Science.gov (United States)

    Rosli, Ruwaida; Kashani, Jamal; Kadir, Mohammed Rafiq Abdul

    There are many cases of injury in the cervical spine due to degenerative disorder, trauma or instability. This condition may produce pressure on the spinal cord or on the nerve coming from the spine. The aim of this study was, to analyze the stabilization of the cervical spine after undergoing laminectomy via computational simulation. For that purpose, a three-dimensional finite element (FE) model for the multilevel cervical spine segment (C1-C7) was developed using computed tomography (CT) data. There are various decompression techniques that can be applied to overcome the injury. Usually, decompression procedures will create an unstable spine. Therefore, in these situations, the spine is often surgically restabilized by using fusion and instrumentation. In this study, a lateral mass screw-rod fixation was created to stabilize the cervical spine after laminectomy. Material properties of the titanium alloy were assigned on the implants. The requirements moments and boundary conditions were applied on simulated implanted bone. Result showed that the bone without implant has a higher flexion and extension angle in comparison to the bone with implant under applied 1Nm moment. The bone without implant has maximum stress distribution at the vertebrae and ligaments. However, the bone with implant has maximum stress distribution at the screws and rods. Overall, the lateral mass screw-rod fixation provides stability to the cervical spine after undergoing laminectomy.

  4. Effect of twist-orientation on mechanical properties of self-reinforced poly(lactic acid) screws in simulated body environment

    Science.gov (United States)

    Sakaguchi, Masato; Kobayashi, Satoshi; composite engineering lab Team

    Poly(lactic acid) (PLA) attracts much attention as a typical biodegradable polymer, and has been applied as a bone fixation device. As one of the methods to improve mechanical properties of PLA bone fixation device, orientations of molecular chains have been investigated. However, conventional uniaxial drawing could not improve mechanical properties along the other loading direction than the drawing direction, such as torsion. In this study, screw is treated as a bone fixation device. In order to improve torsional strength of a bioabsorbable PLA screw, twist-orientation method has been developed. PLA screw is prepared through a series of routes including extrusion molding, extrusion drawing, twist-orientation and forging. This screw was immersed in the phosphate buffer solution for 0, 8, 16 and 24 weeks, then shear strength, orientation function, crystallinity and molecular weight were measured. As a result, twist-orientation improves the initial torsional strength of PLA screw without the decrease in initial shear strength. In addition, the shear strength on twist-oriented screw is equivalent that of non-twist oriented screw during immersion until 24 weeks. This result shown that the twist-orientation does not decrease shear strength after immersion.

  5. Osseointegration of Titanium Implants in Onlay of Cerament™, a New Ceramic Bone Substitute

    Science.gov (United States)

    Truedsson, Anna; Wang, Jian-Sheng; Lindberg, Pia; Warfvinge, Gunnar

    2016-01-01

    The purpose was to investigate whether a new biphasic and injectable ceramic bone substitute Cerament™ that rapidly remodels to bone, may contribute to the retention of titanium implant screws during the healing period, and to analyze the pattern of bone formation around titanium implants.Titanium screws were implanted in rat tibiae and embedded with or without Cerament™ on the cortical surface. Torsional resistance was measured after 1 day, and after 6 and 12 weeks. Implant areas without bone substitute were analyzed histologically for comparison. The torsional resistance increased over time as the screws were osseointegrated. There was no difference in resistance between screws embedded in the bone substitute and control screws. The bone apposition was more pronounced on the proximal side of the screw than on the distal side. Cerament™ is capable of conducting bone growth from a cortical bone surface. The newly formed bone in this application does not significantly add to the osseointegrative strength of the implant screw, as measured by torque resistance, during the first 12 weeks. PMID:26751485

  6. Twin-Screw Extruders in Ceramic Extrusion

    Science.gov (United States)

    Wiedmann, Werner; Hölzel, Maria

    The machines mainly used for compounding plastics, chemicals and food are co-rotating, closely intermeshing twin-screw extruders. Some 30 000 such extruders are in use worldwide, about 1/3 are ZSKs from Coperion Werner & Pfleiderer, Stuttgart. In the chemical industry more and more batch mixers are being replaced by continuous twin-screw kneaders.

  7. The treatment of metastasis to the femoral neck using percutaneous hollow perforated screws with cement augmentation.

    Science.gov (United States)

    Kang, H G; Roh, Y W; Kim, H S

    2009-08-01

    We have developed a hollow perforated cannulated screw. One or more of these was implanted percutaneously in 11 patients with an osteolytic metastasis in the femoral neck and multiple metastases elsewhere. They were supplemented by one or two additional standard 6.5 mm cannulated screws in nine patients. Polymethylmethacrylate bone cement was injected through the screw into the neck of the femur using small syringes, as in vertebroplasty. The mean amount of cement injected was 23.2 ml (17 to 30). Radiotherapy was started on the fourth post-operative day and chemotherapy, on average, was resumed a day later. Good structural stability and satisfactory relief from pain were achieved in all the patients. This technique may be useful in the palliation of metastases in the femoral neck. PMID:19651838

  8. Corrosion of magnesium alloy AZ31 screws is dependent on the implantation site

    Energy Technology Data Exchange (ETDEWEB)

    Willbold, E. [Laboratory for Biomechanics and Biomaterials, Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, D - 30625 Hannover (Germany); Kaya, A.A. [Mugla University, Engineering Faculty, Metallurgy and Materials Engineering Department, Mugla (Turkey); Kaya, R.A. [MedicalPark Hospital, Kueltuer Sok No:1, 34160 Bahcelievler, Istanbul (Turkey); Beckmann, F. [Helmholtz-Zentrum Geesthacht, Institute of Materials Research, Max-Planck-Str.1, D - 21502 Geesthacht (Germany); Witte, F., E-mail: witte.frank@mh-hannover.de [Laboratory for Biomechanics and Biomaterials, Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, D - 30625 Hannover (Germany)

    2011-12-15

    The corrosion of biodegradable materials is a crucial issue in implant development. Among other materials, magnesium and magnesium based alloys are one of the most promising candidates. Since the corrosion of biodegradable materials depends on different physiological parameters like pH or ion concentrations, the corrosion might be different in different biological environments. To investigate this issue, we produced screws from magnesium alloy AZ31 and implanted them into the hip bone of 14 sheep. After 3 and 6 months, the screws were explanted and analyzed with synchrotron-radiation based micro-computed tomography and hard tissue histology. We found considerable differences in the corrosion behavior of the magnesium screws with respect to its original tissue location. However, we could detect a normal immunological tissue response.

  9. Improving fixation strength of pedicle screw by microarc oxidation treatment: an experimental study of osteoporotic spine in sheep.

    Science.gov (United States)

    Shi, Lei; Wang, Ling; Zhang, Yang; Guo, Zheng; Wu, Zi-xiang; Liu, Da; Gao, Ming-xuan; Chen, Huan; Fu, Suo-chao; Lei, Wei

    2012-08-01

    Failure of fixation caused by loosening of pedicle screws in osteoporosis is a problem in spinal surgery. We compared the in vivo fixation strength between pedicle screws treated with microarc oxidation (MAO) and untreated screws in an osteoporotic model of ovariectomized sheep. The MAO treated and untreated screws were placed in lumbar vertebral bodies. After 3 months of implantation, biomechanical tests, micro-CT analysis, and histological observations were conducted to examine the performance of the two groups. At time 0, no significant difference was found between the two groups in biomechanical tests (p > 0.05); 3 months later, higher pull-out strength and load with less displacement were detected in the MAO-treated group (p CT analysis showed that the tissue mineral density, bone volume fraction, trabecular thickness, and trabecular number in the MAO-treated group were all higher than those in untreated group (p sheep.

  10. Twin screw subsurface and surface multiphase pumps

    Energy Technology Data Exchange (ETDEWEB)

    Dass, P. [CAN-K GROUP OF COMPANIES, Edmonton, Alberta (Canada)

    2011-07-01

    A new subsurface twin screw multiphase pump has been developed to replace ESP and other artificial lift technologies. This technology has been under development for a few years, has been field tested and is now going for commercial applications. The subsurface twin screw technology consists of a pair of screws that do not touch and can be run with a top drive or submersible motor; and it carries a lot of benefits. This technology is easy to install and its low slippage makes it highly efficient with heavy oil. In addition twin screw multiphase pumps are capable of handling high viscosity fluids and thus their utilization can save water when used in thermal applications. It also induces savings of chemicals because asphaltenes do not break down easily as well as a reduction in SOR. The subsurface twin screw multiphase pump presented herein is an advanced technology which could be used in thermal applications.

  11. 滑丝空心取钉器的研制及临床应用%Development and clinical application of screw remover for the skidded screws

    Institute of Scientific and Technical Information of China (English)

    童松林; 徐建杰; 虞建浩; 高益斌; 陆忠辉; 王以进

    2012-01-01

    Objective To develop an EZ screw remover for screwing out the skidded screws,discuss its design features and biomechanical characteristics and verify its extracting effect by clinical applications. Methods Fresh skeleton specimens were used in the study,including the femur (n =3),tibia ( n =3 ),radius and ulna ( n =3 ).The screws were fixed to the specimens according to clinical requirements and bone cement was filled into the medullary cavity.The specimens were randomized into three biomechanical test model groups,ie,Group A (measuring the skidded screws with the biggest torsion when the screws were taken out by screwdriver),Group B (measuring the skidded screws with the biggest torsion when the screws were taken out by one handle of EZ screw remover) and Group C ( measuring the skidded screws with the biggest torsion when the screws were taken out by two handles).The fixed screws were divided into two types of φ4.5 mm and φ3.5 mm.The experimental specimens were tested on the universal testing machines to measure the maximum torque,torsion angle,power consumption value and efficiency when drawing out the screws. The experimental data were compared between groups.The skidded screws encountered in clinical were taken out with EZ screw remover to verify the extracting effect. Results The pullout torque in Groups A,B and C was 2.87-3.27 N · m,3.06-4.83N · m and 4.12-8.36 N · m respectively ( P < 0.05 ).The average torsion angle value in each corresponding group was 0.77°,0.28°,0.16° respectively (P < 0.05 ).When the screws were screwed out,the average power consumption was 21 J,32 J and 45 J in Groups A,B and C respectively and power ( mechanical efficiency) was 0.35 J/s,0.53 J/s and 0.75J/s in Groups A,B and C respectively,with significant differences ( P < 0.05 ).Seventeen pieces of the cannulated skidded screws of φ7.3 mm in seven patients were successfully taken out by using the EZ screw remover. Conclusion EZ screw removerhas enough resistance

  12. Root contact with maxillomandibular fixation screws in orthognathic surgery: incidence and consequences.

    Science.gov (United States)

    Camargo, I B; Van Sickels, J E; Laureano Filho, J R; Cunningham, L L

    2016-08-01

    The use of maxillomandibular fixation (MMF) screws in orthognathic surgery has become common in recent years. The risk of injury to adjacent roots with their placement in this population has not been studied extensively. The aim of this study was to review the incidence and consequences of root contact/injury in patients undergoing orthognathic surgery. A retrospective analysis of the treatment and radiographic records of patients who underwent orthognathic surgery between January 2013 and September 2014 at a university in Kentucky, USA was performed. The mean number of screws used was correlated to the mean number of roots affected using Spearman's test, set to a level of significance of 5%. Of 125 patients who underwent orthognathic surgery, 15 (12%) had evidence of root contact. Subsequent radiographs showed resolution of the bone defects. There was no clinical evidence of pulpal necrosis or pain during follow-up. The average number of screws used was 3.14±0.35 per patient, with an average of 0.17±0.52 root contacts per patient. There was no correlation between the number of screws used and the number of roots injured (P=0.279). Based on these results, MMF screws can safely be used to establish interim fixation during orthognathic surgery. Caution should be taken during placement to avoid direct injury to the roots of teeth.

  13. 带缝匠肌骨瓣移植联合空心钉内固定治疗青少年股骨颈骨折的临床效果分析%Clinical effect analysis of sartorial-pedicled ilium bone transplantation combined with hollow screw fixation treating femoral neck fracture of youngsters

    Institute of Scientific and Technical Information of China (English)

    郑凌云; 邓秋平; 田华强; 方良韬

    2015-01-01

    目的:分析带缝匠肌骨瓣移植联合空心钉内固定对青少年股骨颈骨折的治疗效果。方法选取本院2012年7月~2014年6月收治的80例青少年股骨颈骨折患者,按随机数字表法分成研究组和对照组,各40例。研究组采用带缝匠肌骨瓣移植术联合空心钉内固定术进行治疗;对照组单纯采用空心螺钉内固定术进行治疗。比较两组手术时间、术中出血量、住院时间、股骨头缺血性坏死发生率、骨折愈合时间、临床疗效及治疗前、后生活质量。结果研究组手术时间长于对照组(P0.05);研究组股骨头缺血性坏死发生率低于对照组(P0.05);研究组治疗后生活质量得分高于对照组(P0.05). The life quality score of research group after treatment was higher than that of control group (P<0.05). Conclusion Sartorial-pedicled ilium bone transplantation combined with hollow screw fixation treating femoral neck fracture of youngsters has the advantages of rapid recovery and good efficacy.

  14. Bone Cement Augmentation of Pedicle Screw Fixation Combined with Kyphoplasty for Osteoporotic Thoracolumbar Burst Fractures%骨水泥强化椎弓根螺钉固定结合椎体后凸成形术治疗骨质疏松性胸腰段爆裂骨折

    Institute of Scientific and Technical Information of China (English)

    于亮; 蒋伟宇; 赵刘军; 马维虎; 徐荣明

    2014-01-01

    [目的]评估骨水泥强化椎弓根螺钉固定结合椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性胸腰椎爆裂骨折的临床疗效。[方法]收集本院2011年1月至2012年12月采用骨水泥强化椎弓根螺钉固定结合PKP治疗的31例无神经损伤的骨质疏松性胸腰椎爆裂骨折患者,观测术前、术后1周及术后1年伤椎前后缘压缩率改变、后凸Cobb角、视觉模拟评分(visual analogue scale,VAS)及术后并发症,评估手术效果。[结果]术前椎体前、后缘压缩率分别为(49.5±6.1)%和(16.7±3.2)%,术后1年椎体前后缘压缩率分别为(9.1±1.3)%和(1.2±0.9)%,Cobb角由术前平均(25.7±4.5)°矫正至术后(3.3±2.1)°,平均矫正19.8°,VAS评分由术前平均(7.2±0.5)分降为术后(1.9±0.6)分,各项指标术后与术前比较差异均有统计学意义(P<0.05)。术后随访12~24个月,无1例发生手术并发症。[结论]骨水泥强化椎弓根螺钉固定结合PKP治疗骨质疏松性胸腰椎爆裂骨折,能有效恢复脊柱矢状序列,同时也能较好地维持伤椎的高度和强度,避免术后椎体塌陷,有助于早期康复,减少并发症。%Objective] To assess the efficacy of bone cement augmentation of pedicle screw fixation combined with kyphoplasty for osteoporotic thoracolumbar burst fractures. [Methods] Thirty-one cases of neurological y intact osteoporotic thoracolumbar burst fractures treated by bone cement augmentation of pedicle screw fixation combined with kyphoplasty between January 2011 and December 2012 were included in this study. Then analyze the front and back edges height of the injured vertebra, kyphosis Cobb ’s angle, visual analogue scale(VAS) and complications. [Results] Patients were fol owed up for 12 to 24 months(mean 18.2 months), there was no complication. Al patients recovered satisying, front and back edges of the compression ratio was (49.5±6.1)%and

  15. 经皮椎弓根钉体外撑开结合伤椎骨水泥注入治疗中老年胸腰椎骨折的临床研究%Clinical study and of percutaneous pedicle screws vitro distraction combined with injuried vertebrae bone cement infusion for middle-aged thoracolumbar

    Institute of Scientific and Technical Information of China (English)

    王铁铸; 王月; 王清和; 刘璞; 焦甲勋; 闫菁辉; 张晓强; 陈祥云

    2013-01-01

    目的 探讨经皮椎弓根钉体外撑开结合伤椎骨水泥注入治疗中老年胸腰椎骨折的可行性、安全性及有效性.方法 回顾性分析20例经皮椎弓根钉体外撑开结合伤椎骨水泥注入治疗中老年胸腰椎骨折.测量手术前后伤椎Cobb角、椎体前缘的高度丢失率.结果 术前平均腰背痛VAS评分(7.2±1.6)分,ODI(52.6±16).术后平均腰背痛VAS评分(2.4±1.6)分,ODI (21.6±9),平均腰背痛VAS和ODI均明显低于术前(P<0.01).术前椎体前缘的丢失率(49.4±12.5)%,术后(8.2±4.9)%,末次随访时(9.2±5.1)%;术前后凸角度(18.1±4.3)°,术后后凸角度(3.5±1.9)°,末次随访时(4.2±1.8)°.椎体高度丢失率、后凸角度术后、末次随访较术前差异有统计学意义(P<0.05);末次随访与术后比较差异无统计学意义(P>0.05).结论 经皮伤椎成形术结合体外椎弓根钉撑开系统一期矫正伤椎的压缩高度及恢复正常的脊柱生理曲度,创伤小,是中老年胸腰椎骨折安全有效的治疗方法.%Objective To study the feasibility,safety and efficacy of percutaneous pedicle screws vitro distraction combined with injuried vertebrae bone cement infusion for middle-aged thoracolumbar fractures.Methods A retrospective analysis was performed on 20 patients operated for middle-aged thoracolumbar fractures by percutaneous pedicle screws vitro distraction combined with injuries vertebrae bone cement infusion.Results The average preoperative VAS score for radicular pain and ODI were (7.2±1.6) and (52.6±16).The patients had an average VAS of (2.4±1.6) for low bank pain and an average ODI of (21.6±9) afer the operation.The improvements in VAS and ODI were statistically significant (P <0.01).Preoperative vertebral loss rate was (49.4±12.5) percent,postoperative (8.2±4.9),the last follow-up (9.2±5.1); the convex angles before and after surgery was (18.1±4.3)°,postoperative (3.5±1.9)°,last follow-up (4.2±1.8)°.Vertebral height

  16. 空心拉力螺钉加镍钛聚髌器置入内固定重建骨折髌骨的生物力学条件%Biomechanical requirement for the reconstruction of patellar fracture treated with cancellous bone screw and nickel-titanium-patellar concentrator internal fixation

    Institute of Scientific and Technical Information of China (English)

    高振巢; 刘德昌; 蔡国平

    2013-01-01

    BACKGROUND: There are various internal fixation methods for the clinical treatment of patel ar fractures, but each method has advantages and disadvantages, respectively. The selection of proper internal fixation method wil directly affect the healing time and recovery of knee joint function. OBJECTIVE: To investigate the biomechanical reconstruction effect on patel ar fracture treated with cancel ous bone screw and nickel-titanium-patel ar concentrator internal fixation. METHODS: A retrospective analysis was performed on 27 cases of acute patel ar fracture patients from January 2011 to January 2012 in the Department of Orthopedics, Jinshan Hospital, Fudan University, including 13 cases of transverse fracture, 11 cases of comminuted fracture and three cases of upper or lower pole fracture. Al the 27 patients received cancel ous bone screw and nickel-titanium-patel ar concentrator internal fixation without plaster external fixation, and then the quadriceps active contraction training was performed from the 2nd day after internal fixation, and bed knee flexion and extension exercises were performed at 1 week after internal fixation. The knee joint function was evaluated with Böstman score system. RESULTS AND CONCLUSION: Al the 27 patients were fol owed-up for 4-14 months. Incisions obtained stage Ⅰ healing, and there was no fracture fixation or shedding, wound infection, skin necrosis or other complications. The average healing time was 8.5 weeks without delayed healing. According to clinical grading scale of Böstman score system, the mean score was 27.9, included 27 cases of excel ent (81%), four cases of good (15%), one case of poor (4%), and the excel ent and good rate was 96%. The results suggest that cancel ous bone screw combined with nickel-titanium-patel ar concentrator internal fixation can maintain the advantages of traditional internal fixation method, and can avoid the disadvantages of the traditional internal fixation method.%  背景:目前

  17. Screw elastic intramedullary nail for the management of adult forearm fractures

    Directory of Open Access Journals (Sweden)

    Wasudeo Gadegone

    2012-01-01

    Full Text Available Background: The failure of the conventional nailing of both forearm bones or isolated fractures of radius and ulna pose a potential problem of nail migration and rotational instability, despite the best reduction. The purpose of this paper is to evaluate the results of screw elastic intramedullary nail for the treatment of adult diaphyseal fractures of both forearm bones, which effectively addresses the problems associated with the conventional nailing systems for the forearm fractures. Materials and Methods: Seventy-six adults with forearm fractures (radius and ulna or isolated fracture of the single bone were retrospectively evaluated. Fifty males and 26 females with the mean age of 38 years (range, 18-70 years underwent closed reduction and screw intramedullary nail fixation. Ten patients required limited open reduction. The fractures were classified according to the AO/OTA system. The average followup was 12 months (range, 6 to 18 months. Results: The mean surgical time was 45 minutes (35 to 65 minutes. The meantime to union was 14 weeks (10-21 weeks. The results were graded as excellent in 50, good in 18 patients, and acceptable in eight patients, using the criteria of Grace and Eversman. We had superficial infection in three cases, one case of delayed infection, painful bursa in two cases, delayed union in two cases, malunion with dislocation of the DRUJ in two cases, injury to the extensor tendon of the thumb in one case, and one case of incomplete radioulnar synostosis. Conclusion: Closed reduction and internal fixation of forearm fractures by screw intramedullary nails reestablishes the near normal relationship of the fractured fragments. Screw intramedullary nail effectively controls both rotatory forces and the migration of the nail. It produces excellent clinical results in isolated fractures of either bones, as well as both bones of the forearm in adults.

  18. 椎间打压植骨联合棘突椎板复合体回植内固定治疗退变性腰椎不稳症%LUMBAR INTERBODY FUSION IMPACTED BONE GRAFTS COMBINED WITH REGRAFTING IN SITU WITH SPINOUS PROCESS AND VERTEBRAL PLATE COMPLEX AND PEDICLE SCREW FIXATION FOR LUMBAR DEGENERATIVE INSTABILITY

    Institute of Scientific and Technical Information of China (English)

    张超远; 孟祥翔; 秦晓彬; 付玉娟; 付鹏军

    2012-01-01

    Objective To evaluate the effectiveness of lumbar interbody fusion impacted bone grafts combined with regrafting in situ with spinous process and vertebral plate complex and pedicle screw fixation for lumbar degenerative instability. Methods Between January 1998 and October 2010, 48 patients with lumbar degenerative instability were treated by posterior decompression, lumbar interbody fusion impacted bone grafts combined with regrafting in situ with spinous process and vertebral plate complex and pedicle screw fixation. There were 26 males and 22 females, aged 52-76 years (mean, 62.4 years). The disease duration was 7 months to 25 years (mean, 6.5 years). One segmental instability was located at L3,4 in 1 case, at L4,5 in 10 cases, and at L5, S1 in 11 cases; multi-segmental instability was located at L3,4, L4,5, and L5, S1 in 5 cases, at L2,3 and L3,4 in 2 cases, at L3,4 and L4,5 in 10 cases, and at L4,5 and L5, S1 in 9 cases. Of 48 patients, 32 complicated by lumbar disc herniation, 46 by lumbar spinal stenosis, and 16 by degenerative scoliosis. The clinical results were evaluated by the Japanese Orthopaedic Association (JOA) score, recovery rate, disc height, and lumbar lordosis angles. Results The incisions obtained healing by first intention after operation. No nerve injury, rod or screw breakage, and infection occurred during and after operation. All 48 patients were followed up 1 to 6 years. The fusion time was 12-18 weeks (mean, 16.2 weeks). Vertebra slipping or degenerative scoliosis was corrected, and spinal column series became normal. At preoperation, 6 months after operation, and last follow-up, the disc heights were (5.2 ± 2.3), (11.9 ± 2.0), and (11.6 + 2.1) mm, respectively; the JOA scores were 3.2 + 2.1, 12.8 ± 1.6, and 13.6 + 1.2, respectively; and the lumbar lordosis angles were (-20.5 ± 10.5), (30.5 ± 8.5), and (31.2 + 5.6)°, respectively. The JOA scores, disc heights, and lumbar lordosis angles were significantly improved at 6 months after

  19. Biomechanical and surface physico-chemical analyses of used osteosynthesis plates and screws - Potential for reuse in developing countries?

    NARCIS (Netherlands)

    Magetsari, Rahadyan; van der Houwen, Eduard B.; Bakker, Martine T. J.; van der Mei, Henny C.; Verkerke, Gijsbertus J.; Rakhorst, Gerhard; Hilmy, Chehab R.; van Horn, Jim R.; Busscher, Henk J.

    2006-01-01

    Reprocessing of single-use devices is an upcoming issue in the Western world, but has been for many years in developing countries. In developing countries, the number of bone fractures due to traffic or industrial accidents is high. Patients often need an osteosynthesis with plates and screws, but m

  20. Twin Screw Mixer/Fine Grind Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The 40-mm Twin-Screw Mixer/Extruder (TSE) pilot plant is a continuous, remotely operated, flexible facility that can significantly enhance safety and environmental...

  1. QWIX螺钉置入内固定修复髌骨骨折:骨折断端的持续动静态加压作用%QWIX screw fixation in repair of patellar fractures:continuous dynamic and static pressure in the broken ends of the bones

    Institute of Scientific and Technical Information of China (English)

    刘杰; 高仕长; 梁安霖

    2014-01-01

    remaining patients. In accordance with Bostman score, there were excellent in 27 cases, good in 3 cases, and poor in 0 case, with an excellent and good rate of 100%at 1 year fol owing surgery. Results data suggested that QWIX screws combined with Kirschner wire and wire fixation in repair of patel ar fracture have some advantages such as continuous dynamic and static pressure at the broken ends of the bones, early flexion and extension exercises, and reducing the fixation-related complications. It is an effective method to repair patel ar fracture.

  2. 骨水泥填塞动力髋螺钉主钉孔:抗弯曲和抗扭转强度%Dynamic hip screw hole filled by bone cement: Anti-flexion and anti-torsion strength

    Institute of Scientific and Technical Information of China (English)

    郑海; 李神; 郭艳龙

    2010-01-01

    目的:评价髋关节后侧入路加骨水泥填塞后内侧支撑植骨治疗转子间骨折的临床效果.方法:应用计算机检索Science Direct数据库、Ei数据库1960-01/2009-10期间的相关文章,检索词为"bone cement,Intertrochanteric fracture",并限定文章语言种类为English.同时计算机检索中国期刊全文数据库、中国生物医学文献数据库等1994-01/2009-10期间的相关文章,检索词为"转子间骨折,髋内翻,髋关节后侧入路,主钉孔植入骨水泥",并限定文章语言种类为中文.此外还手工查阅相关专著数部.纳入有关股骨转子间骨折治疗方式研究,骨水泥治疗股骨转子间骨折的基础与临床实验.结果:股骨转子间骨折手术治疗方法都为外侧或前侧入路行动力髋钢板系统、动力髋螺钉、股骨近端髓内钉常规内固定.动力髋螺钉是治疗股骨转子间骨折的标准内固定,具有较强的抗旋转功能,符合生物力学要求.但螺钉松动、拔出和断裂等并发症发生率较高.采用骨水泥强化松质骨钉道后,骨水泥强化不仅增加螺钉把持力,有利于尾钉加压;同时也扩大了骨.钉接触界面,应力被分散传递至更大的钉-骨界面区域,明显提高动力髋螺钉固定的抗弯曲和抗扭转强度,整体提高骨折稳定性.骨水泥的强化机制在于通过充填于骨小梁闯隙与周围松质骨微观交锁,形成松质骨-骨水泥-螺钉的整体结构.结论:使用骨水泥填塞动力髋螺钉,可明显增强动力髋螺钉固定的抗弯曲和抗扭转强度,整体提高骨折稳定性.

  3. Fixation of femoral capital physeal fractures with 7.0 mm cannulated screws in five bulls

    International Nuclear Information System (INIS)

    Salter-Harris type I fractures of the femoral capital physis were repaired in five Holstein bulls with three 7.0 mm cannulated screws placed in lag fashion. Radiographically at months 7 to 10, the fractures were healed and there was periarticular bone production on the femoral necks and the dorsal acetabular rims. Four bulls had normal gaits, and one bull had muscle atrophy and barely detectable lameness

  4. Comparative endurance testing of the Biomet Matthews Nail and the Dynamic Compression Screw, in simulated condylar and supracondylar femoral fractures

    Directory of Open Access Journals (Sweden)

    Davies Benjamin M

    2008-01-01

    Full Text Available Abstract Background The dynamic compression screw is a plate and screws implant used to treat fractures of the distal femur. The Biomet Matthews Nail is a new retrograde intramedullary nail designed as an alternative surgical option to treat these fractures. The objective of this study was to assess the comparative endurance of both devices. Method The dynamic compression screw (DCS and Biomet Matthews Nail (BMN were implanted into composite femurs, which were subsequently cyclically loaded using a materials testing machine. Simulated fractures were applied to each femur prior to the application of load. Either a Y type fracture or a transverse osteotomy was prepared on each composite femur using a jig to enable consistent positioning of cuts. Results The Biomet Matthews Nail demonstrated a greater endurance limit load over the dynamic compression screw in both fracture configurations. Conclusion The distal locking screws pass through the Biomet Matthews Nail in a unique "cruciate" orientation. This allows for greater purchase in the bone of the femoral condyle and potentially improves the stability of the fracture fixation. As these fractures are usually in weak osteoporotic bone, the Biomet Matthews Nail represents a favourable surgical option in these patients.

  5. SURVEY SUBAXIAL CERVICAL VERTEBRAE FOR TRANSPEDICULAR SCREW FIXATION

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective In this study, the pedicles of subaxial vertebrae from C3 to C7 were measured to provide some morphometric data for cervical transpedicular screw fixation. Methods 20 dried bone cervical spinal columns (C3-C7), pedicle dimensions (pedicle height, width, length), and transverse and sagittal angles of the pedicles were performed with vernier in linear and angular measurements. Results The obtained data revealed that the mean values were approximately ranging from 6.7 to 7.2 mm for pedicle height, 4.4 to 4.9 mm for pedicle width, 22.2 to 27.7 mm for pedicle axis length, 42.3° to 51.5° for transverse angle, and 5.2° to 14.1° for sagittal angle. Conclusion Linear measurements of pedicle dimensions and also axial angles from horizontal and vertical planes may provide some anatomic limitations for subaxial cervical transpedicular screw fixation, and also contribute to the safety of the surgical procedure.

  6. The effect of hydroxyapatite coated screw in the lateral fragility fractures of the femur. A prospective randomized clinical study.

    Science.gov (United States)

    Pesce, V; Maccagnano, G; Vicenti, G; Notarnicola, A; Moretti, L; Tafuri, S; Vanni, D; Salini, V; Moretti, B

    2014-01-01

    Due to a growing numbers of lateral fragility fractures of the femur and their high social costs the need to work out an effective strategy in order to find a better solution for these patients is warranted. From January 2010 to July 2011, we carried out a prospective randomized clinical study comparing the results of patients with femoral lateral fractures treated by nail and cephalic hydroxyapatite coated screws (study group including 27 patients) compared to the patients with the same fractures treated with nail and head standard screws (control group including 27 patients). We defined the two parts of the femoral neck as ROI 1 (under the head screw) and ROI 2 (above the femoral screw) on the AP view. The bone density of the two areas was calculated using DEXA at T0 (1st day post-surgery), at T1 (40th day post-surgery), at T2 (3 months later), at T3 (1 year later). The clinical-radiography evaluations were based on the Harris Hip Score (HHS), ADL test and x-ray views of the hip. As far as the bone mineral density average of ROI 1 and ROI 2 is concerned, we found a significant statistical increase at T1 and T3 in the study group, while it was not significant in the control group. We could account for this data through the higher mechanical stability of hydroxyapatite coated screws than standard screws. In fact, this material was responsible for improved implant osteointegration. Thanks to a 1 year follow-up we were able to demonstrate the implant utility associated with augmentation and the importance of densitometry exams such as easily repeatable and low cost diagnostics to prevent the onset of complications linked to screw loosening.

  7. Biofilm formation on titanium alloy and anatase-Bactercline® coated titanium healing screws: an in vivo human study

    Directory of Open Access Journals (Sweden)

    Antonio Scarano

    2013-03-01

    Full Text Available Aim Bacterial adherence to implants is considered to be an important event in the pathogenesis of bacterial infections. In fact, this infection process is a first stage of peri-implant mucositis and peri-implantitis, and a positive correlation has been found between oral hygiene and marginal bone loss around implants in the edentulous mandible. Surface properties of transgingival implant components are important determinants in bacterial adhesion. The purpose of this study was to characterize the biofilm formation, in vivo, on healing screws made of titanium alloy or coated with a combination of anatase and Bactercline® product. Materials and methods Twenty-five patients, between 21- 37 years, in excellent systemic health, participated in this study. In each of the 25 participants, one anatase-Bactercline® coated healing screw (Test and one titanium alloy (TI6Al4V healing screw (Control were adapted to two different implants. Quantitative and qualitative biofilm formation on healing abutments was analyzed by culture method.Results Bacterial adherence to the two different healing screws used in this study were compared. Statistically significant differences were found between the Control and the Test group for both aerobic and anaerobic bacterial counts (p<0,05. The microflora consisted both of Gram-positive and Gram-negative bacteria, and displayed a high variability. The anaerobic S. intermedius, potentially “pathogenic”, was isolated only from the Control group. Both healing screws harbored primarily Gram-positive rods as Actinomyces spp, A. naeslundii, A. viscosus and the Gram-negative rods (Fusobacterium spp, Prevotella spp, Capnocythophaga spp were mostly found on the Control healing screws.Conclusion Anatase-Bactercline® coated healing screws reduce the number of initially adhering bacteria, formed mainly of Gram-positive microorgnisms, while, on the contrary, the microflora covering the titanium alloy healing screws was, for the

  8. Design and biomechanical study of a modified pedicle screw

    Institute of Scientific and Technical Information of China (English)

    LIU Tao; ZHENG Wen-jie; LI Chang-qing; LIU Guo-dong; ZHOU Yue

    2010-01-01

    Objective: In pedicle screw fixation,the heads of monoaxial screws need to be directed in the same straight line to accommodate the rod placement by backing out during operation, which decreases the insertional torque and internal fixation strength. While polyaxial screws facilitate the assembly of the connecting rod, but its ball-in-cup locking mechanism reduces the static compressive bending yield strength as compared with monoaxial screws. Our study aimed to assess the mechanical performance of a modified pedicle screw.Methods: In this study, the tail of the screw body of the modified pedicle screw was designed to be a cylindershaped structure that well matched the inner wall of the screw head and the screw head only rotated around the cyclinder. Monoaxial screws, modified screws and polyaxial screws were respectively assembled into 3 groups ofvertebrectomy models simulated by ultra high molecular weight polyethylene (UHMWPE) blocks. This model was developed according to a standard for destructive mechanical testing published by the American Society for Testing Materials (ASTM F1717-04). Each screw design had 6 subgroups, including 3 for static tension, load compression and torsion tests, and the rest for dynamic compression tests. In dynamic tests, the cyclic loads were 25%, 50%, and 75% of the compressive bending ultimate loads respectively.Yield load, yield ultimate load, yield stiffness, torsional stiffness, cycles to failure and modes of failure for the 3 types of screws were recorded. The results of modified screws were compared with those ofmonoaxial and polyaxial screws.Results: In static tests, results of bending stiffness,yield load, yield torque and torsional stiffness indicated no significant differences between the modified and monoaxial screws (P>0.05), but both differed significantly from those ofpolyaxial screws (P<0.05). In dynamic compression tests,both modified and monoaxial screws showed failures that occurred at the insertion point of screw

  9. Screwing and holding device for lock nuts, especially for screwed joints of reactor pressure vessels

    International Nuclear Information System (INIS)

    A screwing and holding device for lock nuts of reactor pressure vessels is described which can be remote-controlled and will apply the forces required to unscrew the nuts. In addition, it allows unscrewing, tranporting to and from the place and screwing on again of the nuts within shorter time then all similar devices known until now. (RW)

  10. Experimental and Numerical Analysis of Screw Fixation in Anterior Cruciate Ligament Reconstruction

    Science.gov (United States)

    Chizari, Mahmoud; Wang, Bin; Snow, Martyn; Barrett, Mel

    2008-09-01

    This paper reports the results of an experimental and finite element analysis of tibial screw fixation in anterior cruciate ligament (ACL) reconstruction. The mechanical properties of the bone and tendon graft are obtained from experiments using porcine bone and bovine tendon. The results of the numerical study are compared with those from mechanical testing. Analysis shows that the model may be used to establish the optimum placement of the tunnel in anterior cruciate ligament reconstruction by predicting mechanical parameters such as stress, strain and displacement at regions in the tunnel wall.

  11. Standard Waste Box Lid Screw Removal Option Testing

    Energy Technology Data Exchange (ETDEWEB)

    Anast, Kurt Roy [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-03-11

    This report provides results from test work conducted to resolve the removal of screws securing the standard waste box (SWB) lids that hold the remediated nitrate salt (RNS) drums. The test work evaluated equipment and process alternatives for removing the 42 screws that hold the SWB lid in place. The screws were secured with a red Loctite thread locker that makes removal very difficult because the rivets that the screw threads into would slip before the screw could be freed from the rivet, making it impossible to remove the screw and therefore the SWB lid.

  12. Transpedicular screw fixation in the thoracic and lumbar spine with a novel cannulated polyaxial screw system

    Directory of Open Access Journals (Sweden)

    Lutz Weise

    2008-10-01

    Full Text Available Lutz Weise, Olaf Suess, Thomas Picht, Theodoros KombosNeurochirurgische Klinik, Charité – Universitätsmedizin Berlin, Berlin, GermanyObjective: Transpedicular screws are commonly and successfully used for posterior fixation in spinal instability, but their insertion remains challenging. Even using navigation techniques, there is a misplacement rate of up to 11%. The aim of this study was to assess the accuracy of a novel pedicle screw system.Methods: Thoracic and lumbar fusions were performed on 67 consecutive patients for tumor, trauma, degenerative disease or infection. A total of 326 pedicular screws were placed using a novel wire-guided, cannulated, polyaxial screw system (XIA Precision®, Stryker. The accuracy of placement was assessed post operatively by CT scan, and the patients were followed-up clinically for a mean of 16 months.Results: The total medio-caudal pedicle wall perforation rate was 9.2% (30/326. In 19 of these 30 cases a cortical breakthrough of less than 2 mm occurred. The misplacement rate (defined as a perforation of 2 mm or more was 3.37% (11/326. Three of these 11 screws needed surgical revision due to neurological symptoms or CSF leakage. There have been no screw breakages or dislocations over the follow up-period.Conclusion: We conclude that the use of this cannulated screw system for the placement of pedicle screws in the thoracic and lumbar spine is accurate and safe. The advantages of this technique include easy handling without a time-consuming set up. Considering the incidence of long-term screw breakage, further investigation with a longer follow-up period is necessary.Keywords: spinal instrumentation, pedicle screws, misplacement, pedicle wall perforation

  13. Treatment options for unstable trochanteric fractures: Screw or helical proximal femoral nail

    Institute of Scientific and Technical Information of China (English)

    Jeetendra Bajpai; Rajesh Maheshwari; Akansha Bajpai; Sumit Saini

    2015-01-01

    Purpose: To compare treatment outcome of screw proximal femoral nail (PFN) system with that of a helical PFN.Methods: The study included 77 patients with closed unstable intertrochanteric fracture classified as AO 31A2 & 31A3, between June 2008 to August 2011.Inclusion criteria were: all mature skeletons above 50 years of age;closed unstable trochanteric fracture classified as AO 31A2 & A3.Exclusion criteria were: immature skeleton, pathological fracture of any cause other than osteoporosis, inability to walk independently prior to injury.Patients were randomized to 2 treatment groups based on admission sequence.Forty patients were treated with screw PFN and thirty seven were treated with helical PFN.Results: Both groups were similar in respect of time of surgery, blood loss and functional assessment and duration of hospitalization.In screw PFN group 2 patients had superficial wound infection, 1 patient had persistent hip pain and 1 patient had shortening >1 cm but <2 cm, while in helical PFN group 1 patient had superficial wound infection.Conclusion: Both screw and helical PFN are very effective implants in osteoporotic and unstable trochanteric fractures even in Indian patients where the bones are narrow and neck diameter is small.It is an implant of choice for osteoporotic and unstable trochanteric fractures.

  14. Can experimental data in humans verify the finite element-based bone remodeling algorithm?

    DEFF Research Database (Denmark)

    Wong, C.; Gehrchen, P.M.; Kiaer, T.

    2008-01-01

    STUDY DESIGN: A finite element analysis-based bone remodeling study in human was conducted in the lumbar spine operated on with pedicle screws. Bone remodeling results were compared to prospective experimental bone mineral content data of patients operated on with pedicle screws. OBJECTIVE......, in the human spine, the bone remodeling algorithms have neither been evaluated experimentally nor been examined by comparing to unsystematic experimental data. METHODS: The site-specific and nonsite-specific iterative bone remodeling algorithms were applied to a finite element model of the lumbar spine...... operated on with pedicle screws between L4 and L5. The stress shielding effect was also examined. The bone remodeling results were compared with prospective bone mineral content measurements of 4 patients. They were measured after surgery, 3-, 6- and 12-months postoperatively. RESULTS: After 1 year...

  15. 增加椎弓根螺钉稳定性的方法与技术研究进展%Research progress in stability of pedicle screw

    Institute of Scientific and Technical Information of China (English)

    周子红; 程立; 殷渠东

    2011-01-01

    BACKGROUND: Pedicle screw which passes through the three columns and has three-dimensional correction function, which has quickly become the standard posterior spinal internal fixation But loss of correction and screw loosening often occurs in patients with osteoporosis, or screw has less stability in revision surgery and re-adjust of screw position.OBJECTIVE: To summarize and analyze the stability of pedicle screw, to introduce the methods of improving the stability of pedicle screw and its clinical applications.METHODS: A computer-based online search of PubMed database, CNKI database, VIP database was performed for related articles published between 1990 and 2010 with key words "bone nails, osteoporosis, revision, pedicle screw, stability" in English and Chinese.RESULTS AND CONCLUSION: The focus on increasing stability of pedicle screw is to increase screw withdrawal resistance Screw augmented with bone cement or replaced with thicker, longer screws or special screws (hollow screw and expandable screw hole) can lead to increase in the absolute value of screw stability Screws in the upper and the lower, the left and the right side with different connectors, different directions of placement will affect the stability of the entire device of pedicle screw, which is the change in the relative value of screw stability Other methods are those such as improving structure of fixator, and adding with bone in screw-path, etc Various methods have advantages and disadvantages, clinical application should be based on different situations to choose specific methods In general for Osteoporosis below grade n (Jikei grade), using thicker and longer screws,horizontal connection device and screws with stiff connection with rod At the same time, screws in left and right, upper and down side placed with larger angle to increase the stability of pedicle screw is a safe and convenient way, for Osteoporosis grade Ⅱ or more , more reliable screw augmented method with bone cement or

  16. Biomass granular screw feeding: An experimental investigation

    Energy Technology Data Exchange (ETDEWEB)

    Dai, Jianjun; Grace, John R. [Department of Chemical and Biological Engineering, University of British Columbia, 2360 East Mall, Vancouver, BC, V6 T 1Z3 (Canada)

    2011-02-15

    Successful feeding is critical to biomass utilization processes, but difficult due to the heterogeneity, physical properties and moisture content of the particles. The objectives of the present study were to find the mechanisms of blockage in screw feeding and to determine the effects of particle mean size (0.5-15 mm), size distribution, shape, moisture content (10-60%), density and compressibility on biomass particle feeding at room temperature. Wood pellets, sawdust, hog fuel and wood shavings were tested in a screw feeder/lock hopper system previously employed to feed sawdust into a pilot-scale circulating fluidized-bed gasifier. Experimental results showed that large particles, wide size distributions, large bulk densities and high moisture contents generally led to larger torque requirements for screw feeding. The ''choke section'' and seal plug play important roles in determining the torque requirements. (author)

  17. Adhesive bone bonding prospects for lithium disilicate ceramic implants

    Science.gov (United States)

    Vennila Thirugnanam, Sakthi Kumar

    Temporomandibular Joint (TMJ) implants articulating mandible with temporal bone in humans have a very high failure rate. Metallic TMJ implants available in the medical market are not osseointegrated, but bond only by mechanical interlocking using screws which may fail, mandating a second surgery for removal. Stress concentration around fixture screws leads to aseptic loosening or fracture of the bone. It has been proposed that this problem can be overcome by using an all-ceramic TMJ implant bonded to bone with dental adhesives. Structural ceramics are promising materials with an excellent track record in the field of dentis.

  18. A Fluoroscopy-Free Technique for Percutaneous Screw Positioning During Arthroscopic Treatment of Depression Tibial Plateau Fractures.

    Science.gov (United States)

    Thaunat, Mathieu; Camelo Barbosa, Nuno; Tuteja, Sanesh; Jan, Nicolas; Fayard, Jean Marie; Sonnery-Cottet, Bertrand

    2016-06-01

    This article aims to describe a simple and reliable technique that helps in positioning the cannulated percutaneous screws during fixation of depression-type tibial plateau fractures. After fracture reduction under arthroscopic control, an outside-in anterior cruciate ligament femoral guide is introduced through the tibial cortical metaphyseal window and positioned under endoscopic control just underneath the elevated fragment. When proper height is achieved, a guide pin is drilled from lateral to medial through the sleeve, 1 to 2 cm distal to the articular surface of the depressed fragment. The cannulated screw can then be introduced under endoscopic control, without fluoroscopic assistance, just under the previously elevated joint surface. This technique ensures optimal placement of the cannulated screw in the middle of the bony tunnel to obtain optimal subchondral bone support during fixation of the depressed tibial plateau fracture. PMID:27656370

  19. Drag and Torque on Locked Screw Propeller

    Directory of Open Access Journals (Sweden)

    Tomasz Tabaczek

    2014-09-01

    Full Text Available Few data on drag and torque on locked propeller towed in water are available in literature. Those data refer to propellers of specific geometry (number of blades, blade area, pitch and skew of blades. The estimation of drag and torque of an arbitrary propeller considered in analysis of ship resistance or propulsion is laborious. The authors collected and reviewed test data available in the literature. Based on collected data there were developed the empirical formulae for estimation of hydrodynamic drag and torque acting on locked screw propeller. Supplementary CFD computations were carried out in order to prove the applicability of the formulae to modern moderately skewed screw propellers.

  20. Screw Extruder for Pellet Injection System

    Directory of Open Access Journals (Sweden)

    Sharadkumar K. Chhantbar

    2014-05-01

    Full Text Available Solid hydrogenic pellets are used as fuel for fusion energy reactor. A technique for continuous production of solid hydrogen and its isotopes by a screw extruder is suggested for the production of an unlimited number of pellets. The idea was developed and patented by PELIN laboratories, Inc. (Canada. A Gifford McMahon cryocooler is used for the generation of solid hydrogenic fluid pellets. Requirements of the pellets is depends upon the energy to be produced by tokamak. This review paper focuses on the model for the screw extruder for solidification of hydrogen ice having high injection reliability.

  1. The additon of screws and the axodes of gear pairs

    Institute of Scientific and Technical Information of China (English)

    张文祥

    2001-01-01

    In the light of screw addition, the distribution of instantaneous axes along the common perpendicular of the two screws is determined and all possible sorts of axodes are derived cinematically with the pitch of the relative-motion screw in the gear pair as the basis and the transmission ratio i as an independent variable.

  2. Dual-worm screw compressors; Compresseurs bi-vis

    Energy Technology Data Exchange (ETDEWEB)

    Baleydier, J.P. [Bitzer France, 69 - Lyon (France)

    1997-12-31

    Low power worm-screw moto-compressors are used in any king of refrigerating machineries and more and more in air conditioning systems. This paper presents the principle of dual-screw moto-compressors: worm-screw technology, role of oil (lubrication, tightness, cooling), compression, internal pressure, power reduction, lubrication, economizer, operation, model selection and accessories. (J.S.)

  3. The additon of screws and the axodes of gear pairs

    Institute of Scientific and Technical Information of China (English)

    ZHANG Wen-xiang

    2001-01-01

    In the light of screw addition, the distribution of instantaneous axes along the common perpendicular of the two screws is determined and all possible sorts of axodes are derived cinematically with the pitch of the relative-motio n screw in the gear pair as the basis and the transmission ratio i as an inde pendent variable.

  4. Favorable outcome of a total hip arthroplasty with insufficient bone coverage of the roof reinforcement ring

    Directory of Open Access Journals (Sweden)

    Fernando M. Judas

    2015-01-01

    Conclusion: This result can be supported by the good fixation of the metal ring to the pelvis with screws, the adequate orientation of both components of the total hip arthroplasty, and the bone graft incorporation.

  5. Cortical screw trajectory for instrumentation and fusion in the setting of osteopathic compression fracture allows for percutaneous kyphoplasty for adjacent level compression fractures.

    Science.gov (United States)

    Pacione, Donato; Kim, Irene; Wilson, Taylor A; Frempong-Boadu, Anthony

    2015-05-01

    Spinal fixation in the osteoporotic patient can be challenging due to the poor trabecular bone quality of the vertebral body. Patients with osteoporotic vertebral body compression fractures are at risk for future compression fractures at adjacent levels, especially after cement augmentation. The purpose of this technical report is to describe the utilization of a cortical screw trajectory along with kyphoplasty for a patient with an osteoporotic compression fracture as well as degenerative spinal disease. This trajectory allows for the possibility of percutaneous pedicle access in the event of future compression fractures. Our patient underwent a decompressive laminectomy and kyphoplasty at the level of an osteoporotic compression fracture. The fracture was stabilized with cortical screw instrumentation and fusion at a level above and a level below the fracture. Subsequently the patient developed an adjacent level fracture within the fusion construct. Due to the utilization of a cortical screw trajectory for the initial fusion, the traditional pedicle trajectory was still accessible. As a result, the new fracture was treated with a percutaneous kyphoplasty through a standard pedicle trajectory. In conclusion, the use of a cortical screw trajectory for stabilization of osteoporotic compression fractures provides for a stronger bone screw interface and avoids osteoporotic trabecular vertebral body bone. At the same time this trajectory allows for future percutaneous pedicular access in the event that the patient suffers future compression fractures.

  6. Biopolymer augmentation of the lag screw in the treatment of femoral neck fractures--a biomechanical in-vitro study.

    Science.gov (United States)

    Paech, A; Wilde, E; Schulz, A P; Heinrichs, G; Wendlandt, R; Queitsch, C; Kienast, B; Jürgens, Ch

    2010-04-01

    The cut-out of the sliding screw is one of the most common complications in the treatment of intertrochanteric fractures. The reasons for the cut-out are: a suboptimal position of the hip-screw in the femoral head, the type of fracture and poor bone quality. The aim of this study was to reproduce the cut-out event biomechanically and to evaluate the possible prevention of this event by the use of a biopolymer augmentation of the hip screw. Concerning the density and compression force of osteoporotic femoral bone polyurethane foam according to the terms of the Association for Standard Testing Material (ASTMF 1839-97) was used as test material. The polyurethane foam Lumoltan 200 with a compression force of 3.3 Mpa and a density of 0.192 g/cm(3) was used to reproduce the osteoporotic bone of the femoral fragment (density 12 lbm/ft(3)). A cylinder of 50 mm of length and 50 mm of width was produced by a rotary splint raising procedure with planar contact. The axial load of the system was performed by a hydraulic force cylinder of a universal test machine type Zwick 1455, Ulm, Germany. The CCD-angle of the used TGN-System was preset at 130 degrees. The migration pattern of the hip screw in the polyurethane foam was measured and expressed as a curve of the distance in millimeter (mm) against the applied load in Newton (N) up to the cut-out point. During the tests the implants reached a critical changing point from stable to unstable with an increased load progression of steps of 50 Newton. This unstable point was characterized by an increased migration speed in millimeters and higher descending gradient in the migration curve. This peak of the migration curve served as an indicator for the change of the hip screw position in the simulated bone material. The applied load in the non-augmented implant showed that in this group for a density degree of 12 (0,192 g/cm(3)) the mean force at the failure point was 1431 Newton (+/- 52 Newton). In the augmented implant we found that

  7. Biopolymer augmentation of the lag screw in the treatment of femoral neck fractures - a biomechanical in-vitro study

    Directory of Open Access Journals (Sweden)

    Paech A

    2010-04-01

    Full Text Available Abstract The cut-out of the sliding screw is one of the most common complications in the treatment of intertrochanteric fractures. The reasons for the cut-out are: a suboptimal position of the hip-screw in the femoral head, the type of fracture and poor bone quality. The aim of this study was to reproduce the cut-out event biomechanically and to evaluate the possible prevention of this event by the use of a biopolymer augmentation of the hip screw. Concerning the density and compression force of osteoporotic femoral bone polyurethane foam according to the terms of the Association for Standard Testing Material (ASTMF 1839-97 was used as test material. The polyurethane foam Lumoltan 200 with a compression force of 3.3 Mpa and a density of 0.192 g/cm3 was used to reproduce the osteoporotic bone of the femoral fragment (density 12 lbm/ft3. A cylinder of 50 mm of length and 50 mm of width was produced by a rotary splint raising procedure with planar contact. The axial load of the system was performed by a hydraulic force cylinder of a universal test machine type Zwick 1455, Ulm, Germany. The CCD-angle of the used TGN-System was preset at 130 degrees. The migration pattern of the hip screw in the polyurethane foam was measured and expressed as a curve of the distance in millimeter [mm] against the applied load in Newton [N] up to the cut-out point. During the tests the implants reached a critical changing point from stable to unstable with an increased load progression of steps of 50 Newton. This unstable point was characterized by an increased migration speed in millimeters and higher descending gradient in the migration curve. This peak of the migration curve served as an indicator for the change of the hip screw position in the simulated bone material. The applied load in the non-augmented implant showed that in this group for a density degree of 12 (0,192 g/cm3 the mean force at the failure point was 1431 Newton (± 52 Newton. In the augmented

  8. A New Electromagnetic Navigation System for Pedicle Screws Placement: A Human Cadaver Study at the Lumbar Spine.

    Directory of Open Access Journals (Sweden)

    Patrick Hahn

    Full Text Available Technical developments for improving the safety and accuracy of pedicle screw placement play an increasingly important role in spine surgery. In addition to the standard techniques of free-hand placement and fluoroscopic navigation, the rate of complications is reduced by 3D fluoroscopy, cone-beam CT, intraoperative CT/MRI, and various other navigation techniques. Another important aspect that should be emphasized is the reduction of intraoperative radiation exposure for personnel and patient. The aim of this study was to investigate the accuracy of a new navigation system for the spine based on an electromagnetic field.Twenty pedicle screws were placed in the lumbar spine of human cadavers using EMF navigation. Navigation was based on data from a preoperative thin-slice CT scan. The cadavers were positioned on a special field generator and the system was matched using a patient tracker on the spinous process. Navigation was conducted using especially developed instruments that can be tracked in the electromagnetic field. Another thin-slice CT scan was made postoperatively to assess the result. The evaluation included the position of the screws in the direction of trajectory and any injury to the surrounding cortical bone. The results were classified in 5 groups: grade 1: ideal screw position in the center of the pedicle with no cortical bone injury; grade 2: acceptable screw position, cortical bone injury with cortical penetration ≤ 2 mm; grade 3: cortical bone injury with cortical penetration 2,1-4 mm, grad 4: cortical bone injury with cortical penetration 4,1-6 mm, grade 5: cortical bone injury with cortical penetration >6 mm.The initial evaluation of the system showed good accuracy for the lumbar spine (65% grade 1, 20% grade 2, 15% grade 3, 0% grade 4, 0% grade 5. A comparison of the initial results with other navigation techniques in literature (CT navigation, 2D fluoroscopic navigation shows that the accuracy of this system is

  9. A New Electromagnetic Navigation System for Pedicle Screws Placement: A Human Cadaver Study at the Lumbar Spine

    Science.gov (United States)

    Hahn, Patrick; Oezdemir, Semih; Komp, Martin; Giannakopoulos, Athanasios; Heikenfeld, Roderich; Kasch, Richard; Merk, Harry; Godolias, Georgios; Ruetten, Sebastian

    2015-01-01

    Introduction Technical developments for improving the safety and accuracy of pedicle screw placement play an increasingly important role in spine surgery. In addition to the standard techniques of free-hand placement and fluoroscopic navigation, the rate of complications is reduced by 3D fluoroscopy, cone-beam CT, intraoperative CT/MRI, and various other navigation techniques. Another important aspect that should be emphasized is the reduction of intraoperative radiation exposure for personnel and patient. The aim of this study was to investigate the accuracy of a new navigation system for the spine based on an electromagnetic field. Material and Method Twenty pedicle screws were placed in the lumbar spine of human cadavers using EMF navigation. Navigation was based on data from a preoperative thin-slice CT scan. The cadavers were positioned on a special field generator and the system was matched using a patient tracker on the spinous process. Navigation was conducted using especially developed instruments that can be tracked in the electromagnetic field. Another thin-slice CT scan was made postoperatively to assess the result. The evaluation included the position of the screws in the direction of trajectory and any injury to the surrounding cortical bone. The results were classified in 5 groups: grade 1: ideal screw position in the center of the pedicle with no cortical bone injury; grade 2: acceptable screw position, cortical bone injury with cortical penetration ≤ 2 mm; grade 3: cortical bone injury with cortical penetration 2,1-4 mm, grad 4: cortical bone injury with cortical penetration 4,1-6 mm, grade 5: cortical bone injury with cortical penetration >6 mm. Results The initial evaluation of the system showed good accuracy for the lumbar spine (65% grade 1, 20% grade 2, 15% grade 3, 0% grade 4, 0% grade 5). A comparison of the initial results with other navigation techniques in literature (CT navigation, 2D fluoroscopic navigation) shows that the accuracy of

  10. Biomechanical Evaluation of Two Arthroscopic Biceps Tenodesis Techniques: Proximal Interference Screw and Modified Percutaneous Intra-Articular Transtendon.

    Science.gov (United States)

    Hartigan, David E; Beran, Matthew C; Fleischli, James E; D'Alessandro, Donald F; Zheng, Naiquan Nigel

    2016-01-01

    The percutaneous intra-articular transtendon (PITT) technique has recently been shown to have results comparable to those of more accepted techniques. Its mode of failure was secondary to the suture pulling through the tendon substance. A modification was made whereby the tendon is locked within the suture configuration in an attempt to avoid pullout. We compared this new technique with a well-accepted technique of all-arthroscopic interference screw. In each of 8 pairs of cadaveric shoulders (mean age, 55 years; range, 51-59 years), one shoulder was randomized to be treated with either modified PITT or interference screw (Biceptor; Smith & Nephew) biceps tenodesis, and the other shoulder was treated with the other technique. The tendons were preloaded at 10 N and then cycled at 0 to 50 N for 100 cycles at 1 Hz. Load to failure was calculated at a rate of 1.0 mm per second until peak load was observed. Mean (SD) ultimate load to failure was 157 (41) N for the modified PITT technique and 107 (29) N for the interference screw technique (P = .003). In 7 of 8 specimens, the interference screw technique failed at the junction of the tendon, the screw, and the bone interface. In 7 of 8 specimens, the PITT technique failed by the tendon slipping through the suture or pulling through transverse ligament/rotator interval tissue. Study results showed the modified PITT technique was a biomechanically superior construct. PMID:27552463

  11. The mechanical benefit of medial support screws in locking plating of proximal humerus fractures.

    Directory of Open Access Journals (Sweden)

    Wen Zhang

    Full Text Available BACKGROUND: The purpose of this study was to evaluate the biomechanical advantages of medial support screws (MSSs in the locking proximal humeral plate for treating proximal humerus fractures. METHODS: Thirty synthetic left humeri were randomly divided into 3 subgroups to establish two-part surgical neck fracture models of proximal humerus. All fractures were fixed with a locking proximal humerus plate. Group A was fixed with medial cortical support and no MSSs; Group B was fixed with 3 MSSs but without medial cortical support; Group C was fixed with neither medial cortical support nor MSSs. Axial compression, torsional stiffness, shear stiffness, and failure tests were performed. RESULTS: Constructs with medial support from cortical bone showed statistically higher axial and shear stiffness than other subgroups examined (P<0.0001. When the proximal humerus was not supported by medial cortical bone, locking plating with medial support screws exhibited higher axial and torsional stiffness than locking plating without medial support screws (P ≤ 0.0207. Specimens with medial cortical bone failed primarily by fracture of the humeral shaft or humeral head. Specimens without medial cortical bone support failed primarily by significant plate bending at the fracture site followed by humeral head collapse or humeral head fracture. CONCLUSIONS: Anatomic reduction with medial cortical support was the stiffest construct after a simulated two-part fracture. Significant biomechanical benefits of MSSs in locking plating of proximal humerus fractures were identified. The reconstruction of the medial column support for proximal humerus fractures helps to enhance mechanical stability of the humeral head and prevent implant failure.

  12. Numerical simulation of in vivo intraosseous torsional failure of a hollow-screw oral implant

    Directory of Open Access Journals (Sweden)

    Akca Kivanc

    2006-11-01

    Full Text Available Abstract Background Owing to the complexity and magnitude of functional forces transferred to the bone-implant interface, the mechanical strength of the interface is of great importance. The purpose of this study was to determine the intraosseous torsional shear strength of an osseointegrated oral implant using 3-D finite element (FE stress analysis implemented by in vivo failure torque data of an implant. Methods A Ø 3.5 mm × 12 mm ITI® hollow screw dental implant in a patient was subjected to torque failure test using a custom-made strain-gauged manual torque wrench connected to a data acquisition system. The 3-D FE model of the implant and peri-implant circumstances was constructed. The in vivo strain data was converted to torque units (N.cm to involve in loading definition of FE analysis. Upon processing of the FE analysis, the shear stress of peri-implant bone was evaluated to assume torsional shear stress strength of the bone-implant interface. Results The in vivo torque failure test yielded 5952 μstrains at custom-made manual torque wrench level and conversion of the strain data resulted in 750 N.cm. FE revealed that highest shear stress value in the trabecular bone, 121 MPa, was located at the first intimate contact with implant. Trabecular bone in contact with external surface of hollow implant body participated shear stress distribution, but not the bone resting inside of the hollow. Conclusion The torsional strength of hollow-screw implants is basically provided by the marginal bone and the hollow part has negligible effect on interfacial shear strength.

  13. Nylon screws make inexpensive coil forms

    Science.gov (United States)

    Aucoin, G.; Rosenthal, C.

    1978-01-01

    Standard nylon screws act as coil form copper wire laid down in spiral thread. Completed coil may be bonded to printed-circuit board. However, it is impossible to tune coil by adjusting spacing between windings, technique sometimes used with air-core coils.

  14. CFD Simulation of the Flow Field Inside Screw Powder Feeder

    Institute of Scientific and Technical Information of China (English)

    SHI Yang-he; SHAO Zong-heng

    2011-01-01

    A screw powder feeder is an important device for industrial applications. There are many parameters which affect the performance of the screw powder feeder, such as the shapes of the helical screw impeller, the number of screw pitches, etc. This paper presents an analysis of a gas-solid two-phase through screw powder feeder by using a commercial Computational Fluid Dynamics(CFD) code, Fluent. The K-ε model is used to simulate gas flow. Particle trajectory is obtained by the use of a discrete phase model. The results show the effects of gas velocity and panicle size on the transportation performance.

  15. Internal fixation with headless compression screws and back buttress plate for treatment of old Hoffa fracture

    Institute of Scientific and Technical Information of China (English)

    Min Li; Tu Chongqi; Wang Guanglin; Fang Yue; Duan Hong; Liu Lei; Zhang Hui

    2014-01-01

    Objective:To analyze the early clinical and radiographic outcomes of Hoffa fractures treated by a standard protocol of open reduction and internal fixation using headless compression screws combined with back buttress plate in a consecutive series of 8 Chinese patients.Methods:Open reduction and internal fixation was performed on all patients.The fractures were anatomically reduced and held temporarily by K-wire.If the ends of fractures were atrophic,autologous bone graft from the ipsilateral iliac crest was packed between the ends.Then the fracture fragments were fixed with AO 6.5 mm headless compression cannulated screws.At least two screws were used to provide rotational stability.One pre-contoured reconstruction plate was placed on the nonarticular surface posteromedially or posterolaterally as back buttress plate.Results:All the patients were followed up for at least 12 months (range 12-25 months).All fractures achieved anatomical reduction and healed clinically and radiographically.At recent follow-up,the mean flexion degree was 120.6° (range 110°-135°) and the mean extension degree was 2.5° (range 0°-5°).The average visual analogue scale score was 1.6 points (range 0-3).Six patients were assessed as excellent and 2 as good according to the hospital for special surgery knee score system.There were no superficial or deep infections,or hardware breakages.No patient had giving way or locking of the knee,though some had intermittent pain and swelling after strenuous exercise.Injury mechanism had significant influence on the functional outcome (P=0.046).Conclusion:Headless compression screws combined with back buttress plate and/or autologous bone grafting to treat old Hoffa fracture is one of effective measures.It would be conducive to not only fracture healing but also early exercise and functional recovery.

  16. Influence of bone morphological properties on a new expandable orthopaedic fastener

    Science.gov (United States)

    Oldakowski, M.; Oldakowska, I.; Kirk, T. B.; Ford, C. T.; Sercombe, T. B.; Hardcastle, P.; Day, R. E.

    2016-03-01

    Previous studies have demonstrated that bone morphological properties are a significant determinant of orthopaedic fastener fixation strength. The authors previously tested a new design of unthreaded expandable fastener (UEF) prototype against screws and demonstrated a significant increase in pull-out strength. However the effect of bone morphology on the pull-out strength of the UEF and expandable fasteners in general is unknown. This study assessed the correlation between failure force and maximum force against five microstructural parameters. The failure force of the UEF was correlated to the trabecular bone volume fraction, as with screws. Unlike screws, however, the maximum force of the UEF has an inverse relationship with cortical volume. No correlation was found between failure force and the Structural Model Index (SMI). Additionally the critical volume of interest (VOI) for the UEF is around the bottom of the fastener where the expansion occurs, whereas for the screw a full height VOI is critical. Furthermore, we observed that screw mechanical performance may be affected more by bone morphological parameters that are associated with poorer quality bone. Therefore the UEF may perform better than screws in low quality osteoporotic bone.

  17. A Review of Screw Conveyors Performance Evaluation During Handling Process

    Directory of Open Access Journals (Sweden)

    Hemad Zareiforoush

    2010-04-01

    Full Text Available This paper reviews recent work on screw conveyors performance evaluation during handling process, especially in the case of agricultural grains and bulk materials. Experimental work has been mainly carried out to determine a range of parameters, such as auger dimension, screw rotational speed, screw clearance, conveyor intake length and conveying angle for horizontal, inclined and vertical screw conveyors. Several measurement techniques including theoretical models and DEM have been utilized to study the screw conveyors performance. However, each of these techniques is limited in its application. Difficulties in representing vortex motion and interactions among conveying grains and between the particles and screw rotating flight have so far limited the success of advanced modeling. Further work is needed to be conducted on screw augers performance to understand and improve the agricultural grains and bulk materials handling process.

  18. Vertical and lateral capacity of screw anchor piles

    Energy Technology Data Exchange (ETDEWEB)

    Law, D.J.; Tweedie, R.W.; Harris, M.C. [Thurber Engineering Ltd., Edmonton, AB (Canada); Niedermaier, J. [Alberta Anchor Inc., Calgary, AB (Canada)

    1996-09-01

    Test programs were conducted to investigate the deformation behaviour of screw anchors during loading. Screw anchors are used in foundation applications for transmission towers and retaining walls, as well as for foundation elements for buildings, pipe racks, storage tanks and equipment. Screw anchor piles were installed at a site near Fort Saskatchewan, at a site underlain by typical stiff glacial soils. Single and multi-helix screw anchors with helix diameters up to 381 mm were tested in compression and tension. Lateral load tests were conducted on screw anchors with shaft diameters ranging from 114 mm to 273 mm. Results from the study showed that vertical and horizontal loads can be carried by screw anchor piles that are comparable with those achieved with driven steel piles, but screw anchors are easier to install, and can be more cost effective in some cases. 4 refs., 3 tabs., 4 figs.

  19. Bone tumor

    Science.gov (United States)

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  20. In vivo degradation of magnesium plate/screw osteosynthesis implant systems: Soft and hard tissue response in a calvarial model in miniature pigs.

    Science.gov (United States)

    Schaller, Benoit; Saulacic, Nikola; Imwinkelried, Thomas; Beck, Stefan; Liu, Edwin Wei Yang; Gralla, Jan; Nakahara, Ken; Hofstetter, Willy; Iizuka, Tateyuki

    2016-03-01

    Biodegradable magnesium plate/screw osteosynthesis systems were implanted on the frontal bone of adult miniature pigs. The chosen implant geometries were based on existing titanium systems used for the treatment of facial fractures. The aim of this study was to evaluate the in vivo degradation and tissue response of the magnesium alloy WE43 with and without a plasma electrolytic surface coating. Of 14 animals, 6 received magnesium implants with surface modification (coated), 6 without surface modification (uncoated), and 2 titanium implants. Radiological examination of the skull was performed at 1, 4, and 8 weeks post-implantation. After euthanasia at 12 and 24 weeks, X-ray, computed tomography, and microfocus computed tomography analyses and histological and histomorphological examinations of the bone/implant blocks were performed. The results showed a good tolerance of the plate/screw system without wound healing disturbance. In the radiological examination, gas pocket formation was found mainly around the uncoated plates 4 weeks after surgery. The micro-CT and histological analyses showed significantly lower corrosion rates and increased bone density and bone implant contact area around the coated screws compared to the uncoated screws at both endpoints. This study shows promising results for the further development of coated magnesium implants for the osteosynthesis of the facial skeleton. PMID:26805919

  1. Femoral fracture following knee ligament reconstruction surgery due to an unpredictable complication of bioabsorbable screw fixation: a case report and review of literature

    OpenAIRE

    Konan, Sujith; Haddad, Fares Sami

    2009-01-01

    We report an unusual case of femoral fracture from minimal trauma, due to the rapid disappearance of a bioabsorbable interference screw used for reconstruction of the posterolateral corner of the knee. The literature on bone tunnel fractures following knee ligament reconstruction surgery is also reviewed.

  2. [Bone-based anchorage failure].

    Science.gov (United States)

    Mer, Grégoria; Brezulier, Damien; Sorel, Olivier

    2016-03-01

    The aim of this article is to list the circumstances likely to give rise to failure of orthodontic temporary bone-supported anchorage and, hence, to attempt to define criteria for correct miniscrew usage. Our study was based on a review of the literature and analyses of clinical cases. Our findings show that, with a sound knowledge of the indications for screw selection and positioning and of the insertion protocols combined with a clear understanding of orthodontic mechanics, bone-based anchorage can henceforth provide orthodontists with an essential tool to enable formerly unachievable dental movements and to stabilize unwanted movements, thus making treatment both more reliable and more effective. PMID:27083224

  3. Biomechanical Analysis of Tapered Integrated Screw and Sensitivity Analysis on Abutment Loosening in Dental Implants

    Directory of Open Access Journals (Sweden)

    Milad Farzadi

    2013-02-01

    Full Text Available Background and Aims: Different mechanisms have been developed for connecting abutment to implant. One of the most popular mechanisms is Tapered Integrated Screw (TIS, which is a Tapered Interference Fit (TIF with a screw integrated at the bottom of that. The aim of this study was to investigate the mechanism of TIS and effective factors in employing TIS during design and implementation processes using an analytic method.Materials and Methods: Relevant equations were developed to predict tightening and loosening torques, contactpressure and preloads with and without bone tissue in this analysis. The efficiency is defined as the ratio of the loosening torque to the tightening torque. The effects of the change in elastic modulus and thickness of the bone on operation of this mechanism were investigated.Results: In this study, 14 independent parameters such as taper angle, friction coefficient, abutment and implantgeometry that are effective on performance of TIS mechanism were presented. The role of some factors was shown in the performance of ITI implant using sensitivity analysis.Conclusion: It was shown that friction coefficient, contact length, and implant radius play major roles on tightening and loosening torques and efficiency of the mechanism. Furthermore, the results revealed that the change in the elastic modulus and thickness of the bone influenced the efficiency of the mechanism less than 15%.

  4. Reduction of Zygomatic Fractures Using the Carroll-Girard T-bar Screw

    Directory of Open Access Journals (Sweden)

    Ji Eun Baek

    2012-09-01

    Full Text Available Zygomatic fractures are the second most common facial bone fractures encountered andtreated by plastic surgeons. Stable fixation of fractured fragments after adequate exposureis critical for ensuring three-dimensional anatomic reduction. Between January 2008 andDecember 2010, 17 patients with zygomatic fractures were admitted to our hospital; therewere 15 male and 2 female patients. The average age of the patients was 41 years (range, 19to 75 years. We exposed the inferior orbital rim and zygomatic complex through a lateralbrow, intraoral, and subciliary incisions, which allowed for visualization of the bone, andthen the fractured parts were corrected using the Carroll-Girard T-bar screw. Postoperativecomplications such as malar asymmetry, diplopia, enophthalmos, and postoperative infectionwere not observed. Lower eyelid retraction and temporary ectropion occurred in 1 of the 17patients. Functional and cosmetic results were excellent in nearly all of the cases. In this report,we describe using the Carroll-Girard T-bar screw for the reduction of zygomatic fractures.Because this instrument is easy to use and can rotate to any direction and vector, it can beused to correct displaced zygomatic bone more accurately and safely than other devices,without leaving facial scars.

  5. The applicability of PEEK-based abutment screws.

    Science.gov (United States)

    Schwitalla, Andreas Dominik; Abou-Emara, Mohamed; Zimmermann, Tycho; Spintig, Tobias; Beuer, Florian; Lackmann, Justus; Müller, Wolf-Dieter

    2016-10-01

    The high-performance polymer PEEK (poly-ether-ether-ketone) is more and more being used in the field of dentistry, mainly for removable and fixed prostheses. In cases of screw-retained implant-supported reconstructions of PEEK, an abutment screw made of PEEK might be advantageous over a conventional metal screw due to its similar elasticity. Also in case of abutment screw fracture, a screw of PEEK could be removed more easily. M1.6-abutment screws of four different PEEK compounds were subjected to tensile tests to set their maximum tensile strengths in relation to an equivalent stress of 186MPa, which is aused by a tightening torque of 15Ncm. Two screw types were manufactured via injection molding and contained 15% short carbon fibers (sCF-15) and 40% (sCF-40), respectively. Two screw types were manufactured via milling and contained 20% TiO2 powder (TiO2-20) and >50% parallel orientated, continuous carbon fibers (cCF-50). A conventional abutments screw of Ti6Al4V (Ti; CAMLOG(®) abutment screw, CAMLOG, Wimsheim, Germany) served as control. The maximum tensile strength was 76.08±5.50MPa for TiO2-20, 152.67±15.83MPa for sCF-15, 157.29±20.11MPa for sCF-40 and 191.69±36.33MPa for cCF-50. The maximum tensile strength of the Ti-screws amounted 1196.29±21.4MPa. The results of the TiO2-20 and the Ti screws were significantly different from the results of the other samples, respectively. For the manufacturing of PEEK abutment screws, PEEK reinforced by >50% continuous carbon fibers would be the material of choice. PMID:27434650

  6. Comparison of Multidetector Computed Tomography and Flat-Panel Computed Tomography Regarding Visualization of Cortical Fractures, Cortical Defects, and Orthopedic Screws

    Science.gov (United States)

    Neubauer, Jakob; Benndorf, Matthias; Lang, Hannah; Lampert, Florian; Kemna, Lars; Konstantinidis, Lukas; Neubauer, Claudia; Reising, Kilian; Zajonc, Horst; Kotter, Elmar; Langer, Mathias; Goerke, Sebastian M.

    2015-01-01

    Abstract To compare the visualization of cortical fractures, cortical defects, and orthopedic screws in a dedicated extremity flat-panel computed tomography (FPCT) scanner and a multidetector computed tomography (MDCT) scanner. We used feet of European roe deer as phantoms for cortical fractures, cortical defects, and implanted orthopedic screws. FPCT and MDCT scans were performed with equivalent dose settings. Six observers rated the scans according to number of fragments, size of defects, size of defects opposite orthopedic screws, and the length of different screws. The image quality regarding depiction of the cortical bone was assessed. The gold standard (real number of fragments) was evaluated by autopsy. The correlation of reader assessment of fragments, cortical defects, and screws with the gold standard was similar for FPCT and MDCT. Three readers rated the subjective image quality of the MDCT to be higher, whereas the others showed no preferences. Although the image quality was rated higher in the MDCT than in the FPCT by 3 out of 6 observers, both modalities proved to be comparable regarding the visualization of cortical fractures, cortical defects, and orthopedic screws and of use to musculoskeletal radiology regarding fracture detection and postsurgical evaluation in our experimental setting. PMID:26252281

  7. Comparison of Multidetector Computed Tomography and Flat-Panel Computed Tomography Regarding Visualization of Cortical Fractures, Cortical Defects, and Orthopedic Screws: A Phantom Study.

    Science.gov (United States)

    Neubauer, Jakob; Benndorf, Matthias; Lang, Hannah; Lampert, Florian; Kemna, Lars; Konstantinidis, Lukas; Neubauer, Claudia; Reising, Kilian; Zajonc, Horst; Kotter, Elmar; Langer, Mathias; Goerke, Sebastian M

    2015-08-01

    To compare the visualization of cortical fractures, cortical defects, and orthopedic screws in a dedicated extremity flat-panel computed tomography (FPCT) scanner and a multidetector computed tomography (MDCT) scanner.We used feet of European roe deer as phantoms for cortical fractures, cortical defects, and implanted orthopedic screws. FPCT and MDCT scans were performed with equivalent dose settings. Six observers rated the scans according to number of fragments, size of defects, size of defects opposite orthopedic screws, and the length of different screws. The image quality regarding depiction of the cortical bone was assessed. The gold standard (real number of fragments) was evaluated by autopsy.The correlation of reader assessment of fragments, cortical defects, and screws with the gold standard was similar for FPCT and MDCT. Three readers rated the subjective image quality of the MDCT to be higher, whereas the others showed no preferences.Although the image quality was rated higher in the MDCT than in the FPCT by 3 out of 6 observers, both modalities proved to be comparable regarding the visualization of cortical fractures, cortical defects, and orthopedic screws and of use to musculoskeletal radiology regarding fracture detection and postsurgical evaluation in our experimental setting. PMID:26252281

  8. Analysis of Modeling Parameters on Threaded Screws.

    Energy Technology Data Exchange (ETDEWEB)

    Vigil, Miquela S. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Brake, Matthew Robert [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Vangoethem, Douglas [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-06-01

    Assembled mechanical systems often contain a large number of bolted connections. These bolted connections (joints) are integral aspects of the load path for structural dynamics, and, consequently, are paramount for calculating a structure's stiffness and energy dissipation prop- erties. However, analysts have not found the optimal method to model appropriately these bolted joints. The complexity of the screw geometry cause issues when generating a mesh of the model. This paper will explore different approaches to model a screw-substrate connec- tion. Model parameters such as mesh continuity, node alignment, wedge angles, and thread to body element size ratios are examined. The results of this study will give analysts a better understanding of the influences of these parameters and will aide in finding the optimal method to model bolted connections.

  9. Translaminar facetal screw (magerl′s fixation

    Directory of Open Access Journals (Sweden)

    Rajasekaran S

    2005-01-01

    Full Text Available Translaminar facet screw fixation (TLFS achieves stabilization of the vertebral motion segment by screws inserted at the base of the spinous process, through the opposite lamina, traversing the facet joint, and ending in the base of the transverse process. It is simple, does not require any specialized equipment, and has the advantages of being a procedure of lesser magnitude, lesser operative time, less cost and few complication rate. Recently there is growing interest in this technique to augment the anterior lumbar fusions to achieve global fusion less invasively. In this review article, we discuss the clinical and biomechanical considerations, surgical technique, indications, contraindications and recent developments of TLFS fixation in lumbar spine fusion.

  10. A retrospective comparison of the modified tension band technique and the parallel titanium cannulated lag screw technique in transverse patella fracture

    Directory of Open Access Journals (Sweden)

    Wang Chengxue

    2014-07-01

    Full Text Available 【Abstract】Objective: To compare efficacy between the modified tension band technique and the parallel titanium cannulated lag screw technique for the transverse patella fracture. Methods:Seventy-two patients were retrospectively analyzed aged 22 to 79 years (mean, 55.6 years with transverse patella fractures, among whom 37 patients underwent the modified tension band and 35 patients received the titanium cannulated lag screw. Patients were followed up for 1-3 years. We analyzed the difference of operation time, complications, fracture reduction, fracture healing time, and the Iowa score for knee function between both groups. Results:In modified tension band group, five patients had skin irritation and seven suffered wire migration, two of whom required a second operation. In comparison, there were no complications in the titanium cannulated lag screw group, which also had a higher fracture reduction rate and less operation time. Conclusion:The parallel titanium cannulated lag screw technique has superior results and should be considered as an alternative method to treat transverse patella fracture. Key words: Fractures, bone; Patella; Titanium; Bone screws

  11. Rancang Bangun Alat Pemarut Kelapa Tipe Screw

    OpenAIRE

    Sitohang, Domen

    2016-01-01

    In improving agricultural production, that including pre- to post-harvest facilities and infrastructure, require, effective agricultural tools and machines. This research was aimed to design and test screw type coconut grater using coconut new materil. This study was conducted in February 2016 until March 2016 at the Laboratory of Agricultural Engineering Study Program of Agricultural Engineering Faculty of Agriculture, University of North Sumatra, Medan. The parameters observed were the effe...

  12. Applied anatomy of the lower cervical pedicle screw insertion

    Institute of Scientific and Technical Information of China (English)

    LI Xing-guo; LIU Zong-liang; HE Yun; ZHAO Yan; ZOU Zhi-rong; ZHANG Peng; LUO Ji-hong; GUO Yong-fu; ZHANG Yang-jie; ZHANG Yu-ran

    2007-01-01

    process was observed on all lateral masses (50 sides ). The internal and external position of the entrance point could depend on anatomic landmarks: the lateral edge of the lateral fovea of the articular process. The horizontal length between the lateral fovea of the articular process and the entrance point was (3.14 ± 1.45 ) mm. 4 ) The diameter of pedicle screw,about (2.78 ± 1.71 ) mm, was the transverse diameter of the cancellous bone of the greatest narrow part of the cervical pedicle.Conclusions: The median point between the superior edge and the inferior edge of the base of the posterior tubercle of the transverse process, the lateral fovea of the articular process, and the triangular sulcule between the base of the posterior tubercle of the transverse process and the anterolateral edge of inferior articular process, are easy to be exposed and identified in surgical operation. The pedicle screw can be precisely inserted through this method.

  13. Evaluation of Occipitocervical Arthrodesis Rates with Screw-based Fixation and Osteoinductive Fusion Adjuncts.

    Science.gov (United States)

    Stone, Jeremy G; Panczykowski, David M; Tempel, Zachary J; Tormenti, Matthew; Kanter, Adam S; Okonkwo, David O

    2015-09-01

    Occipitocervical (OC) instability may be associated with neurologic impairment and even death. There is a paucity of research on the rate of arthrodesis utilizing modern screw-based constructs coupled with adjuvant osteoinductive agents. We reviewed our experience with OC constructs and compared the fusion rate, functional outcome, and rate of adverse events between recombinant human bone morphogenetic protein (BMP)-2, autologous iliac crest bone graft (ICBG), a combination of BMP and ICBG, and local bone autograft alone. We performed a retrospective cohort analysis of all adult admissions for operative treatment of OC instability utilizing segmental screw-based constructs for OC arthrodesis between January 2003 and September 2012. Data concerning demographic characteristics, diagnostic and procedural details, radiographic pathology, and clinical course were abstracted from medical records. The primary end point was evidence of stable fixation and osseous union on either dynamic lateral radiographs or computed tomography (CT) imaging at most recent follow-up. Secondary end points included functional outcome as determined by Nurick scale and Neck disability index (NDI) at ≥ 1year postoperation, as well as perioperative morbidity and mortality at 30 days and 3 months. During the study period, 94 patients (mean age: 62 ± 18 years) underwent OC fixation with segmental screw-based constructs. The four fusion adjunct cohorts analyzed included local autograft alone (32%), ICBG (41%), BMP (14%), or a combination of ICBG and BMP (14%). Notably, demineralized bone matrix was also used in 61% of cases overall, but its use did not differ significantly among the four cohorts (p = 0.28). Median radiographic follow-up was 6 months postoperatively (range: 1.5-54 months). Clinical outcomes were assessed at a median postoperative follow-up of 45 months (range: 12-87 months). Overall, radiographic evidence of arthrodesis was present in 83% of patients assessed and was

  14. Research and application of absorbable screw in orthopedics: a clinical review comparing PDLLA screw with metal screw in patients with simple medial malleolus fracture

    Institute of Scientific and Technical Information of China (English)

    TANG Jin; HU Jin-feng; GUO Wei-chun; YU Ling; ZHAO Sheng-hao

    2013-01-01

    Objective:To observe the therapeutic effect of absorbable screw in medial malleolus fracture and discuss its clinical application in orthopedics.Methods:A total of 129 patients with simple medial malleolus fracture were studied.Among them,64 patients were treated with poly-D,L-lactic acid (PDLLA) absorbable screws,while the others were treated with metal screws.All the patients were followed up for 12-20 months (averaged 18.4 months) and the therapeutic effect was evaluated according to the American Orthopaedic Foot and Ankle Society clinical rating systems.Results:In absorbable screw group,we obtained excellent and good results in 62 cases (96.88%); in steel screw group,61 cases (93.85%) achieved excellent and good results.There was no significant difference between the two groups.Conclusion:In the treatment of malleolus fracture,absorbable screw can achieve the same result compared with metal screw fixation.Absorbable screw is preferred due to its advantages of safety,cleanliness and avoiding the removal procedure associated with metallic implants.

  15. Technical and clinical outcome of percutaneous CT fluoroscopy-guided screw placement in unstable injuries of the posterior pelvic ring

    Energy Technology Data Exchange (ETDEWEB)

    Strobl, Frederik F.; Haeussler, Sophia M.; Paprottka, Philipp M.; Hoffmann, Ralf-Thorsten; Reiser, Maximilian F.; Trumm, Christoph G. [Institute for Clinical Radiology, Munich (Germany); Pieske, Oliver [Ludwig-Maximilians-University Hospital Munich, Department of Trauma Surgery, Munich (Germany)

    2014-08-15

    To evaluate technical success, complications, and effective dose in patients undergoing CT fluoroscopy-guided iliosacral screw placement for the fixation of unstable posterior pelvic ring injuries. Our retrospective analysis includes all consecutive patients with vertical sacral fractures and/or injury of the iliosacral joint treated with CT fluoroscopy-guided screw placement in our department from 11/2005 to 03/2013. Interventions were carried out under general anesthesia and CT fluoroscopy (10-20 mAs; 120 kV; 16- or 128-row scanner, Siemens Healthcare, Erlangen, Germany). Technical outcome, major and minor complications, and effective patient dose were analyzed. We treated 99 consecutive patients (mean age 53.1 ± 21.7 years, 50 male, 49 female) with posterior pelvic ring instability with CT fluoroscopy-guided screw placement. Intervention was technically successful in all patients (n = 99). No major and one minor local complication occurred (1 %, secondary screw dislocation). General complications included three cases of death (3 %) due to pulmonary embolism (n = 1), hemorrhagic shock (n = 1), or cardiac event (n = 1) during a follow-up period of 30 days. General complications were not related to the intervention. Mean effective patient radiation dose per intervention was 12.28 mSv ± 7.25 mSv. Mean procedural time was 72.1 ± 37.4 min. CT fluoroscopy-guided screw placement for the treatment of posterior pelvic ring instabilities can be performed with high technical success and a low complication rate. This method provides excellent intrainterventional visualization of iliac and sacral bones, as well as the sacral neuroforamina for precise screw placement by applying an acceptable effective patient dose. (orig.)

  16. In vitro evaluation of force-expansion characteristics in a newly designed orthodontic expansion screw compared to conventional screws

    Directory of Open Access Journals (Sweden)

    Oshagh Morteza

    2009-01-01

    Full Text Available Objective : Expansion screws like Hyrax, Haas and other types, produce heavy interrupted forces which are unfavorable for dental movement and could be harmful to the tooth and periodontium. The other disadvantage of these screws is the need for patient cooperation for their regular activation. The purpose of this study was to design a screw and compare its force- expansion curve with other types. Materials and Methods : A new screw was designed and fabricated in the same dimension, with conventional types, with the ability of 8 mm expansion (Free wire length: 12 mm, initial compression: 4.5 mm, spring wire diameter: 0.4 mm, spring diameter: 3 mm, number of the coils: n0 ine, material: s0 tainless steel. In this in vitro study, the new screw was placed in an acrylic orthodontic appliance, and after mounting on a stone cast, the force-expansion curve was evaluated by a compression test machine and compared to other screws. Results : Force-expansion curve of designed screw had a flatter inclination compared to other screws. Generally it produced a light continuous force (two to 3.5 pounds for every 4 mm of expansion. Conclusion : In comparison with heavy and interrupted forces of other screws, the newly designed screw created light and continuous forces.

  17. [Fractures of carpal bones].

    Science.gov (United States)

    Lögters, T; Windolf, J

    2016-10-01

    Fractures of the carpal bones are uncommon. On standard radiographs fractures are often not recognized and a computed tomography (CT) scan is the diagnostic method of choice. The aim of treatment is to restore pain-free and full functioning of the hand. A distinction is made between stable and unstable carpal fractures. Stable non-displaced fractures can be treated conservatively. Unstable and displaced fractures have an increased risk of arthritis and non-union and should be stabilized by screws or k‑wires. If treated adequately, fractures of the carpal bones have a good prognosis. Unstable and dislocated fractures have an increased risk for non-union. The subsequent development of carpal collapse with arthrosis is a severe consequence of non-union, which has a heterogeneous prognosis.

  18. Regional alterations in long bone produced by internal fixation devices. Part I. 85Sr clearance

    International Nuclear Information System (INIS)

    We examined the effect of rigid plate application on the radiostrontium clearance of the intact canine femur at 6 months. We examined each of the component surgical steps. We calculated the clearance both for the whole bone and for each of the five transverse sections of the whole bone. Screw application, but not drilling, increased the clearance in the segment about the screw holes. Plate application produced an increase in the segment beneath the plate as well as around the screws and in the whole bone. These changes are accomplished not only by an absolute increase in clearance to the middle three segments, but by a relative diminution in clearance by the most proximal and distal segments. The histomorphometric changes in long bones following rigid plating may be accompanied by regional increases in bone blood flow

  19. Tissue reaction to implants of different metals: A study using guide wires in cannulated screws

    Directory of Open Access Journals (Sweden)

    DM Devine

    2009-10-01

    Full Text Available Cannulated screws, along with guide wires, are typically used for surgical fracture treatment in cancellous bone. Breakage or bending deformation of the guide wire is a clinical concern. Mechanically superior guide wires made of Co-Cr alloys such as MP35N and L605 may reduce the occurrence of mechanical failures when used in combination with conventional (316L stainless steel cannulated screws. However the possibility of galvanic or crevice corrosion and adverse tissue reaction, exists when using dissimilar materials, particularly in the event that a guide wire breaks, and remains in situ. Therefore, we designed an experiment to determine the tissue reaction to such an in vivo environment. Implant devices were designed to replicate a clinical situation where dissimilar metals can form a galvanic couple. Histological and SEM analyses were used to evaluate tissue response and corrosion of the implants. In this experiment, no adverse in vivo effects were detected from the use of dissimilar materials in a model of a broken guide wire in a cannulated screw.

  20. Missing Screw as a Rare Complication of Anterior Cervical Instrumentation

    Directory of Open Access Journals (Sweden)

    Yusuf Kurtuluş Duransoy

    2013-01-01

    Full Text Available Although anterior cervical arthrodesis is an effective procedure for the treatment of cervical disorders, the method has some complications. Here, we describe this rare complication of cervical instrumentation with a literature review. A 23-year-old male patient was operated for a C6-C7 dislocation. At postoperative month 10, he presented with hemoptysis and dysphagia. Cervical roentgenograms showed anterior migrations of one broken screw and a plate-locking screw at the C6 corpus. One screw was missing. We concluded that the missing screw had perforated the esophagus and had been eliminated spontaneously through the gastrointestinal tract. No screw should migrate. Even loose screws should be noted in follow-up X-ray studies. If such findings are detected, a second operation for revision should be considered as soon as possible to prevent potentially fatal complications.

  1. Iliosacral Screw Placement With Local Anesthesia Using C T Scan

    Directory of Open Access Journals (Sweden)

    Shahriar Kamrani R

    2003-07-01

    Full Text Available Ilio-sacral screw is a technique for posterior pelvic fixation. In spite of its benefits, it had not performed commonly in Iran because of its difficulties. We changed this technique to insert the screw under CT-Scan guide with lical anesthesia to increase image quality and decrease neurological complications and performed it in two patients. In both cases the screws were inserted in correct position without any complication."n"n 

  2. Missing Screw as a Rare Complication of Anterior Cervical Instrumentation

    OpenAIRE

    Yusuf Kurtuluş Duransoy; Mesut Mete; Baha Zengel; Mehmet Selçukı

    2013-01-01

    Although anterior cervical arthrodesis is an effective procedure for the treatment of cervical disorders, the method has some complications. Here, we describe this rare complication of cervical instrumentation with a literature review. A 23-year-old male patient was operated for a C6-C7 dislocation. At postoperative month 10, he presented with hemoptysis and dysphagia. Cervical roentgenograms showed anterior migrations of one broken screw and a plate-locking screw at the C6 corpus. One screw ...

  3. Abrasion of abutment screw coated with TiN

    OpenAIRE

    Jung, Seok-Won; Son, Mee-Kyoung; Chung, Chae-Heon; Kim, Hee-Jung

    2009-01-01

    STATEMENT OF PROBLEM Screw loosening has been a common complication and still reported frequently. PURPOSE The purpose of this study was to evaluate abrasion of the implant fixture and TiN coated abutment screw after repeated delivery and removal with universal measuring microscope. MATERIAL AND METHODS Implant systems used for this study were Osstem and 3i. Seven pairs of implant fixtures, abutments and abutment screws for each system were selected and all the fixtures were perpendicularly m...

  4. SCREW MIGRATION IN TOTAL KNEE ARTHROPLASTY: CLINICAL REPORT

    OpenAIRE

    Fonseca, Fernando; Tomé, José; Barreto, Manuel

    2015-01-01

    Complications from total knee arthroplasty caused by the implanted material are rare, with the exception of polyethylene wear. Descriptions of screw migration into the knee joint cavity are very rare. The authors report intra-articular migration of a polyethylene safety screw in a case of total knee arthroplasty, with sacrifice of the posterior cruciate ligament (TKA Performance; Biomet, Warsaw, IN, USA), which necessitated new surgery to remove the screw, replace the polyethylene insert and ...

  5. Discrete element modelling of screw conveyor-mixers

    Directory of Open Access Journals (Sweden)

    Jovanović Aca

    2015-01-01

    Full Text Available Screw conveyors are used extensively in food, plastics, mineral processing, agriculture and processing industries for elevating and/or transporting bulk materials over short to medium distances. Despite their apparent simplicity in design, the transportation action is very complex for design and constructors have tended to rely heavily on empirical performance data. Screw conveyor performance is affected by its operating conditions (such as: the rotational speed of the screw, the inclination of the screw conveyor, and its volumetric fill level. In this paper, horizontal, several single-pitch screw conveyors with some geometry variations in screw blade was investigated for mixing action during transport, using Discrete Element Method (DEM. The influence of geometry modifications on the performance of screw conveyor was examined, different screw designs were compared, and the effects of geometrical variations on mixing performances during transport were explored. During the transport, the particle tumbles down from the top of the helix to the next free surface and that segment of the path was used for auxiliary mixing action. The particle path is dramatically increased with the addition of three complementary helices oriented in the same direction as screw blades (1458.2 mm compared to 397.6 mm in case of single flight screw conveyor Transport route enlarges to 1764.4 mm, when installing helices oriented in the opposite direction from screw blades. By addition of straight line blade to single flight screw conveyor, the longest particle path is being reached: 2061.6 mm [Projekat Ministarstva nauke Republike Srbije, br. TR-31055

  6. Dynamic hip screw with locking side plate: a viable treatment option for intertrochanteric fracture

    Institute of Scientific and Technical Information of China (English)

    Nilesh Barwar; Sanjay Meena; Shashi Kant Aggarwal; Prashant Garhwal

    2014-01-01

    Objective:Dynamic hip screw (DHS) is recommended for the fixation of stable intertrochanteric fractures.Its postoperative cut-out rate ranges from 1% to 6%.In osteoporotic bone,normal screws in DHS blade provide less anchorage compared to locking screws.This study aims to compare DHS with locking side plate and conventional side plate.Methods:Fifty consecutive patients with intertrochanteric fractures were randomly allocated for fixation with a standard DHS (group A) and locking DHS (Combi plate,group B).We compared the clinical and radiological outcomes for the conventional DHS and locking DHS in intertrochanteric fractures.Functional outcome was evaluated using the Parker mobility score.Results:Coxa valga was found more frequently in group A than in group B (12% vs.0%,P=0.42).Coxa vara showed the same trend (12% vs.8%,P=0.81).Rate of restoration of postoperative neck-shaft angle within 20° of sound side was higher in group B (8% cases) than in group A (4% cases,P=0.98).The rate of anteversion angle restoration within 10° of sound side was also higher in group B (100% vs.88%,P=0.85).The average lag screw slippage in group A and group B was 3.2 mm and 4.2 mm,the average fracture union duration was 17.1 weeks and 16.4 weeks,and the mean Parker score was 5.6 and 5.8 respectively.Screw cut-out was seen in one patient in group A.No cut-out was seen in any of the patient in group B.No patient developed deep infection,avascular necrosis,deep vein thrombosis or any other significant complications.Conclusion:The present study demonstrated that treating intertrochanteric fracture with a locking DHS allows sound bone healing and is not associated with any major complications.Although this report is promising,it should be interpreted with caution because only a prospective study with a large sample size would allow definitive conclusion.

  7. Insertion torques influenced by bone density and surface roughness of HA–TiO{sub 2} coatings

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, T.; Chen, Y.; Nie, X., E-mail: xnie@uwindsor.ca

    2013-12-31

    Bio-ceramic TiO{sub 2} coatings containing calcium (Ca) and phosphorous (P) were deposited onto Ti–6Al–4V alloy screws using plasma electrolytic oxidation (PEO) processes in an alkaline electrolyte with hydroxyapatite (HA) suspension. Coating on each screw had different surface roughness and morphology. Insertion torque (IT) of the coated screws in low (10 pcf, pounds per cubic feet), medium–high (20 pcf), and high (40 pcf) density of artificial bones was measured in comparison with that of the uncoated and sandblasted screws having similar surface roughness. Higher insertion torques and final seating torques were obtained in the coated screws which may result in less micro-movement during the primary implantation stage and thus lower the risk of implant failure. Scanning electron microscopy (SEM) analysis indicated that all coatings still adhesively remained on the screw surfaces after inserted into the bones with different densities. The relationship between coefficient of friction and surface roughness was also addressed to better understand the results of insertion torque. It was found that a lower density bone (similar to aged bone) would need a surface-rougher coated screw to achieve a high torque while a high density bone can have a wide range of selections for surface roughness of the screw. - Highlights: • The insertion torque of PEO-coated screws is higher than machined and sandblasting implants. • Lower density bone needs a rougher coated implant to increase the insertion torque. • The composite HA–TiO{sub 2} coating could benefit dental implants in both primary and secondary stability stages.

  8. Central tarsal bone fracture in the border collie.

    Science.gov (United States)

    Guilliard, M

    2007-07-01

    Fracture of the plantar process of the central tarsal bone together with a dorsomedial displacement of the body of the bone was seen in six border collies. All injuries occurred during free exercise, with no extrinsic trauma. Three dogs had concomitant tarsal fractures. Primary treatment was by lag screwing the central tarsal bone to the fourth tarsal bone. All cases eventually made an excellent recovery. The superficial radiographic appearance was of a luxation of the bone as reported in a previous series, but appraisal of the radiographs showed evidence of fracture in all cases. A cadaver study to assess the mechanism of luxation showed that it is unlikely to occur naturally. PMID:17490445

  9. Bone Biopsy

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Bone Biopsy Bone biopsy uses a needle and imaging guidance ... limitations of Bone Biopsy? What is a Bone Biopsy? A bone biopsy is an image-guided procedure ...

  10. Bone Diseases

    Science.gov (United States)

    ... avoid smoking and drinking too much alcohol. Bone diseases can make bones easy to break. Different kinds ... break Osteogenesis imperfecta makes your bones brittle Paget's disease of bone makes them weak Bones can also ...

  11. Process and apparatus for optimizing screwing position for closure stud

    International Nuclear Information System (INIS)

    The stud is fixed to a screwing and unscrewing device. The vertical position and alignment of the stud with the axis of the threated hole is checking. The stud is descended into the hole and rotated in the unscrewing direction. After detection of the point of engagement, the stud is rotated in the screwing direction. When a gamming is detected the descent is stopped and the screwing device is positioned in a new position. When the screwing couple returns below the disconnection couple, the stud is rotated with a reduced speed and then with a normal speed until the end

  12. Hydrodynamic screws. Calculation and optimal design of Archimedean screws as a hydro-power machine; Wasserkraftschnecken. Berechnung und optimaler Entwurf von archimedischen Schnecken als Wasserkraftmaschine

    Energy Technology Data Exchange (ETDEWEB)

    Nuernbergk, Dirk M.

    2012-07-01

    The author of the contribution under consideration reports on the calculation and optimal design of Archimedes screw as a hydroelectric turbine screw. The main aspects of this contribution are: Field of application and definitions; injectivity; inflow and outflow; hydraulic losses; performance and efficiency; equipment components and plant efficiency; measurements at hydrodynamic screws; Design flow for a hydrodynamic screw.

  13. Evaluation of Posterolateral Lumbar Fusion in Sheep Using Mineral Scaffolds Seeded with Cultured Bone Marrow Cells

    OpenAIRE

    Cuenca-López, María D.; Andrades, José A.; Santiago Gómez; Plácido Zamora-Navas; Enrique Guerado; Nuria Rubio; Jerónimo Blanco; José Becerra

    2014-01-01

    The objective of this study is to investigate the efficacy of hybrid constructs in comparison to bone grafts (autograft and allograft) for posterolateral lumbar fusion (PLF) in sheep, instrumented with transpedicular screws and bars. Hybrid constructs using cultured bone marrow (BM) mesenchymal stem cells (MSCs) have shown promising results in several bone healing models. In particular, hybrid constructs made by calcium phosphate-enriched cells have had similar fusion rates to bone autografts...

  14. 椎弓根螺钉内固定材料置入并植骨融合后路矫正治疗重度僵硬性青少年特发性脊柱侧凸20例%Posterior correction using pedicle screw fixation combined with bone grafting and fusion for treatment of severe and rigid adolescent idiopathic scoliosis in 20 cases

    Institute of Scientific and Technical Information of China (English)

    臧危平; 刘祖德; 李展春; 冯宇; 张磊

    2008-01-01

    主弯平均Cobb角从术前的82°(75o~ 92o)矫正到31°(22°~37°),平均矫正率为62%.③双肩高度差及住院时间:术后脊柱侧位片均显示患者胸腰椎基本恢复正常后凸及前凸,平均双肩高度差为7.5 mm(0~11 mm),患者住院日为8~11 d, 平均9 d.④随访结果:所有患者均获术后4年随访,所有侧凸主弯矫正角度未发生丢失,固定节段全部融合,无断钉、断棒发生.结论:单纯后路椎弓根螺钉内固定材料置入并植骨融合术能有效治疗主弯在75o~92o,柔韧性≥ 20%的重度僵硬性青少年特发性脊柱侧凸.%BACKGROUND: Traditional anterior release followed by posterior correction and fusion is frequently used to treat severe and rigid adolescent idiopathic scoliosis, which is considered as Cobb angle of the major curve > 65° and flexibility < 34.5%; however, there are a great majority of complications. Whether isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion may provide better effects on severe and rigid adolescent idiopathic scoliosis needs to be further studied.OBJECTIVE: To evaluate isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion for the treatment of severe and rigid adolescent idiopathic scoliosis. DESIGN: Case analysis.SETTING: Department of Orthopaedics, Renji Hospital, Medical College of Shanghai Jiao Tong University.PARTICIPANTS: Twenty patients with severe and rigid adolescent idiopathic scoliosis, including 8 males and 12 females, were selected from Department of Orthopaedics, Renji Hospital, Medical College of Shanghai Jiaotong University from June 1999 to August 2005. They were 12-18 years old, and the mean age was 14.6 years. All patients were finally diagnosed as X-ray of whole spine. According to King-Moe criteria, patients were classified into type Ⅰ(n =4), type Ⅱ(n =6), type Ⅲ (n =5), type Ⅳ(n =3) and type Ⅴ(n =2). Before surgery, mean Cobb angle of the major curve was 82

  15. Minimally Invasive Spinal Arthrodesis in Osteoporotic Population Using a Cannulated and Fenestrated Augmented Screw: Technical Description and Clinical Experience

    Directory of Open Access Journals (Sweden)

    Alphonse Lubansu

    2012-01-01

    Full Text Available We describe a percutaneous or minimally invasive approach to apply an augmentation of pedicle fenestrated screws by injection of the PMMA bone cement through the implant and determine the safety and efficiency of this technique in a clinical series of 15 elderly osteoporotic patients. Clinical outcome and the function were assessed using respectively the Visual Analogue Scale (VAS score and the Oswestry Disability Index (ODI. Peri- and post-operative complications were monitored during a minimum of 2 years of follow-up. Radiographic follow-up was based on plain fluoroscopic control at 3, 6 and 12 months and every year. In this approach, four steps were considered with care: optimal positioning of the screws, correct alignment of the screw heads, waiting time before the injection of cement, fluoroscopic control of the cement injection. Using these precautions, only 2 minor complications occurred. VAS scores and ODI questionnaires showed a statistically significant improvement up to 13.3 months postoperatively. No radiological complications were observed. Based on this experience, PMMA augmentation technique through the novel fenestrated screws provided an effective and long lasting fixation in osteoporotic patients. Applying this procedure through percutaneous or minimally invasive approach under fluoroscopic control seems to be safe.

  16. Metaphyseal bone loss in revision knee arthroplasty.

    Science.gov (United States)

    Ponzio, Danielle Y; Austin, Matthew S

    2015-12-01

    The etiology of bone loss encountered during revision total knee arthroplasty (TKA) is often multifactorial and can include stress shielding, osteolysis, osteonecrosis, infection, mechanical loss due to a grossly loose implant, and iatrogenic loss at the time of implant resection. Selection of the reconstructive technique(s) to manage bone deficiency is determined by the location and magnitude of bone loss, ligament integrity, surgeon experience, and patient factors including the potential for additional revision, functional demand, and comorbidities. Smaller, contained defects are reliably managed with bone graft, cement augmented with screw fixation, or modular augments. Large metaphyseal defects require more extensive reconstruction such as impaction bone grafting with or without mesh augmentation, prosthetic augmentation, use of bulk structural allografts, or use of metaphyseal cones or sleeves. While each technique has advantages and disadvantages, the most optimal method for reconstruction of large metaphyseal bone defects during revision TKA is not clearly established. PMID:26362647

  17. A universal pedicle screw and V-rod system for lumbar isthmic spondylolysis: a retrospective analysis of 21 cases.

    Directory of Open Access Journals (Sweden)

    Xiong-sheng Chen

    Full Text Available OBJECTIVE: To investigate the surgical outcome of a universal pedicle screw-V rod system and isthmic bone grafting for isthmic spondylolysis. METHODS: Twenty-four patients with isthmic spondylolysis at L5 and grade 0-I spondylolisthesis (Meyerding classification received isthmic bone graft and stabilization using the universal pedicle screw-V rod system. Back pain was evaluated using the visual analog scale (VAS and time to bone healing, improvement in spondylolisthesis and intervertebral space height at L5/S1 and L4/L5 were assessed. RESULTS: Twenty-one patients were followed up for 24 months and included in the analysis. Back pain was markedly improved at 3 months postoperatively with a statistical difference in VAS scores compared with preoperative VAS scores (P<0.001. The VAS scores were 0 to 3 at 6 months postoperatively in all patients and no back pain was reported in all patients except 2 patients who complained of back pain after prolonged sitting. X-ray examination showed a bone graft healing time of 3 to 12 months. Grade I spondylolisthesis improved to grade 0 in 4 patients and no noticeable change was observed in the remaining 17 cases. The intervertebral space height at L5/S1 was statistically increased (P<0.05 while no statistically significant change was seen at L4/L5. There was no statistically significant difference in the ROM of the intervertebral disks of L5/S1 and L4/5 before and after surgery. CONCLUSIONS: The universal pedicle screw-V rod system and isthmic bone grafting directly repairs isthmic spondylolysis and reduces back pain, prevents anterior displacement of the diseased segment and maintains intervertebral space height, thus offering a promising alternative to current approaches for isthmic spondylolysis.

  18. Tibial inlay press-fit fixation versus interference screw in posterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Max Ettinger

    2013-11-01

    Full Text Available Reconstruction of the posterior cruciate ligament (PCL by a tibial press-fit fixation of the patellar tendon with an accessory bone plug is a promising approach because no foreign materials are required. Until today, there is no data about the biomechanical properties of such press-fit fixations. The aim of this study was to compare the biomechanical qualities of a bone plug tibial inlay technique with the commonly applied interference screw of patellar tendon PCL grafts. Twenty patellar tendons including a bone block were harvested from ten human cadavers. The grafts were implanted into twenty legs of adult German country pigs. In group P, the grafts were attached in a press-fit technique with accessory bone plug. In group S, the grafts were fixed with an interference screw. Each group consisted of 10 specimens. The constructs were biomechanically analyzed in cyclic loading between 60 and 250 N for 500 cycles recording elongation. Finally, ultimate failure load and failure mode were analyzed. Ultimate failure load was 598.6±36.3 N in group P and 653.7±39.8 N in group S (not significant, P>0.05. Elongation during cyclic loading between the 1st and the 20th cycle was 3.4±0.9 mm for group P and 3.1±1 mm for group S. Between the 20th and the 500th cycle, elongation was 4.2±2.3 mm in group P and 2.5±0.9 mm in group S (not significant, P>0.05. This is the first study investigating the biomechanical properties of tibial press-fit fixation of the patellar tendon with accessory bone plug in posterior cruciate ligament reconstruction. The implant-free tibial inlay technique shows equal biomechanical characteristics compared to an interference screw fixation. Further in vivo studies are desirable to compare the biological behavior and clinical relevance of this fixation device.

  19. 下颈椎经关节螺钉联合侧块或椎弓根螺钉固定的效果%The effect of trausarticular screws combined with lateral mass screws or pedicle screws fixation in the lower cervical spine

    Institute of Scientific and Technical Information of China (English)

    马维虎; 刘观燚; 徐荣明; 孙韶华; 胡勇; 赵刘军; 蒋伟宇; 顾勇杰

    2009-01-01

    目的 探讨在下颈椎经颈后正中入路应用经关节螺钉联合侧块螺钉或椎弓根螺钉行内固定治疗的固定效果.方法 2003年2月至2007年10月,对22例患者通过后路应用经关节螺钉联合侧块螺钉或椎弓根螺钉行内固定治疗,男14例,女8例;年龄24~73岁,平均43岁.其中下颈椎创伤性骨折脱位13例,颈椎后纵韧带骨化症4例,颈椎管狭窄伴Ⅱ型齿突骨折1例,颈椎间盘突出伴椎管狭窄4例.结果 共置入经关节螺钉45枚,其中C4,5 2枚,C5,639枚,C6,74枚;共置入侧块螺钉12枚,C3、C4各6枚;共置入椎弓根螺钉41枚,其中C24枚,C32枚,C46枚,C721枚,T18枚.术中所有螺钉均成功置入,未出现椎动脉、神经根和脊髓损伤等置钉相关并发症.22例患者均获随访,随访时间10个月~3年8个月,平均17个月.植骨融合时间3~5个月,平均3.5个月.术后发现1例患者的2枚经关节螺钉松动,部分脱出.经加强颈托制动,术后4个月获得融合.结论 通过后路固定下颈椎时,采用经关节螺钉联合侧块螺钉或椎弓根螺钉固定,均可取得较好的固定效果.%Objective To discuss the effect of transarticular screws combined with lateral mass screws or pedicle screws through posterior approach in the lower cervical spine. Methods From February 2003 to October 2007, 22 patients were treated using transarticular screws internal fixation combined with lateral mass screws or pedicle screws in Axis plating system and Vertex system. There were cervical fracture and dislocation in 13 patients, ossification of the posterior longitudinal ligament in 4, cervical canal stenosis associated with dentoid process fracture in 1, and cervical disc herniation associated with cervical stenosis in 4 patients. Lamina or facet bone grafting were used to achieve a long-term stability, with decompression and anterior approach or not. The starting point for screw insertion was located 1 mm medial to the midpoint of the lateral mass and

  20. Quantitative Anatomy of C7 Vertebra in Southern Chinese for Insertion of Lateral Mass Screws and Pedicle Screws

    Science.gov (United States)

    Chan, Chi Hin; Wong, Kam Kwong; Wong, Wing Cheung

    2016-01-01

    Study Design Retrospective study. Purpose To analyze the quantitative anatomy of C7 vertebra for insertion of lateral mass screws and pedicle screws in Southern Chinese patients. Overview of Literature C7 lateral mass is smaller when compared to other subaxial cervical levels, which limits the length of lateral mass screws that can be used. Some studies have suggested pedicle screws for better fixation. But, this option is limited by the narrow pedicle width. Methods We have obtained computed tomography (CT) cervical spine data in 0.625 mm slices from our radiology department. The patients were adults. CTs were from May to August, 2015. The lateral mass screw length was measured using Margerl's technique and pedicle width and pedicle screw trajectory were determined in three-dimensional reformated images. Results CT scans of cervical spines of 94 patients were obtained and 188 lateral masses and pedicles of C7 vertebrae were measured. The mean lateral mass screw length was 13.2 mm (standard deviation [SD] 1.6 mm), mean outer pedicle width was 5.9 mm (SD 1.0 mm) and mean pedicle screw trajectory was 29.4 degrees (SD 3.6 degrees). Most (91.0%) of the pedicles had an outer diameter ≥4.5 mm. Conclusions The mean lateral mass screw length was longer when compared with other similar studies, while the mean outer pedicle width was narrower. Nearly 10% of the pedicles were unable to accommodate 3.5 mm screws. These findings favor the use of lateral mass screws to provide a safe and stable fixation for C7 vertebrae in Southern Chinese patients, while the final choice of fixation method should only be confirmed after careful preoperative planning with CT scan. PMID:27559451

  1. KINEMATICS OF 3-DOF PYRAMID MANIPULATOR BY PRINCIPAL SCREWS

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Kinematics of a 3-RPS parallel pyramid manipulator are investigated by principal screw. Firstly, the principal screws are identified by quadric degeneration. The planar conics representing the relations between the pitches and the three linear inputs are described, and the three-dimensional distribution of the axes of all the twists is illustrated. Finally, a numerical example is given successfully.

  2. Determination of the of rate cross slip of screw dislocations

    DEFF Research Database (Denmark)

    Vegge, Tejs; Rasmussen, Torben; Leffers, Torben;

    2000-01-01

    The rate for cross slip of screw dislocations during annihilation of screw dipoles in copper is determined by molecular dynamics simulations. The temperature dependence of the rate is seen to obey an Arrhenius behavior in the investigated temperature range: 225-375 K. The activation energy...

  3. OPTIMAL DISTAL SCREW ALIGNMENT IN THE GAMMA NAIL

    Institute of Scientific and Technical Information of China (English)

    Ching-KongChao; Chun-ChingHsiao; Po-QuangChen

    2002-01-01

    The effect of stress distribution due to the changes of the distal screw alignment in relation to the Gamma nail and the femoral shaft is thoroughly studied in this paper. Failure of the Gamma nail composite occurs through the cranial aperture of the distal screws and the insertion hole for the lag screw due to nonunion, delayed-union and continued weight-bearing. A three-dimensional finite element model was used to study the fractured femur, the Gamma nail, the lag screw and the distal locking screws. The first and the second distal screws were inserted into the Gamma nail in four different configurations. We found that the stress of the Gamma nail composite was substantially reduced with the two screws configured in the anterior to posterior direction. This alignment can bear greater loading in the more demanding fracture types. In the subtrochanteric fracture or the comminuted fractures at the proximal femur, the optimal alignment of the two distal screws was in the anterior to posterior direction.

  4. Electromagnetic Lead Screw for Potential Wave Energy Application

    DEFF Research Database (Denmark)

    Lu, Kaiyuan; Wu, Weimin

    2014-01-01

    This paper presents a new type electromagnetic lead screw (EMLS) intended for wave energy application. Similar to the mechanical lead screw, this electromagnetic version can transfer slow linear motion to high-rotational motion, offering gearing effects. Compared with the existing pure magnetic...

  5. Increasing pedicle screw anchoring in the osteoporotic spine by cement injection through the implant. Technical note and report of three cases.

    Science.gov (United States)

    Fransen, Patrick

    2007-09-01

    Instrumented spinal fusion in patients with osteoporosis is challenging because of the poor bone quality and is complicated by an elevated risk of delayed hardware failure. The author treated two patients presenting with severe osteoporosis, spinal stenosis, and degenerative spondylolisthesis. He performed decompressive laminectomy, posterolateral fusion, and pedicle screw (PS) fixation involving screws with side openings that allow cement to be injected through the implant. The cement injection was conducted under fluoroscopic control without complications. Although this technique needs validation in a larger population of patients, the author believes that the injection of cement through these PSs can be performed safely in carefully selected patients. This technique creates not only a vertebroplasty-like effect that strengthens the vertebral body but also provides the additional stability afforded by the immediate anchoring of the screw, which may allow a shorter-length construct, save mobile segments, and finally reduce the risk of hardware failure. PMID:17877276

  6. Better Axial Stiffness of a Bicortical Screw Construct Compared to a Cable Construct for Comminuted Vancouver B1 Proximal Femoral Fractures.

    Science.gov (United States)

    Griffiths, Jamie T; Taheri, Arash; Day, Robert E; Yates, Piers J

    2015-12-01

    The aim of this study was to biomechanically evaluate the Locking attachment plate (LAP) construct in comparison to a Cable plate construct, for the fixation of periprosthetic femoral fractures after cemented total hip arthroplasty. Each construct incorporated a locking compression plate with bi-cortical locking screws for distal fixation. In the Cable construct, 2 cables and 2 uni-cortical locking screws were used for proximal fixation. In the LAP construct, the cables were replaced by a LAP with 4 bi-cortical locking screws. The LAP construct was significantly stiffer than the cable construct under axial load with a bone gap (P=0.01). The LAP construct offers better axial stiffness compared to the cable construct in the fixation of comminuted Vancouver B1 proximal femoral fractures.

  7. The Analysis of Soil Resistance During Screw Displacement Pile Installation

    Science.gov (United States)

    Krasinski, Adam

    2015-02-01

    The application of screw displacement piles (SDP) is still increasing due to their high efficiency and many advantages. However, one technological problem is a serious disadvantage of those piles. It relates to the generation of very high soil resistance during screw auger penetration, especially when piles are installed in non-cohesive soils. In many situations this problem causes difficulties in creating piles of designed length and diameter. It is necessary to find a proper method for prediction of soil resistance during screw pile installation. The analysis of screw resistances based on model and field tests is presented in the paper. The investigations were carried out as part of research project, financed by the Polish Ministry of Science and Higher Education. As a result of tests and analyses the empirical method for prediction of rotation resistance (torque) during screw auger penetration in non-cohesive subsoil based on CPT is proposed.

  8. The Analysis of Soil Resistance During Screw Displacement Pile Installation

    Directory of Open Access Journals (Sweden)

    Krasinski Adam

    2015-02-01

    Full Text Available The application of screw displacement piles (SDP is still increasing due to their high efficiency and many advantages. However, one technological problem is a serious disadvantage of those piles. It relates to the generation of very high soil resistance during screw auger penetration, especially when piles are installed in non-cohesive soils. In many situations this problem causes difficulties in creating piles of designed length and diameter. It is necessary to find a proper method for prediction of soil resistance during screw pile installation. The analysis of screw resistances based on model and field tests is presented in the paper. The investigations were carried out as part of research project, financed by the Polish Ministry of Science and Higher Education. As a result of tests and analyses the empirical method for prediction of rotation resistance (torque during screw auger penetration in non-cohesive subsoil based on CPT is proposed.

  9. Twin screw granulation - review of current progress.

    Science.gov (United States)

    Thompson, M R

    2015-01-01

    Twin screw granulation (TSG) is a new process of interest to the pharmaceutical community that can continuously wet granulate powders, doing so at lower liquid concentrations and with better product consistency than found by a high shear batch mixer. A considerable body of research has evolved over the short time since this process was introduced but generally with little comparison of results. A certain degree of confidence has been developed through these studies related to how process variables and many attributes of machinery configuration will affect granulation but some major challenges still lay ahead related to scalability, variations in the processing regimes related to degree of channel fill and the impact of wetting and granulation of complex powder formulations. This review examines the current literature for wet granulation processes studied in twin screw extrusion machinery, summarizing the influences of operational and system parameters affecting granule properties as well as strives to provide some practical observations to newly interested users of the technique. PMID:25402966

  10. Supermassive screwed cosmic string in dilaton gravity

    Energy Technology Data Exchange (ETDEWEB)

    Bezerra, V B [Departamento de Fisica, Universidade Federal da ParaIba, 58059-970, Joao Pessoa, PB (Brazil); Ferreira, Cristine N [Nucleo de Fisica, Centro Federal de Educacao Tecnologica de Campos, Rua Dr Siqueira, 273-Parque Dom Bosco, 28030-130, Campos dos Goytacazes, RJ (Brazil); Cuesta, H J Mosquera [Instituto de Cosmologia, Relatividade e AstrofIsica (ICRA-BR), Centro Brasileiro de Pesquisas Fisicas, Rua Dr Xavier Sigaud 150, Urca 22290-180, Rio de Janeiro, RJ (Brazil)

    2006-06-21

    The early universe might have undergone phase transitions at energy scales much higher than the one corresponding to the grand unified theories (GUT) scales. At these higher energy scales, the transition at which gravity separated from all other interactions, the so-called Planck era, more massive strings called supermassive cosmic strings could have been produced, with energy of about 10{sup 19} GeV. The dynamics of strings formed with this energy scale cannot be described by means of the weak-field approximation, as in the standard procedure for ordinary GUT cosmic strings. As suggested by string theories, at this extreme energy, gravity may be transmitted by some kind of scalar field (usually called the dilaton) in addition to the tensor field of Einstein's theory of gravity. It is then permissible to tackle the issue regarding the dynamics of supermassive cosmic strings within this framework. With this aim, we obtain the gravitational field of a supermassive screwed cosmic string in a scalar-tensor theory of gravity. We show that for the supermassive configuration, exact solutions of scalar-tensor screwed cosmic strings can be found in connection with the Bogomol'nyi limit. We show that the generalization of Bogomol'nyi arguments to the Brans-Dicke theory is possible when torsion is present and we obtain an exact solution in this supermassive regime, with the dilaton solution obtained by consistency with internal constraints.

  11. Minimal access direct spondylolysis repair using a pedicle screw-rod system: a case series

    Directory of Open Access Journals (Sweden)

    Mohi Eldin Mohamed

    2012-11-01

    Full Text Available Abstract Introduction Symptomatic spondylolysis is always challenging to treat because the pars defect causing the instability needs to be stabilized while segmental fusion needs to be avoided. Direct repair of the pars defect is ideal in cases of spondylolysis in which posterior decompression is not necessary. We report clinical results using segmental pedicle-screw-rod fixation with bone grafting in patients with symptomatic spondylolysis, a modification of a technique first reported by Tokuhashi and Matsuzaki in 1996. We also describe the surgical technique, assess the fusion and analyze the outcomes of patients. Case presentation At Cairo University Hospital, eight out of twelve Egyptian patients’ acute pars fractures healed after conservative management. Of those, two young male patients underwent an operative procedure for chronic low back pain secondary to pars defect. Case one was a 25-year-old Egyptian man who presented with a one-year history of axial low back pain, not radiating to the lower limbs, after falling from height. Case two was a 29-year-old Egyptian man who presented with a one-year history of axial low back pain and a one-year history of mild claudication and infrequent radiation to the leg, never below the knee. Utilizing a standardized mini-access fluoroscopically-guided surgical protocol, fixation was established with two titanium pedicle screws place into both pedicles, at the same level as the pars defect, without violating the facet joint. The cleaned pars defect was grafted; a curved titanium rod was then passed under the base of the spinous process of the affected vertebra, bridging the loose fragment, and attached to the pedicle screw heads, to uplift the spinal process, followed by compression of the defect. The patients were discharged three days after the procedure, with successful fusion at one-year follow-up. No rod breakage or implant-related complications were reported. Conclusions Where there is no

  12. Evaluation of a prototype correction algorithm to reduce metal artefacts in flat detector computed tomography of scaphoid fixation screws

    Energy Technology Data Exchange (ETDEWEB)

    Filli, Lukas; Finkenstaedt, Tim; Andreisek, Gustav; Guggenberger, Roman [University Hospital of Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); Marcon, Magda [University Hospital of Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); University of Udine, Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, Udine (Italy); Scholz, Bernhard [Imaging and Therapy Division, Siemens AG, Healthcare Sector, Forchheim (Germany); Calcagni, Maurizio [University Hospital of Zurich, Division of Plastic Surgery and Hand Surgery, Zurich (Switzerland)

    2014-12-15

    The aim of this study was to evaluate a prototype correction algorithm to reduce metal artefacts in flat detector computed tomography (FDCT) of scaphoid fixation screws. FDCT has gained interest in imaging small anatomic structures of the appendicular skeleton. Angiographic C-arm systems with flat detectors allow fluoroscopy and FDCT imaging in a one-stop procedure emphasizing their role as an ideal intraoperative imaging tool. However, FDCT imaging can be significantly impaired by artefacts induced by fixation screws. Following ethical board approval, commercially available scaphoid fixation screws were inserted into six cadaveric specimens in order to fix artificially induced scaphoid fractures. FDCT images corrected with the algorithm were compared to uncorrected images both quantitatively and qualitatively by two independent radiologists in terms of artefacts, screw contour, fracture line visibility, bone visibility, and soft tissue definition. Normal distribution of variables was evaluated using the Kolmogorov-Smirnov test. In case of normal distribution, quantitative variables were compared using paired Student's t tests. The Wilcoxon signed-rank test was used for quantitative variables without normal distribution and all qualitative variables. A p value of < 0.05 was considered to indicate statistically significant differences. Metal artefacts were significantly reduced by the correction algorithm (p < 0.001), and the fracture line was more clearly defined (p < 0.01). The inter-observer reliability was ''almost perfect'' (intra-class correlation coefficient 0.85, p < 0.001). The prototype correction algorithm in FDCT for metal artefacts induced by scaphoid fixation screws may facilitate intra- and postoperative follow-up imaging. (orig.)

  13. Painful knee joint after ACL reconstruction using biodegradable interference screws- SPECT/CT a valuable diagnostic tool? A case report

    Directory of Open Access Journals (Sweden)

    Hirschmann Michael T

    2010-09-01

    Full Text Available Abstract With the presented case we strive to introduce combined single photon emission computerized tomography and conventional computer tomography (SPECT/CT as new diagnostic imaging modality and illustrate the possible clinical value in patients after ACL reconstruction. We report the case of a painful knee due to a foreign body reaction and delayed degradation of the biodegradable interference screws after ACL reconstruction. The MRI showed an intact ACL graft, a possible tibial cyclops lesion and a patella infera. There was no increased fluid collection within the bone tunnels. The 99mTc-HDP-SPECT/CT clearly identified a highly increased tracer uptake around and within the tibial and femoral tunnels and the patellofemoral joint. On 3D-CT out of the SPECT/CT data the femoral graft attachment was shallow (50% along the Blumensaat's line and high in the notch. At revision arthroscopy a diffuse hypertrophy of the synovium, scarring of the Hoffa fat pad and a cyclops lesion of the former ACL graft was found. The interference screws were partially degraded and under palpation and pressure a grey fluid-like substance drained into the joint. The interference screws and the ACL graft were removed and an arthrolysis performed. In the case presented it was most likely a combination of improper graft placement, delayed degradation of the interference screws and unknown biological factors. The too shallow and high ACL graft placement might have led to roof impingement, chronic intraarticular inflammation and hence the delayed degradation of the screws. SPECT/CT has facilitated the establishment of diagnosis, process of decision making and further treatment in patients with knee pain after ACL reconstruction. From the combination of structural (tunnel position in 3D-CT and metabolic information (tracer uptake in SPECT/CT the patient's cause of the pain was established.

  14. Nanoscale characterization of bone-implant interface and biomechanical modulation of bone ingrowth

    International Nuclear Information System (INIS)

    Bone-implant interface is characterized by an array of cells and macromolecules. This study investigated the nanomechancial properties of bone-implant interface using atomic force microscopy in vitro, and the mechanical modulation of implant bone ingrowth in vivo using bone histomorphometry. Upon harvest of screw-type titanium implants placed in vivo in the rabbit maxilla and proximal femur for 4 weeks, nanoindentation was performed in the bone-implant interface at 60-μm intervals radially from the implant surface. The average Young's Moduli (E) of the maxillary bone-implant interface was 1.13 ± 0.27 MPa, lacking significant differences at all intervals. In contrast, an increasing gradient of E was observed radially from the femur bone-implant interface: 0.87 ± 0.25 MPa to 2.24 ± 0.69 MPa, representing significant differences among several 60-μm intervals. In a separate experiment, bone healing was allowed for 6 weeks for proximal femur implants. The right femoral implant received axial cyclic loading at 200 mN and 1 Hz for 10 min/d over 12 days, whereas the left femoral implant served as control. Cyclic loading induced significantly higher bone volume, osteoblast numbers per endocortical bone surface, mineral apposition rate, and bone formation rate than controls. These data demonstrate nanoscale and microscale characterizations of bone-implant interface, and mechanical modulation of bone ingrowth surrounding titanium implants

  15. Nanoscale characterization of bone-implant interface and biomechanical modulation of bone ingrowth

    Energy Technology Data Exchange (ETDEWEB)

    Clark, Paul A. [Tissue Engineering Laboratory MC 841, Departments of Anatomy and Cell Biology, Bioengineering, and Orthodontics, University of Illinois at Chicago, Chicago, 801 South Paulina Street, Illinois 60612 (United States)]. E-mail: pclark4@gmail.com; Clark, Andrew M. [Tissue Engineering Laboratory MC 841, Departments of Anatomy and Cell Biology, Bioengineering, and Orthodontics, University of Illinois at Chicago, Chicago, 801 South Paulina Street, Illinois 60612 (United States); Rodriguez, Anthony [Tissue Engineering Laboratory MC 841, Departments of Anatomy and Cell Biology, Bioengineering, and Orthodontics, University of Illinois at Chicago, Chicago, 801 South Paulina Street, Illinois 60612 (United States); Hussain, Mohammad A. [Tissue Engineering Laboratory MC 841, Departments of Anatomy and Cell Biology, Bioengineering, and Orthodontics, University of Illinois at Chicago, Chicago, 801 South Paulina Street, Illinois 60612 (United States); Mao, Jeremy J. [Tissue Engineering Laboratory MC 841, Departments of Anatomy and Cell Biology, Bioengineering, and Orthodontics, University of Illinois at Chicago, Chicago, 801 South Paulina Street, Illinois 60612 (United States)]. E-mail: jmao2@uic.edu

    2007-04-15

    Bone-implant interface is characterized by an array of cells and macromolecules. This study investigated the nanomechancial properties of bone-implant interface using atomic force microscopy in vitro, and the mechanical modulation of implant bone ingrowth in vivo using bone histomorphometry. Upon harvest of screw-type titanium implants placed in vivo in the rabbit maxilla and proximal femur for 4 weeks, nanoindentation was performed in the bone-implant interface at 60-{mu}m intervals radially from the implant surface. The average Young's Moduli (E) of the maxillary bone-implant interface was 1.13 {+-} 0.27 MPa, lacking significant differences at all intervals. In contrast, an increasing gradient of E was observed radially from the femur bone-implant interface: 0.87 {+-} 0.25 MPa to 2.24 {+-} 0.69 MPa, representing significant differences among several 60-{mu}m intervals. In a separate experiment, bone healing was allowed for 6 weeks for proximal femur implants. The right femoral implant received axial cyclic loading at 200 mN and 1 Hz for 10 min/d over 12 days, whereas the left femoral implant served as control. Cyclic loading induced significantly higher bone volume, osteoblast numbers per endocortical bone surface, mineral apposition rate, and bone formation rate than controls. These data demonstrate nanoscale and microscale characterizations of bone-implant interface, and mechanical modulation of bone ingrowth surrounding titanium implants.

  16. Bone Grafts

    Science.gov (United States)

    ... repair and rebuild diseased bones in your hips, knees, spine, and sometimes other bones and joints. Grafts can also repair bone loss caused by some types of fractures or cancers. Once your body accepts the bone ...

  17. A finite element analysis of the pelvic reconstruction using fibular transplantation fixed with four different rod-screw systems after transplantation fixed with four different rod-screw systems after type Ⅰ resection

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background The pelvis often needs to be reconstructed after bone tumor resection.A major challenge here for the orthopedic surgeons is to choose a method that gives the best performance which depends upon its biomechanical properties.In this study,a 3-dimensional finite element analysis(FEA)was used to analyze the biomechanical properties of reconstructed pelvis using fibula transplant fixed by four commonly used rod-screw systems.Methods A total pelvic finite-element model including the lumbar-sacral spine and proximal femur was constructed based on the geometry of CT image from a healthy volunteer.Three-dimensional finite element models of different implants including fibula,rod and screw were simulated using ways of solid modeling.Then various reconstructed finite element models were assembled with different finite element implant model and type Ⅰ resected pelvic finite element model.The load of 500 N was imposed vertically onto the superior surface of L3 vertebral body,and the pelvis was fixed in bilateral leg standing positions.FEA was performed to account for the stress distribution on the bones and implants.The pelvis displacement of the different rod-screw fixation methods and the maximum equivalent stress(max EQV)on all nodes and element were figured out to evaluate the advantages and disadvantages of different reconstructive methods.Results Stress concentration in the fibula transplant was extremely high in the reconstructed pelvis,but could be substantially decreased by internal fixation,which partially transferred the stress from the fibula to the rod-screw systems.High stress concentration was also found in the implants,especially in the connection sites between screw and rod.Among the four methods of fixation,a double rod system with L5-S1 pedicle and ilium screws(L5-S1 HR)produced the best performance:least stress concentrations and least total displacement.Conclusion According to the stability and stress concentration,the method of L5-S1 HR

  18. Pedicle screw fixation for thoracolumbar fracture with spinal cord injury:a comparison of the selective injury segment and the whole bone graft fusion%椎弓根置钉修复胸腰椎骨折合并脊髓损伤:选择性损伤节段及全部固定节段植骨融合的比较

    Institute of Scientific and Technical Information of China (English)

    史晓林; 张昊; 刘磊; 史晓东; 金晓宁; 刘清阁; 袁伟东

    2016-01-01

    BACKGROUND:Spinal canal decompression is needed in posterior pedicle screw fixation surgery for thoracolumbar burst fractures combine with spinal cord injury. The structure of posterior spine is often damaged. The posterolateral bone fusion in al fixed segment is stil the main surgery. In order to further reduce fusion segment and maintain motor unit, it is necessary to perform selective segmental bone graft fusion during fixation and decompression. OBJECTIVE: To discuss the advantages of selective posterolateral vertebral fusion for thoracolumbar fracture with spinal injury through comparing with posterolateral vertebral fusion. METHODS: Data of 83 thoracolumbar burst fracture cases, who received posterior lumbar decompression and short segment fixation with pedicle screws and bone graft through injured vertebra from January 2006 to July 2013, were analyzed retrospectively. According to fusion segments, above patients were divided into selective posterolateral vertebral fusion group (n=42) and the whole posterolateral vertebral fusion group (n=41). Perioperative index, internal fixation, vertebral height loss rate, Cobb angle, spinal nerve recovery and Oswestry Disability Index were compared between the two groups. RESULTS AND CONCLUSION:(1) Al cases were folowed up for 25-32 months. (2) There was no statistical significance in operation time, intraoperative blood loss and ambulation time between the two groups (P > 0.05). Postoperative drainage volume was less in the selective posterolateral vertebral fusion group than in the whole posterolateral vertebral fusion group (P 0.05). (4) There was no significant difference in fusion rate at 6 months after treatment between the two groups (P > 0.05). Fusion was achieved in both groups before removal of the fixator. (5) Spinal nerve recovery was found after treatment in both groups. No significant difference in Oswestry Disability Index was detected in final folow-up (P > 0.05). (6) Results verified that compared with

  19. Clinical and radiological studies upon a combined method for guided bone regeneration in experimental mandibular defects in dogs - a preliminary communication

    International Nuclear Information System (INIS)

    The treated bone defects were compared clinically and radiologically. After a 3-month period of survey, the best results were obtained in the group treated with partially demineralized bone matrix, enzymatically processed and lyophilized dura mater and mucoperiosteal flap. The placement of titanium screw dental implants did not impair the guided bone regeneration, that was confirmed by their good osteointegration

  20. Bone within a bone

    Energy Technology Data Exchange (ETDEWEB)

    Williams, H.J.; Davies, A.M. E-mail: wendy.turner@roh.nhs.uk; Chapman, S

    2004-02-01

    The 'bone within a bone' appearance is a well-recognized radiological term with a variety of causes. It is important to recognize this appearance and also to be aware of the differential diagnosis. A number of common conditions infrequently cause this appearance. Other causes are rare and some remain primarily of historical interest, as they are no longer encountered in clinical practice. In this review we illustrate some of the conditions that can give the bone within a bone appearance and discuss the physiological and pathological aetiology of each where known.

  1. Design and fabrication of a low-frequency (1-3 MHz) ultrasound transducer for accurate placement of screw implants in the spine

    Science.gov (United States)

    Manbachi, Amir; Lee, Mike; Foster, F. Stuart; Ginsberg, Howard J.; Cobbold, Richard S. C.

    2014-03-01

    In 2012 approximately 800,000 spinal fusion surgeries were performed in the United States, requiring the insertion of screws into the pedicles. Their exact placement is critical and made complex due to limited visibility of the spine, continuous bleeding in the exposed regions, and variability in morphologies. The alarmingly high rate of screw misplacements (up to 20%) reported in the literature is of major concern since such misplacements can place the surrounding vital structures at risk. A potential guidance method for determining the best screw trajectory is by the use of real-time ultrasound imaging similar to that used for intravascular imaging. An endovascular transducer could be inserted into the pedicle to image the anatomy from within and identify bone boundaries. A major challenge of imaging within bone is high signal attenuation. The rapid increase of attenuation with frequency requires much lower frequencies (1-3 MHz) than those used in intravascular imaging. This study describes the custom design and fabrication of 2 MHz ultrasound probes (3.5 mm diameter/ 11 Fr) for pedicle screw guidance. Three transducer designs are explored to provide improved sensitivity and signal to noise ratio, compared to the previously tested transducer within the pedicle. Experimental measurements are compared with the results obtained using various simulation tools. The work reported in this paper represents the first stage in our ultimate goal of developing a 32- element phased array that is capable of generating a radial B-mode image.

  2. Experiments on screw-pinch plasmas with elongated cross section

    International Nuclear Information System (INIS)

    In this thesis experiments are described carried out with SPICA II, a toroidal screw-pinch plasma device. this device is the last one in a series of plasma machines of the toroidal screw-pinch differing from its predecessor in its race-track shaped section. In devices of the type toroidal screw-pinch stable confinement is possible of plasmas with larger β values than in a tokamak discharge. In a pinch the plasma is screwed up, during the formation, in such a way that in a relatively small volume a plasma is formated with a high pressure. During the screwing up the plasma is heated by shock heating as well as adiabatic compression. With the modified snowplow model the density and temperature after the formation can be calculated, starting from the initial conditions. When all ions arrive into the plasma column, the density in the column is determined by the volume compression. First purpose of the experiments was to find a stable discharge. Subsequently discharges have been made with a high as possible β in order to investigate at which maximum β it is possible to confine screw-pinch plasmas stably. When these had been found, the nature and importance could be investigated of the processes following which the screw-pinch plasma looses its energy. (author), 75 res.; 95 figs.; 8 tabs

  3. Engineering Aspects of Single- and Twin-screw Extrusion-cooking of Biopolymers

    NARCIS (Netherlands)

    Zuilichem, D.J. van; Stolp, W.; Janssen, L.P.B.M.

    1983-01-01

    A survey is given of the properties of single- and twin-screw extruders. The influence on the design of the different leakage gaps existing in co-rotating, counter-rotating, self-wiping, twin-screw extruders and single-screw equipment is discussed. The mixing effects in single- and twin-screw equipm

  4. Test Research on Special Sucker Rod for Screw Pump

    Institute of Scientific and Technical Information of China (English)

    Zhang Mingyi; Chen Mingzhan; Li Zhi

    2006-01-01

    @@ According to the statistics of straight thread sucker rods' application in screw pump in Daqing Oilfield before2000, the proportion of sucker rods' yearly breakaway reached to 41.6%, taking up 70% of the total wells that were checked. Thus it can be seen that the rods breakaway problem was becoming the main barrier restricting screw pump large-scale population and application. Since then,the development work on the special sucker rods for screw pump had been carried on. Through the analysis on the failure position and failure form of the sucker rods',the following conclusions arepresented:

  5. Noninvasive method for retrieval of broken dental implant abutment screw

    Directory of Open Access Journals (Sweden)

    Jagadish Reddy Gooty

    2014-01-01

    Full Text Available Dental implants made of titanium for replacement of missing teeth are widely used because of ease of technical procedure and high success rate, but are not free of complications and may fail. Fracturing of the prosthetic screw continues to be a problem in restorative practice and great challenge to remove the fractured screw conservatively. This case report describes and demonstrates the technique of using an ultrasonic scaler in the removal of the fracture screw fragment as a noninvasive method without damaging the hex of implants.

  6. A power recirculating test rig for ball screw endurance tests

    Directory of Open Access Journals (Sweden)

    Giberti Hermes

    2016-01-01

    Full Text Available A conceptual design of an innovative test rig for endurance tests of ball screws is presented in this paper. The test rig layout is based on the power recirculating principle and it also allows to overtake the main critical issues of the ball screw endurance tests. Among these there are the high power required to make the test, the lengthy duration of the same and the high loads between the screw and the frame that holds it. The article describes the test rig designed scheme, the kinematic expedients to be adopted in order to obtain the required performance and functionality and the sizing procedure to choose the actuation system.

  7. 钉道强化提高椎弓根螺钉固定强度的生物力学研究%Biomechanical study of the improvement of pedicle screw fixation with application of local screw tunnel augmentation technique and expansive pedicle screws

    Institute of Scientific and Technical Information of China (English)

    杨彬奎; 雷伟; 王军; 吴子祥; 刘达; 李运明

    2008-01-01

    Objective To evaluate the improvement of pedicle screw fixation with the application of local screw tunnel augmentation technique and expansive pediele screws.Methods Injecting CaSO4 bone cement into the perine of pediele screw tunnel by new design instruments in order to augment the screw tunnel.Twenty lumbar vertebrae from five frozen human spine specimens were divided into 10 blocks by randomized block design.Four fixation methods were applied:group A(common pedicle screws),group B(common pedicle screws+local screw tunnel augmentation technique),group C(expansive pedicle screws+local screw tunnel augmentation technique),group D(common pedicle screws+CaSO4 bone cement filled into pedicle screw tunnels).Four fixation methods were performed in four screw tunnels of each two blocks at random.And then the maximum axial pullout strength(Fmax)and energy absorbed were measured for comparison.Results Mean values of the Fmax and energy absorbed of group C or D were statistically significantly greater than those of group A(P<0.01)and group B(P<0.05).Mean values of the Fmax and energy absorbed of group B were also statistically significantly greater than those of group A(P<0.01).There was no statistical significant difference between group C and group D(P>0.05).Conclusion The pedicle screw fixation might be improved with the application of local screw tunnel augmentation technique and it might be even finner if combined with expansive pedicle screws.%目的 评价椎弓根钉道局部强化技术及其结合膨胀式椎弓根螺钉提高椎弓根螺钉固定强度的效果.方法 通过自行设计及加工的钉道局部强化装置,向钉道周壁点状注入CaSO4骨水泥以强化椎弓根钉道.5具新鲜冻存人体脊柱标本,每具随机选取4个腰椎共20个腰椎标本,采用随机区组设计方法分为10个区组.设计四种固定方法:A组(普通椎弓根螺钉)、B组(普通椎弓根螺钉+钉道局部强化)、C组(膨胀式椎弓根螺钉+钉

  8. Centrifuging Step-Screw Conveyor for Regolith Project

    Data.gov (United States)

    National Aeronautics and Space Administration — A variety of ISRU operations will utilize lunar regolith as feedstock. The proposed centrifuging step-screw conveyor concept will provide a well controlled robust,...

  9. Lumbar pedicle screw placement: Using only AP plane imaging

    Directory of Open Access Journals (Sweden)

    Anil Sethi

    2012-01-01

    Conclusion: Placement of pedicle screws under fluoroscopic guidance using AP plane imaging alone with tactile guidance is safe, fast, and reliable. However, a good understanding of the radiographic landmarks is a prerequisite.

  10. Kinematic analysis of parallel manipulators by algebraic screw theory

    CERN Document Server

    Gallardo-Alvarado, Jaime

    2016-01-01

    This book reviews the fundamentals of screw theory concerned with velocity analysis of rigid-bodies, confirmed with detailed and explicit proofs. The author additionally investigates acceleration, jerk, and hyper-jerk analyses of rigid-bodies following the trend of the velocity analysis. With the material provided in this book, readers can extend the theory of screws into the kinematics of optional order of rigid-bodies. Illustrative examples and exercises to reinforce learning are provided. Of particular note, the kinematics of emblematic parallel manipulators, such as the Delta robot as well as the original Gough and Stewart platforms are revisited applying, in addition to the theory of screws, new methods devoted to simplify the corresponding forward-displacement analysis, a challenging task for most parallel manipulators. Stands as the only book devoted to the acceleration, jerk and hyper-jerk (snap) analyses of rigid-body by means of screw theory; Provides new strategies to simplify the forward kinematic...

  11. Effect of Twin Screw Granulator Process Parameters on Granule Attributes

    OpenAIRE

    Xu, Haosheng; Sayin, Ridade; Litster, James

    2014-01-01

    Twin screw wet granulation has been considered as an efficient and effective technique of manufacturing granules (agglomerates made up of small particles) and has been widely applied in pharmaceutical industry. However, narrow granule size distributions are difficult to achieve. This study aims to elucidate the effect of process parameters such as liquid feed rate and screw configuration on the granule attributes through granule characterization. The methods used are sieve analysis (for size ...

  12. Rapid prototyping drill guide template for lumbar pedicle screw placement

    Institute of Scientific and Technical Information of China (English)

    LU Sheng; XU Yong-qing; ZHANG Yuan-zhi; LI Yan-bing; SHI Ji-hong; CHEN Guo-ping; CHEN Yu-bing

    2009-01-01

    To develop a novel method of spinal pedical stereotaxy by reverse engineering and rapid prototyping techniques, and to validate its accuracy by experimental and clinical studies. Methods: A 3D reconstruction model for the desired lumbar vertebra was generated by using the Mimics 10.11 software, and the optimal screw size and orientation were determined using the reverse engineering software. Afterwards, a drill template was created by reverse engi-neering principle, whose surface was the antitemplate of the vertebral surface. The drill template and its correspond-ing vertebra were manufactured using the rapid prototyping technique. Results: The accuracy of the drill template was con-firmed by drilling screw trajectory into the vertebral biomodel preoperatively. This method also showed its ability to cus-tomize the placement and size of each screw based on the unique morphology of the lumbar vertebra.The drill tem-plate fits the postural surface of the vertebra very well in the cadaver experiment. Postoperative CT scans for controlling the pedicle bore showed that the personalized template had a high precision in cadaver experiment and clinical application. No misplacement occurred by using the per-sonalized template. During surgery, no additional computer assistance was needed.Conclusions: The authors have developed a novel drill template for lumbar pedicle screw placement with good applicability and high accuracy. The potential use of drill templates to place lumbar pedicle screws is promising. Our methodology appears to provide an accurate technique and trajectory for pedicle screw placement in the lumbar spine.

  13. Robot-assisted Anterior Odontoid Screw Fixation: A Case Report.

    Science.gov (United States)

    Tian, Wei; Wang, Han; Liu, Ya-Jun

    2016-08-01

    Anterior odontoid screw fixation has been proved to be effective but technically challenging because the difficult approach is associated with high risks of screw malposition and damage to surrounding vital structures. Navigation techniques are therefore increasingly being used to improve safety and accuracy. However, no robot-assisted odontoid screw fixation has yet been reported. We here report a 61-year-old woman with a type II dens fracture on whom anterior odontoid screw fixation was performed under the guidance of a newly developed robotic system (TiRobot, co-designed by Beijing Jishuitan Hospital and TINAVI Medical Technologies). One odontoid screw was safely and accurately placed, the calculated deviation between the planned and actual positions being 0.9 mm. No intraoperative complications were identified and the patient was discharged on Day 5. Follow-up studies after 2 weeks showed good clinical and radiological results. We believe this is the first reported case of robot-assisted anterior odontoid screw fixation. We consider that complicated procedures can become feasible, safe and accurate using TiRobot systems. PMID:27627725

  14. Robot-assisted Anterior Odontoid Screw Fixation: A Case Report.

    Science.gov (United States)

    Tian, Wei; Wang, Han; Liu, Ya-Jun

    2016-08-01

    Anterior odontoid screw fixation has been proved to be effective but technically challenging because the difficult approach is associated with high risks of screw malposition and damage to surrounding vital structures. Navigation techniques are therefore increasingly being used to improve safety and accuracy. However, no robot-assisted odontoid screw fixation has yet been reported. We here report a 61-year-old woman with a type II dens fracture on whom anterior odontoid screw fixation was performed under the guidance of a newly developed robotic system (TiRobot, co-designed by Beijing Jishuitan Hospital and TINAVI Medical Technologies). One odontoid screw was safely and accurately placed, the calculated deviation between the planned and actual positions being 0.9 mm. No intraoperative complications were identified and the patient was discharged on Day 5. Follow-up studies after 2 weeks showed good clinical and radiological results. We believe this is the first reported case of robot-assisted anterior odontoid screw fixation. We consider that complicated procedures can become feasible, safe and accurate using TiRobot systems.

  15. Pedicle screw fixation against burst fracture of thoracolumbar vertebrae

    Institute of Scientific and Technical Information of China (English)

    L(U) Fu-xin; HUANG Yong; ZHANG Qiang; SHI Feng-lei; ZHAO Dong-sheng; HU Qiao

    2007-01-01

    Objective: To analyze the application of vertebral pedicle screw fixation in the treatment of burst fracture of thoracolumbar vertebrae.Methods: A total of 48 cases (31 males and 17 females, aged from 18-72 years, mean: 41.3 years) with thoracolumbar vertebrae burst fracture were treated by pedicle screw system since January 2004. According to the AO classification of thoracolumbar vertebrae fracture,there are 36 cases of Type A, 9 of Type B and 3 of Type C.Results: All patients were followed up for 6-25 months (average 12 months ), no secondary nerve root injury, spinal cord injury, loosening or breakage of pedicle screw were observed. The nerve function of 29 patients with cauda equina nerve injury was restored to different degrees. The vertebral body height returned to normal level and posterior process angle was rectified after operation.Conclusions: The vertebral pedicle screw internal fixation was technologically applicable, which can efficiently reposition and stablize the bursting fractured vertabrae,indirectly decompress canalis spinalis, maintain spine stablity, scatter stress of screw system, reduce the risk of loosening or breakage of screw and loss of vertebral height,and prevent the formation of posterior convex after operation.

  16. Fixation strength of biocomposite wedge interference screw in ACL reconstruction: effect of screw length and tunnel/screw ratio. A controlled laboratory study

    Directory of Open Access Journals (Sweden)

    Herrera Antonio

    2010-06-01

    Full Text Available Abstract Background Primary stability of the graft is essential in anterior cruciate ligament surgery. An optimal method of fixation should be easy to insert and provide great resistance against pull-out forces. A controlled laboratory study was designed to test the primary stability of ACL tendinous grafts in the tibial tunnel. The correlation between resistance to traction forces and the cross-section and length of the screw was studied. Methods The tibial phase of ACL reconstruction was performed in forty porcine tibias using digital flexor tendons of the same animal. An 8 mm tunnel was drilled in each specimen and two looped tendons placed as graft. Specimens were divided in five groups according to the diameter and length of the screw used for fixation. Wedge interference screws were used. Longitudinal traction was applied to the graft with a Servohydraulic Fatigue System. Load and displacement were controlled and analyzed. Results The mean loads to failure for each group were 295,44 N (Group 1; 9 × 23 screw, 564,05 N (Group 2; 9 × 28, 614,95 N (Group 3; 9 × 35, 651,14 N (Group 4; 10 × 28 and 664,99 (Group 5; 10 × 35. No slippage of the graft was observed in groups 3, 4 and 5. There were significant differences in the load to failure among groups (ANOVA/P Conclusions Longer and wider interference screws provide better fixation in tibial ACL graft fixation. Short screws (23 mm do not achieve optimal fixation and should be implanted only with special requirements.

  17. A general extrudate bulk density model for both twin-screw and single-screw extruder extrusion cooking processes

    OpenAIRE

    Cheng, Hongyuan; Friis, Alan; Høeg Hansen, Jonas; Tolderlund Rasmussen, Hanne

    2010-01-01

    Effects of extrusion parameters and raw materials on extrudate expansion are respectively investigated in a twin-screw extruder and a single-screw extruder extrusion cooking experiments for fish feed, wheat, and oat & wheat mixture processing. A new phenomenological model is proposed to correlated extrudate bulk density, extrusion parameters and raw material changes based on the experimental results. The average absolute deviation (AAD) of the correlation is 2.2% for fish feed extrusion in th...

  18. The Use of Percutaneous Lumbar Fixation Screws for Bilateral Pedicle Fractures with an Associated Dislocation of a Lumbar Disc Prosthesis

    Directory of Open Access Journals (Sweden)

    William D. Harrison

    2013-01-01

    Full Text Available Study Design. Case report. Objective. To identify a safe technique for salvage surgery following complications of total disc replacement. Summary of Background Data. Lumbar total disc replacement (TDR is considered by some as the gold standard for discogenic back pain. Revision techniques for TDR and their complications are in their infancy. This case describes a successful method of fixation for this complex presentation. Methods and Results. A 48-year-old male with lumbar degenerative disc disease and no comorbidities. Approximately two weeks postoperatively for a TDR, the patient represented with acute severe back pain and the TDR polyethylene inlay was identified as dislocated anteriorly. Subsequent revision surgery failed immediately as the polyethylene inlay redislocated intraoperatively. Further radiology identified bilateral pedicle fractures, previously unseen on the plain films. The salvage fusion of L5/S1 reutilized the anterior approach with an interbody fusion cage and bone graft. The patient was then turned intraoperatively and redraped. The percutaneous pedicle screws were used to fix L5 to the sacral body via the paracoccygeal corridor. Conclusion. The robust locking screw in the percutaneous screw allowed a complete fixation of the pedicle fractures. At 3-year followup, the patient has an excellent result and has returned to playing golf.

  19. A STUDY OF FUNCTIONAL AND RADIOLOGICAL OUTCOME OF UNDISPLACED SCAPHOID FRACTURES TREATED WITH PERCUTANEOUS HEADLESS SCREW FIXATION

    Directory of Open Access Journals (Sweden)

    Tarigopula

    2016-04-01

    Full Text Available BACKGROUND Scaphoid is the most commonly fractured carpal bone, accounting for approximately 60% of all carpal fractures. This injury is commonly seen in active young adults after a fall on an outstretched hand. Management of scaphoid fractures is controversial. Displaced scaphoid fractures are associated with risk of non-union and osteonecrosis. Surgical fixation is recommended for displaced scaphoid fractures of proximal pole, fractures with delayed treatment or diagnosis and non-union. Open reduction and internal fixation of acute scaphoid fractures has been reported to give good results in several nonrandomised, retrospective studies. The incidence of complications after operative treatment of non-displaced fractures has decreased with the advent of safer, more reliable implants and percutaneous techniques. CONCLUSION Percutaneous headless screw fixation is a well-documented surgical procedure. Undisplaced scaphoid fractures fixed by percutaneous headless screw fixation yield better results than patients treated conservatively. Good range of motion is achieved after fixation. It relieves pain and functional disability experienced by patients. Patients achieve good range of motion. Trabecular continuity is achieved in most of the patients before 8 weeks. Most of the patients had resumed normal daily activities before 3 months. This study suggests that percutaneous headless screw fixation for undisplaced scaphoid fractures provides satisfactory clinical and radiographic outcomes after an intermediate duration follow-up. Even though the procedure is not free of complications, the overall functional and clinical outcome had shown good results.

  20. Is the lag screw sliding effective in the intramedullary nailing in A1 and A2 AO-OTA intertrochanteric fractures? A prospective study of Sliding and None-sliding lag screw in Gamma-III nail

    Directory of Open Access Journals (Sweden)

    Zhu Yi

    2012-09-01

    Full Text Available Abstract Object To compare the Sliding with Non-sliding lag screw of a gamma nail in the treatment of A1 and A2 AO-OTA intertrochanteric fractures. Materials and methods 80 patients were prospectively collected. In each group, AO/OTA 31-A were classified into group A. AO/OTA 31-A2.1 was classified as group B. We classified the A2.2 and A2.3 as group C. According to the set-screw locking formation of Gamma-III, the cases were randomly allocated to Sliding subgroup and Non-sliding subgroup in A, B and C groups. Follow-ups were performed 1, 3, 6 and 12 months postoperatively. Results In the Sliding group, the bone healing rate 3, 6, 12 months postoperatively reached 85.00%, 97.50%, 100% in group A, B and C. Meanwhile, in Non-sliding group, postoperatively, bone healing rate were 90.00%, 95.00% and 97.50% in group A, B and C, respectively. Both differences were not significant. Lower limb discrepancy between Sliding and Non-sliding pattern was significantly different in group C which represent fracture types of AO/OTA 31-A2.2 and A2.3 (0.573 ± 0.019 mm in Non-sliding group, 0.955 mm ± 0.024 mm in Sliding group, P Conclusions As a result, we can conclude that the sliding distance is minimal in Gamma nails and it is related to the comminuted extent of the intertrochanteric area in A1 and A2 AO-OTA intertrochanteric fractures. For treating these kinds of fractures, the sliding of the lag screw of an Gamma nail does not improve any clinical results and in certain cases, such as highly comminuted A1 and A2 fractures, can therefore even benefit from a locked lag screw by tightening the set-screw.

  1. Prediction of Deformity Correction by Pedicle Screw Instrumentation in Thoracolumbar Scoliosis Surgery

    Science.gov (United States)

    Kiriyama, Yoshimori; Yamazaki, Nobutoshi; Nagura, Takeo; Matsumoto, Morio; Chiba, Kazuhiro; Toyama, Yoshiaki

    In segmental pedicle screw instrumentation, the relationship between the combinations of pedicle screw placements and the degree of deformity correction was investigated with a three-dimensional rigid body and spring model. The virtual thoracolumbar scoliosis (Cobb’s angle of 47 deg.) was corrected using six different combinations of pedicle-screw placements. As a result, better correction in the axial rotation was obtained with the pedicle screws placed at or close to the apical vertebra than with the screws placed close to the end vertebrae, while the correction in the frontal plane was better with the screws close to the end vertebrae than with those close to the apical vertebra. Additionally, two screws placed in the convex side above and below the apical vertebra provided better correction than two screws placed in the concave side. Effective deformity corrections of scoliosis were obtained with the proper combinations of pedicle screw placements.

  2. Investigation of an 11mm diameter twin screw granulator: Screw element performance and in-line monitoring via image analysis.

    Science.gov (United States)

    Sayin, Ridade; Martinez-Marcos, Laura; Osorio, Juan G; Cruise, Paul; Jones, Ian; Halbert, Gavin W; Lamprou, Dimitrios A; Litster, James D

    2015-12-30

    As twin screw granulation (TSG) provides one with many screw element options, characterization of each screw element is crucial in optimizing the screw configuration in order to obtain desired granule attributes. In this study, the performance of two different screw elements - distributive feed screws and kneading elements - was studied in an 11 mm TSG at different liquid-to-solid (L/S) ratios. The kneading element configuration was found to break large granules more efficiently, leading to narrower granule size distributions. While pharmaceutical industry shifts toward continuous manufacturing, inline monitoring and process control are gaining importance. Granules from an 11 mm TSG were analysed using the Eyecon™, a real-time high speed direct imaging system, which has been used to capture accurate particle size distribution and particle count. The size parameters and particle count were then assessed in terms of their ability to be a suitable control measure using the Shewhart control charts. d10 and particle count were found to be good indicators of the change in L/S ratio. However, d50 and d90 did not reflect the change, due to their inherent variability even when the process is at steady state. PMID:26385406

  3. Helical Screw Expander Evaluation Project. Final report

    Energy Technology Data Exchange (ETDEWEB)

    McKay, R.

    1982-03-01

    A functional 1-MW geothermal electric power plant that featured a helical screw expander was produced and then tested in Utah in 1978 to 1979 with a demonstrated average performance of approximately 45% machine efficiency over a wide range of test conditions in noncondensing operation on two-phase geothermal fluids. The Project also produced a computer-equipped data system, an instrumentation and control van, and a 1000-kW variable load bank, all integrated into a test array designed for operation at a variety of remote test sites. Additional testing was performed in Mexico in 1980 under a cooperative test program using the same test array, and machine efficiency was measured at 62% maximum with the rotors partially coated with scale, compared with approximately 54% maximum in Utah with uncoated rotors, confirming the importance of scale deposits within the machine on performance. Data are presented for the Utah testing and for the noncondensing phases of the testing in Mexico. Test time logged was 437 hours during the Utah tests and 1101 hours during the Mexico tests.

  4. Short segment pedicle screw instrumentation and augmentation vertebroplasty in lumbar burst fractures: an experience.

    Science.gov (United States)

    Afzal, Suhail; Akbar, Saleem; Dhar, Shabir A

    2008-03-01

    To assess the efficacy and feasibility of vertebroplasty and posterior short-segment pedicle screw fixation for the treatment of traumatic lumbar burst fractures. Short-segment pedicle screw instrumentation is a well described technique to reduce and stabilize thoracic and lumbar spine fractures. It is relatively a easy procedure but can only indirectly reduce a fractured vertebral body, and the means of augmenting the anterior column are limited. Hardware failure and a loss of reduction are recognized complications caused by insufficient anterior column support. Patients with traumatic lumbar burst fractures without neurologic deficits were included. After a short segment posterior reduction and fixation, bilateral transpedicular reduction of the endplate was performed using a balloon, and polymethyl methacrylate cement was injected. Pre-operative and post-operative central and anterior heights were assessed with radiographs and MRI. Sixteen patients underwent this procedure, and a substantial reduction of the endplates could be achieved with the technique. All patients recovered uneventfully, and the neurologic examination revealed no deficits. The post-operative radiographs and magnetic resonance images demonstrated a good fracture reduction and filling of the bone defect without unwarranted bone displacement. The central and anterior height of the vertebral body could be restored to 72 and 82% of the estimated intact height, respectively. Complications were cement leakage in three cases without clinical implications and one superficial wound infection. Posterior short-segment pedicle fixation in conjunction with balloon vertebroplasty seems to be a feasible option in the management of lumbar burst fractures, thereby addressing all the three columns through a single approach. Although cement leakage occurred but had no clinical consequences or neurological deficit. PMID:18193300

  5. Posterior cervical spine arthrodesis with laminar screws: a report of two cases

    OpenAIRE

    Nakanishi, Kazuo; Tanaka, Masato; Sugimoto, Yoshihisa; Ozaki,Toshifumi

    2007-01-01

    We performed fixation using laminar screws in 2 patients in whom lateral mass screws, pedicle screws or transarticular screws could not be inserted. One was a 56-year-old woman who had anterior atlantoaxial subluxation (AAS). When a guide wire was inserted using an imaging guide, the hole bled massively. We thought the re-insertion of a guide wire or screw would thus increase the risk of vascular injury, so we used laminar screws. The other case was an 18-year-old man who had a hangman fractu...

  6. Bone reactions adjacent to titanium implants subjected to static load. A study in the dog (I)

    DEFF Research Database (Denmark)

    Gotfredsen, K; Berglundh, T; Lindhe, J

    2001-01-01

    The aim of the study was to evaluate the effect of lateral static load induced by an expansion force on the bone/implant interface and adjacent peri-implant bone. In 3 beagle dogs, the 2nd, 3rd and 4th mandibular premolars were extracted bilaterally. Twelve weeks later 8 implants of the ITI Dental...... Implant System were placed in each dog. Crowns connected in pairs were screwed on the implants 12 weeks after implant installation. The connected crowns contained an orthodontic expansion screw yielding 4 loading units in each dog. Clinical registrations, standardized radiographs and fluorochrome labeling...... were carried out during the 24-week loading period. Biopsies were harvested and processed for ground sectioning. The sections were subjected to histological examination. No evident marginal bone loss was observed at either test or control sites. The bone density and the mineralized bone-to-implant...

  7. RELATION OF PLATE STRAIN AND DISTANCE BETWEEN PLATE AND BONE

    OpenAIRE

    Boonthum Wongchai

    2013-01-01

    The Limited Contact Dynamics Compression Plate (LC-DCP) is normally used in bone fractured with the locking screws. The released distance between the LC-DCP and the bone could bring about the convenience of periosteal blood transportation. However the exceeding distance may cause the plate strain reach yield point and make the LC-DCP deform into plastic zone. This research proposes a study of the effect of the distance between the LC-DCP and the bone on the strain in the LC-DCP. The strains a...

  8. High-purity magnesium interference screws promote fibrocartilaginous entheses regeneration in the anterior cruciate ligament reconstruction rabbit model via accumulation of BMP-2 and VEGF.

    Science.gov (United States)

    Cheng, Pengfei; Han, Pei; Zhao, Changli; Zhang, Shaoxiang; Wu, Hongliu; Ni, Jiahua; Hou, Peng; Zhang, Yuanzhuang; Liu, Jingyi; Xu, Haidong; Liu, Shen; Zhang, Xiaonong; Zheng, Yufeng; Chai, Yimin

    2016-03-01

    Interference screw in the fixation of autologous tendon graft to the bone tunnel is widely accepted for the reconstruction of anterior cruciate ligament (ACL), but the regeneration of fibrocartilaginous entheses could hardly be achieved with the traditional interference screw. In the present work, biodegradable high-purity magnesium (HP Mg) showed good cytocompatibility and promoted the expression of bone morphogenetic protein-2 (BMP-2) and vascular endothelial growth factor (VEGF), fibrocartilage markers (Aggrecan, COL2A1 and SOX-9), and glycosaminoglycan (GAG) production in vitro. The HP Mg screw was applied to fix the semitendinosus autograft to the femoral tunnel in a rabbit model of ACL reconstruction with titanium (Ti) screw as the control. The femur-tendon graft-tibia complex was retrieved at 3, 6, 9 and 12 weeks. Gross observation and range of motion (ROM) of the animal model reached normal levels at 12 weeks. No sign of host reaction was found in the X-ray scanning. The HP Mg group was comparable to the Ti group with respect to biomechanical properties of the reconstructed ACL, and the ultimate load to failure and stiffness increased 12 weeks after surgery. In the histological analysis, the HP Mg group formed distinct fibrocartilage transition zones at the tendon-bone interface 12 weeks after surgery, whereas a disorganized fibrocartilage layer was found in the Ti group. In the immunohistochemical analysis, highly positive staining of BMP-2, VEGF and the specific receptor for BMP-2 (BMPR1A) was shown at the tendon-bone interface of the HP Mg group compared with the Ti group. Furthermore, the HP Mg group had significantly higher expression of BMP-2 and VEGF than the Ti group in the early phase of tendon-bone healing, followed by enhanced expression of fibrocartilage markers and GAG production. Therefore we proposed that the stimulation of BMP-2 and VEGF by Mg ions was responsible for the fibrochondrogenesis of Mg materials. HP Mg was promising as a

  9. Screw theoretic view on dynamics of spatially compliant beam

    Institute of Scientific and Technical Information of China (English)

    Xi-lun DING; J.M.SELIG

    2010-01-01

    Beams with spatial compliance can be deformed as bending in a plane,twisting,and extending.In terms of the screw theory on rigid body motions,the concept of"deflection screw"is introduced,a spatial compliant beam theory via the deflection screw is proposed,and the spatial compliance of such a beam system is presented and analysed based on the material theory and fundamental kinematic assumptions.To study the dynamics of the spatially compliant beam,the potential energy and the kinetic energy of the beam are discussed by using the screw theory to obtain the Lagrangian.The Rayleigh-Ritz method is used to compute the vibrational frequencies based on discussions of boundary conditions and shape functions.The eigenfrequencies of the beam with spatial compliance are compared with those of individual deformation cases,pure bending,extension,or torsion.Finally,dynamics of a robot with two spatial compliant links and perpendicular joints is studied using the spatial compliant beam theory.Coupling between the joint rigid body motions and the deformations of spatial compliant links can easily be found in dynamic simulation.The study shows the effectiveness of using the screw theory to deal with the problems of dynamic modeling and analysis of mechanisms with spatially compliant links.

  10. Numerical simulation of a twin screw expander for performance prediction

    Science.gov (United States)

    Papes, Iva; Degroote, Joris; Vierendeels, Jan

    2015-08-01

    With the increasing use of twin screw expanders in waste heat recovery applications, the performance prediction of these machines plays an important role. This paper presents a mathematical model for calculating the performance of a twin screw expander. From the mass and energy conservation laws, differential equations are derived which are then solved together with the appropriate Equation of State in the instantaneous control volumes. Different flow processes that occur inside the screw expander such as filling (accompanied by a substantial pressure loss) and leakage flows through the clearances are accounted for in the model. The mathematical model employs all geometrical parameters such as chamber volume, suction and leakage areas. With R245fa as working fluid, the Aungier Redlich-Kwong Equation of State has been used in order to include real gas effects. To calculate the mass flow rates through the leakage paths formed inside the screw expander, flow coefficients are considered as constant and they are derived from 3D Computational Fluid Dynamic calculations at given working conditions and applied to all other working conditions. The outcome of the mathematical model is the P-V indicator diagram which is compared to CFD results of the same twin screw expander. Since CFD calculations require significant computational time, developed mathematical model can be used for the faster performance prediction.

  11. Percutaneous Iliac Screws for Minimally Invasive Spinal Deformity Surgery

    Directory of Open Access Journals (Sweden)

    Michael Y. Wang

    2012-01-01

    Full Text Available Introduction. Adult spinal deformity (ASD surgeries carry significant morbidity, and this has led many surgeons to apply minimally invasive surgery (MIS techniques to reduce the blood loss, infections, and other peri-operative complications. A spectrum of techniques for MIS correction of ASD has thus evolved, most recently the application of percutaneous iliac screws. Methods. Over an 18 months 10 patients with thoracolumbar scoliosis underwent MIS surgery. The mean age was 73 years (70% females. Patients were treated with multi-level facet osteotomies and interbody fusion using expandable cages followed by percutaneous screw fixation. Percutaneous iliac screws were placed bilaterally using the obturator outlet view to target the ischial body. Results. All patients were successfully instrumented without conversion to an open technique. Mean operative time was 302 minutes and the mean blood loss was 480 cc, with no intraoperative complications. A total of 20 screws were placed successfully as judged by CT scanning to confirm no bony violations. Complications included: two asymptomatic medial breaches at T10 and L5, and one patient requiring delayed epidural hematoma evacuation. Conclusions. Percutaneous iliac screws can be placed safely in patients with ASD. This MIS technique allows for successful caudal anchoring to stress-shield the sacrum and L5-S1 fusion site in long-segment constructs.

  12. Endovascular aortic injury repair after thoracic pedicle screw placement.

    Science.gov (United States)

    Pesenti, S; Bartoli, M A; Blondel, B; Peltier, E; Adetchessi, T; Fuentes, S

    2014-09-01

    Our objective was to describe the management and prevention of thoracic aortic injuries caused by a malposition of pedicle screws in corrective surgery of major spine deformities. Positioning pedicle screws in thoracic vertebras by posterior approach exposes to the risk of injury of the elements placed ahead of the thoracic spine, as the descending thoracic aorta. This complication can result in a cataclysmic bleeding, needing urgent vascular care, but it can also be totally asymptomatic, resulting in the long run in a pseudoaneurysm, justifying the systematic removal of the hardware. We report the case of a 76-year-old woman who underwent spinal correction surgery for thoraco-lumbar degenerative kypho-scoliosis. Immediately after the surgery, a thoracic aortic injury caused by the left T7 pedicle screw was diagnosed. The patient underwent a two-step surgery. The first step was realized by vascular surgeons and aimed to secure the aortic wall by short endovascular aortic grafting. During the second step, spine surgeons removed the responsible screw by posterior approach. The patient was discharged in a rehabilitation center 7 days after the second surgery. When such a complication occurs, a co-management by vascular and spine surgeons is necessary to avoid major complications. Endovascular management of this kind of vascular injuries permits to avoid an open surgery that have a great rate of morbi-mortality in frail patients. Nowadays, technologies exist to prevent this kind of event and may improve the security when positioning pedicle screws. PMID:25023930

  13. Treatment of scaphoid waist fractures with the HCS screw

    Directory of Open Access Journals (Sweden)

    Gehrmann, Sebastian V.

    2014-11-01

    Full Text Available The aim of the study was to evaluate the clinical results of the Headless Compression Screw (HCS, Synthes when used for treatment of acute scaphoid waist fractures. The new screw design generates interfragmentary compression with use of a compression sleeve. Twenty-one patients were treated for acute scaphoid waist fractures type B2 with HCS screws. The average time to the final follow-up examination was 12.8 months. All 21 fractures united after a mean time of 7.2 weeks. The mean DASH score was 7.1. The average motion of the wrist in extension was 61°, flexion was 46°, radial abduction reached 25° and the ulnar abduction was 31°. The maximally achieved grip strength was 86% compared to the uninjured side. Treatment of type B2 scaphoid fractures with the Headless Compression Screw showed good functional and radiographic results. The results are similar to those identified using other screw fixation systems.

  14. Error Analysis of Robotic Assembly System Based on Screw Theory

    Institute of Scientific and Technical Information of China (English)

    韩卫军; 费燕琼; 赵锡芳

    2003-01-01

    Assembly errors have great influence on assembly quality in robotic assembly systems. Error analysis is directed to the propagations and accumula-tions of various errors and their effect on assembly success.Using the screw coordinates, assembly errors are represented as "error twist", the extremely compact expression. According to the law of screw composition, relative position and orientation errors of mating parts are computed and the necessary condition of assembly success is concluded. A new simple method for measuring assembly errors is also proposed based on the transformation law of a screw.Because of the compact representation of error, the model presented for error analysis can be applied to various part- mating types and especially useful for error analysis of complexity assembly.

  15. Augmentation of Pedicle Screw Fixation with Calcium Phosphate Cement

    Institute of Scientific and Technical Information of China (English)

    YANG Shu-hua; FU De-hao; LI Jin; XU Wei-hua; YANG Cao; YE Zhe-wei; ZUO Xiao-yan

    2004-01-01

    To determine whether a biodegradable calcium phosphate cement(CPC) provides significant augmentation of pedicle screw fixation or not,an in vitro biomechanical study was carried out to evaluate the biomechanical effect of CPC in the restoration and augmentation of pedicle screw fixation.Axial pullout test and cyclic bending resistance test were employed in the experiment,and polymethylmethacrylate (PMMA) was chosen as control.The results demonstrate that the pullout strengths following CPC restoration and augmentation are 74% greater on an average than those of the control group,but less than those of PMMA restoration group and augmentation group respectively (increased by 126% versus control).In cyclic bending resistance test,the CPC augmented screws are found to withstand a greater number of cycles or greater loading with less displacement before loosening,but the augmentation effect of PMMA is greater than that of CPC.

  16. Bone Densitometry (Bone Density Scan)

    Science.gov (United States)

    ... of DXA Bone Densitometry? What is a Bone Density Scan (DXA)? Bone density scanning, also called dual-energy x-ray absorptiometry ( ... is today's established standard for measuring bone mineral density (BMD). An x-ray (radiograph) is a noninvasive ...

  17. In vitro evaluation of flexural strength of different brands of expansion screws

    OpenAIRE

    Kádna Fernanda Mendes de Oliveira; Mário Vedovello Filho; Mayury Kuramae; Adriana Simoni Lucato; Heloisa Cristina Valdhigi

    2012-01-01

    OBJECTIVE: The objective of this study was to compare the flexural strength of the stems of three maxillary expanders screws of Morelli, Forestadent and Dentaurum brands. METHODS: The sample consisted of nine expander screws (totalizing of 36 stems), three from each brand, all stainless steel and 12 mm of expansion capacity. The stems of the expander screws were cut with cutting pliers close to the weld region with screw body, then fixed in a universal testing machine Instron 4411 for tests o...

  18. Extraction of oil from jatropha seeds using a twin-screw extruder: Feasibility study

    OpenAIRE

    Evon, Philippe; Kartika, Ika Amalia; Cerny, Muriel; Rigal, Luc

    2013-01-01

    International audience The objective of this study was to evaluate the feasibility of mechanical pressing to extract oil from jatropha seeds using a twin-screw extruder. Experiments were conducted using a co-rotating (Clextral BC 21, France) twin-screw extruder. The influence of operating conditions on oil yield, specific mechanical energy and oil quality was examined. Operating conditions included screw configuration, pressing temperature and screw rotation speed. Generally, it was the sc...

  19. A Novel Blasted and Grooved Low Profile Pedicle Screw Able to Resist High Compression Bending Loads

    OpenAIRE

    Kuh, Sung-Uk; Kim, Young-Sung; Choi, Hong-June; Kim, Kyung-Hyun; Park, Jeong-Yoon; Jeong, Hyun-Yong; Chin, Dong-Kyu; Kim, Keun-Su; Yoon, Young-Sul; Lee, Yoon-Chul; Cho, Yong-Eun

    2012-01-01

    Objective Polyaxial pedicle screws are a safe, useful adjunct to transpedicular fixation. However, the large screw head size can cause soft tissue irritation, high rod positioning, and facet joint injury. However, the mechanical resistance provided by small and low profile pedicle screws is very limited. We therefore developed a novel, low profile pedicle screw using grooving and blasting treatment that is able to resist a high compression bending load. Methods We evaluated the compression be...

  20. USE OF THE PFO® NUT IN TREATING FRACTURES OF THE PROXIMAL THIRD OF THE HUMERUS IN PATIENTS WITH BONE FRAGILITY

    OpenAIRE

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; da Silva, Luciana Andrade; Pires, Davi Calixto; Mota Neto, Jose da; de Camargo Rossato, Luis Henrique; Checchia, Sergio Luiz

    2015-01-01

    Objective: To evaluate the clinical results from application of the PFO® bone fixation nut, which was developed for use with 4.5 mm cortical screws, and to analyze any complications or bone reactions caused by this synthesis in porotic bone. Method: Between May 1999 and November 2007, the PFO® nut was used on 23 patients who underwent osteosynthesis with a PFS 80® plate in the proximal segment, to treat acute fractures, pseudarthrosis or defective consolidations. The average age of the patien...

  1. Enhancing the mechanical integrity of the implant-bone interface with BoneWelding technology: determination of quasi-static interfacial strength and fatigue resistance.

    Science.gov (United States)

    Ferguson, Stephen J; Weber, Urs; von Rechenberg, Brigitte; Mayer, Joerg

    2006-04-01

    The BoneWelding technology is an innovative bonding method, which offers new alternatives in the treatment of fractures and other degenerative disorders of the musculoskeletal system. The BoneWelding process employs ultrasonic energy to liquefy a polymeric interface between orthopaedic implants and the host bone. Polymer penetrates the pores of the surrounding bone and, following a rapid solidification, forms a strong and uniform bond between implant and bone. Biomechanical testing was performed to determine the quasi-static push-out strength and fatigue performance of 3.5-mm-diameter polymeric dowels bonded to a bone surrogate material (Sawbones solid and cellular polyurethane foam) using the BoneWelding process. Fatigue tests were conducted over 100,000 cycles of 20-100 N loading. Mechanical test results were compared with those obtained with a comparably-sized, commercial metallic fracture fixation screw. Tests in surrogate bone material of varying density demonstrated significantly superior mechanical performance of the bonded dowels in comparison to conventional bone screws (p Ultrasonically inserted implants migrated, on average, less than 20 microm over, and interfacial stiffness remained constant the full duration of fatigue testing. With further refinement, the BoneWelding technology may offer a quicker, simpler, and more effective method for achieving strong fixation and primary stability for fracture fixation or other orthopaedic and dental implant applications. PMID:16211571

  2. Acrylic resin guide for locating the abutment screw access channel of cement-retained implant prostheses.

    Science.gov (United States)

    Ahmed, Ayman; Maroulakos, Georgios; Garaicoa, Jorge

    2016-05-01

    Abutment screw loosening represents a common and challenging technical complication of cement-retained implant prostheses. This article describes the fabrication of a simple and accurate poly(methyl methacrylate) guide for identifying the location and angulation of the abutment screw access channel of a cement-retained implant prosthesis with a loosened abutment screw. PMID:26794698

  3. Posterior cervical spine arthrodesis with laminar screws: a report of two cases

    Directory of Open Access Journals (Sweden)

    Sugimoto,Yoshihisa

    2007-04-01

    Full Text Available We performed fixation using laminar screws in 2 patients in whom lateral mass screws, pedicle screws or transarticular screws could not be inserted. One was a 56-year-old woman who had anterior atlantoaxial subluxation (AAS. When a guide wire was inserted using an imaging guide, the hole bled massively. We thought the re-insertion of a guide wire or screw would thus increase the risk of vascular injury, so we used laminar screws. The other case was an 18-year-old man who had a hangman fracture. Preoperative magnetic resonance angiography showed occlusion of the left vertebral artery. A laminar screw was inserted into the patent side (i.e., the right side of C2. Cervical pedicle screws are the most biomechanically stable screws. However, their use carries a high risk of neurovascular complications during screw insertion, because the cervical pedicle is small and is adjacent laterally to the vertebral artery, medially to the spinal cord, and vertically to the nerve roots. Lateral mass screws are also reported to involve a risk of neurovascular injuries. The laminar screw method was thus thought to be useful, since arterial injuries could thus be avoided and it could also be used as a salvage modality for the previous misinsertion.

  4. Foreign body reaction to a bioabsorbable interference screw after anterior cruciate ligament reconstruction

    OpenAIRE

    Umar, Muhammad; Baqai, Nadeem; Peck, Christopher

    2009-01-01

    Bioabsorbable interference screws have been effective for graft fixation in anterior cruciate ligament (ACL) reconstruction. The overall complication rate associated with the use of these screws is low but some unique problems have been reported in the literature. We present a case of unusual tissue reaction to a bioabsorbable interference screw following ACL reconstruction.

  5. Conceptual framework for model-based analysis of residence time distribution in twin-screw granulation

    DEFF Research Database (Denmark)

    Kumar, Ashish; Vercruysse, Jurgen; Vanhoorne, Valerie;

    2015-01-01

    Twin-screw granulation is a promising continuous alternative for traditional batchwise wet granulation processes. The twin-screw granulator (TSG) screws consist of transport and kneading element modules. Therefore, the granulation to a large extent is governed by the residence time distribution w...

  6. The best location for proximal locking screw for femur interlocking nailing: A biomechanical study

    Directory of Open Access Journals (Sweden)

    Ahmet A Karaarslan

    2016-01-01

    Conclusion: According to our findings, there is twice as much difference in locking screw bending resistance between these two application levels. To avoid proximal locking screw deformation, locking screws should be placed in the level of the lesser trochanter in nailing of 1/3 middle and distal femur fractures.

  7. Low Bone Density

    Science.gov (United States)

    ... Density Exam/Testing › Low Bone Density Low Bone Density Low bone density is when your bone density ... people with normal bone density. Detecting Low Bone Density A bone density test will determine whether you ...

  8. FUNCTIONAL OUTCOME OF ARTHROSCOPY ASSISTED ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING BONE PATELLAR TENDON BONE AUTOGRAFT

    Directory of Open Access Journals (Sweden)

    Vinod Kumar

    2015-04-01

    Full Text Available INTRODUCTION: The anterior cruciate ligament (ACL is one of the most frequently injured ligaments in the human body. 1 The Anterior Cruciate ligament (ACL is the primary stabilizer of the knee and prevents the knee against anterior translation. 2 It is also important in counteracting rotational and valgus stress. 1 The middle third of the patellar tendon autograft for ACL reconstruction can be readily procured and firmly fixed. 3 It can tolerate the loads produced by an intensive rehabilitation programme. 3 Fixation of bone plugs using interference screws provides sufficient stability to meet the demand of a vigorous postoperative protocol. 3 It remains the gold standard for ACL reconstruction. 3 This study is to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone patellar tendon bone autograft. METHODS: This study was conducted in Kempegowda Institute of Medical Sciences Hospital from November 2012 to April 2014. During this period 20 cases of adult patients with ACL deficient patients were selected according to the inclusion criteria. Study aims to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone - patellar tendon - bone autograft in terms of range of motion, postoperative knee stability, graft site morbidity and subjective knee functions. RESULTS: Results of our study showed that arthroscopy assisted anterior cruciate ligament reconstruction with bone - patellar tendon - bone autograft could effectively improve knee stability and functions after surgery without any complication. CONCLUSION : Arthroscopy assisted anterior cruciate l igament reconstruction with bone - patellar tendon - bone autograft is an excellent treatment option for anterior cruciate ligament deficient knees. It provides a stable knee and reduces postoperative morbidity and enables early rehabilitation. The functional outcome of arthroscopy assisted anterior

  9. Augmentation of tendon-to-bone healing.

    Science.gov (United States)

    Atesok, Kivanc; Fu, Freddie H; Wolf, Megan R; Ochi, Mitsuo; Jazrawi, Laith M; Doral, M Nedim; Lubowitz, James H; Rodeo, Scott A

    2014-03-19

    Tendon-to-bone healing is vital to the ultimate success of the various surgical procedures performed to repair injured tendons. Achieving tendon-to-bone healing that is functionally and biologically similar to native anatomy can be challenging because of the limited regeneration capacity of the tendon-bone interface. Orthopaedic basic-science research strategies aiming to augment tendon-to-bone healing include the use of osteoinductive growth factors, platelet-rich plasma, gene therapy, enveloping the grafts with periosteum, osteoconductive materials, cell-based therapies, biodegradable scaffolds, and biomimetic patches. Low-intensity pulsed ultrasound and extracorporeal shockwave treatment may affect tendon-to-bone healing by means of mechanical forces that stimulate biological cascades at the insertion site. Application of various loading methods and immobilization times influence the stress forces acting on the recently repaired tendon-to-bone attachment, which eventually may change the biological dynamics of the interface. Other approaches, such as the use of coated sutures and interference screws, aim to deliver biological factors while achieving mechanical stability by means of various fixators. Controlled Level-I human trials are required to confirm the promising results from in vitro or animal research studies elucidating the mechanisms underlying tendon-to-bone healing and to translate these results into clinical practice. PMID:24647509

  10. Postoperative evaluation of the position of interference screws, boneblocks and ligamentum patellae autografts in anterlor cruciate ligament replacement; Evaluierung von Knochenblockposition, Interferenzschraubenlage und Ersatzplastik des vorderen Kreuzbandes nach Ligamentum patellae-Transplantat mittels CT

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, R, [Leipzig Univ. (Germany). FUSt 8/Radiologie; Kolbus, F.; Brueckner, B. [Leipzig Univ. (Germany). Abt. 2/Chirurgie des Bundeswehrkrankenhauses Leipzig

    2000-06-01

    Purpose: Evaluation of arthroscopically assisted reconstruction of the anterior cruciate ligament using ligamentum patellae autografts in the bone-tendon-bone technique with special regard to the position of blocks and interference screws. Material and methods: In a prospective study 28 patients were included after undergoing arthroscopic anterior cruciate ligament replacement surgery. Data thus obtained were correlated with the postoperatively determined functional parameters of the affected joint. Results: Interference screws, bone-blocks and ligamentous transplants could be well imaged using CT. In a comparison of our data with clinical results there was a statistically highly significant correlation between clinical outcome and the position of bone-blocks and interference screws in the tibia. Angles between screw and bone-block exceeding a standard deviation led to significantly worse results, while a divergence in femoral angles did not lead to significantly worse results. (orig./AJ) [German] Ziel: Evaluation der arthroskopischen Ersatzplastik des vorderen Kreuzbandes unter besonderer Beruecksichtigung der Lage der Knochenbloecke, Interferenzschrauben und Bohrkanaele mittels CT und Vergleich der radiologischen Daten mit klinischen und funktionellen Parametern. Material und Methodik: In einer prospektiven Studie wurden 28 Patienten nach arthroskopischer Ersatzplastik des vorderen Kreuzbandes mittels Lig. patellae-Transplantat im CT untersucht. Anschliessend erfolgte die Pruefung der Korrelation mit postoperativ erhobenen klinisch-funktionellen Parametern des Kniegelenks. Ergebnisse: Die Interferenzschrauben, Bohrkanaele und Knochenbloecke sowie das Transplantat konnten in allen Faellen gut dargestellt werden. Bei einem Vergleich unserer Daten mit den klinischen Untersuchungsergebnissen der Chirurgen zeigte sich ein statistisch hochsignifikanter Zusammenhang mit den Winkeldivergenzen zwischen Interferenzschraube und Bohrkanal im Bereich der Tibia. Divergenzen

  11. Bone Cancer

    Science.gov (United States)

    ... cancer. Surgery is often the main treatment for bone cancer. Other treatments may include amputation, chemotherapy, and radiation therapy. Because bone cancer can come back after treatment, regular follow-up visits are important. NIH: National ...

  12. Coupled Thermodynamic Behavior of New Screw Compressors Rotors Profile

    Directory of Open Access Journals (Sweden)

    Arístides Rivera Torres

    2010-05-01

    Full Text Available The article displays an evaluation of the thermodynamic behavior of screw compressor rotors with new profiles, obtained with the help of the Scorpath 2000 software. This allows predicting precisely the operation of the compressor, as well as its thermodynamic evaluation, under equal conditions, with the work of other compressors fitted with rotor profiles of other kinds.

  13. Are inclined screw blades for vertical grain augers advantageous?

    NARCIS (Netherlands)

    Rademacher, F.J.C.

    1978-01-01

    Due to modern technology, screw blades are often manufactured by rolling them out of one single strip of steel. When simultaneously some blade inclination is applied, less residual stresses and/or larger possible ratios between outer and shaft diameter are claimed by some manufacturers, which seems

  14. Kinematics of a Hybrid Manipulator by Means of Screw Theory

    International Nuclear Information System (INIS)

    In this work the kinematics of a hybrid manipulator, namely a fully parallel-serial manipulator, with a particular topology is approached by means of the theory of screws. Given the length of the six independent limbs, the forward position analysis of the mechanism under study, indeed the computation of the resulting pose, position and orientation, of the end-platform with respect to the fixed platform, is carried out in closed-form solution. Therefore conveniently this initial analysis avoids the use of a numerical technique such as the Newton-Raphson method. Writing in screw form the reduced acceleration state of the translational platform, with respect to the fixed platform, a simple expression for the computation of the acceleration of the translational platform is derived by taking advantage of the properties of reciprocal screws, via the Klein form, a bilinear symmetric form of the Lie algebra e(3). Following a similar procedure, a simple expression for the computation of the angular acceleration of the end-platform, with respect to the translational platform, is easily derived. Naturally, as an intermediate step, this contribution also provides the forward and inverse velocity analyses of the chosen parallel-serial manipulator. Finally, in order to prove the versatility of the expressions obtained via screw theory for solving the kinematics, up to the acceleration analysis, of the proposed spatial mechanism, a numerical example is solved with the help of commercial computer codes

  15. Optimisation of acoustic silencer for the screw compressor system

    NARCIS (Netherlands)

    Swamy, M.; Lier, L.J. van; Smeulers, J.P.M.

    2014-01-01

    In one of the screw compressor system, designed silencer was not optimal. A great challenge was the large variation in operating conditions, especially the variation of the molecular weight of the gas. There was need to optimize the silencer. This paper describes the acoustic modelling tools to opti

  16. Sacroiliac screw fixation: A mini review of surgical technique

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2014-01-01

    Full Text Available The sacral percutaneous fixation has many advantages but can be associated with a significant exposure to X-ray radiation. Currently, sacroiliac screw fixation represents the only minimally invasive technique to stabilize the posterior pelvic ring. It is a technique that should be used by experienced surgeons. We present a practical review of important aspects of this technique.

  17. Residence time distribution in twin-screw extruders.

    NARCIS (Netherlands)

    Jager, T.

    1992-01-01

    For the twin-screw extruders used in the food industry at short time high temperature processes the knowledge of their reactor properties is incomplete for mass- and heat flow. Therefore each process change such as: scale-up or product development requires a great number of measurements before an ac

  18. Kinematics Analysis Based on Screw Theory of a Humanoid Robot

    Institute of Scientific and Technical Information of China (English)

    MAN Cui-hua; FAN Xun; LI Cheng-rong; ZHAO Zhong-hui

    2007-01-01

    A humanoid robot is a complex dynamic system for its idiosyncrasy. This paper aims to provide a mathematical and theoretical foundation for the design of the configuration, kinematics analysis of a novel humanoid robot. It has a simplified configuration and design for entertainment purpose. The design methods, principle and mechanism are discussed. According to the design goals of this research, there are ten degrees of freedom in the two bionic arms.Modularization, concurrent design and extension theory methods were adopted in the configuration study and screw theory was introduced into the analysis of humanoid robot kinematics. Comparisons with other methods show that: 1) only two coordinates need to be established in the kinematics analysis of humanoid robot based on screw theory; 2) the spatial manipulator Jacobian obtained by using twist and exponential product formula is succinct and legible; 3) adopting screw theory to resolve the humanoid robot arms kinematics question can avoid singularities; 4) using screw theory can solve the question of specification insufficiency.

  19. Numerical Simulation of Twin-Screw Extrusion with Wall Slip

    Institute of Scientific and Technical Information of China (English)

    胡冬冬; 陈晋南

    2004-01-01

    Wall slip boundary condition is first introduced into twin-screw extrusion with the Navier slip law. Three-dimensional isothermal flow in the twin-screw extruder is simulated by using the finite element package POLYFLOW. Profiles of velocity contours in the screw channel and shear rate distributions in the intermeshing region are presented for different slip coefficients. Curves of axial pressure difference, average shear rate and dispersive mixing index vs. the slip coefficient are plotted and discussed. Comparisons are also made between the wall slip conditions and the non-slip condition. The simulation results indicate that, as the level of wall slip decreases, the axial pressure difference rises, the shear effect is intensified and the axial mixing is also enhanced. All these flow characteristics seem to level off with the increase of the slip coefficient. However, because of the inherent limitation of the Navier slip law, use of an overestimated slip coefficient would predict an over-sticky state between the screw surface and the polymer melt.

  20. Ankle fusion using a 2-incision, 3-screw technique

    NARCIS (Netherlands)

    R.P.M. Hendrickx; G.M.M.J. Kerkhoffs; S.A.S. Stufkens; C.N. van Dijk; R.K. Marti

    2011-01-01

    Reliable fusion and optimal correction of the alignment of the ankle joint using a 2-incision, 3-screw technique. Symptomatic osteoarthritis of the ankle joint after insufficient other treatment, severe deformity of the osteoarthritic ankle joint, or salvation procedure after failed arthroplasty. Ac

  1. Aqueous extraction of oleic sunflower oil from whole plant by twin-screw extruder: feasibility study, influence of screw configuration and operating conditions

    OpenAIRE

    Evon, Philippe; Vandenbossche, Virginie; Pontalier, Pierre-Yves; Rigal, Luc

    2007-01-01

    Aqueous extraction process using water alone as medium is an alternative to the solvent oil extraction process from oilseeds. It enables simultaneous recovery of oil and protein. The implementation of a co-rotating twin-screw extruder allows the aqueous extraction of oleic sunflower oil from whole plant. Screw configuration, screw rotation speed and whole plant input flow rate affect directly the efficiency of liquid/solid separation. Wringing out the mixing is possible because of the natu...

  2. A technique for the management of screw access opening in cement-retained implant restorations

    Directory of Open Access Journals (Sweden)

    Hamid Kermanshah

    2014-01-01

    Full Text Available Introduction: Abutment screw loosening has been considered as a common complication of implant-supported dental prostheses. This problem is more important in cement-retained implant restorations due to their invisible position of the screw access opening. Case Report: This report describes a modified retrievability method for cement-retained implant restorations in the event of abutment screw loosening. The screw access opening was marked with ceramic stain and its porcelain surface was treated using hydrofluoric acid (HF, silane, and adhesive to bond to composite resin. Discussion: The present modified technique facilitates screw access opening and improves the bond between the porcelain and composite resin.

  3. Use of computational fluid dynamics simulations for design of a pretreatment screw conveyor reactor.

    Science.gov (United States)

    Berson, R Eric; Hanley, Thomas R

    2005-01-01

    Computational fluid dynamics simulations were employed to compare performance of various designs of a pretreatment screw conveyor reactor. The reactor consisted of a vertical screw used to create cross flow between the upward conveying solids and the downward flow of acid. Simulations were performed with the original screw design and a modified design in which the upper flights of the screw were removed. Results of the simulations show visually that the modified design provided favorable plug flow behavior within the reactor. Pressure drop across the length of the reactor without the upper screws in place was predicted by the simulations to be 5 vs 40 kPa for the original design.

  4. STRUCTURE SYNTHESIS OF 4-DOF PARALLEL ROBOT MECHANISMS BASED ON SCREW THEORY

    Institute of Scientific and Technical Information of China (English)

    Fang Hairong; Fang Yuefa; Guo Sheng

    2004-01-01

    Structural synthesis for 4-DOF parallel manipulators using screw theory is systematically studied. Motion properties and constraint conditions of 4-DOF parallel manipulators according to the relationship between screw and reciprocal screw are analyzed. Mathematical expressions for constraint screws and twist screws of moving platform are constructed, and all possible limbs, which provide one or more force constraints, are enumerated. Finally, a parallel manipulator with 3-rotation-DOF and 1-translation-DOF is used as an example to describe the synthesis procedure for symmetrical and non-symmetrical 4-DOF parallel manipulators.

  5. Alveolar bone preservation subsequent to miniscrew implant placement in a canine model

    DEFF Research Database (Denmark)

    Melsen, Birte; Huja, Sarandeep; Chien, Hua-Hong;

    2015-01-01

    below the alveolar crest on the experimental side in the region of the extraction. The dogs were killed after 12 weeks. The bone at the extraction sites was analyzed using μCT and 3D analysis. A cylindrical core was placed around the actual and a virtual screw placed in the identical location...

  6. Outcomes of osteoporotic trochanteric fractures treated with cement-augmented dynamic hip screw

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar Gupta

    2012-01-01

    Full Text Available Background: Dynamic hip screw (DHS has been the standard treatment for stable trochanteric fracture patterns, but complications of lag screw cut out from a superior aspect, due to inadequate bone anchorage, occur frequently in elderly osteoporotic patients. Polymethylmethacrylate (PMMA has been used as an augmentation tool to facilitate fixation stability in cadaveric femora for biomechanical studies and in pathological fractures. However, there are very few reports on the utilization of PMMA cement to prevent these complications in fresh intertrochanteric fractures. A prospective study was conducted to evaluate the outcome and efficacy of PMMA augmented DHS in elderly osteoporotic patients with intertrochanteric fractures. Materials and Methods: The study included 64 patients (AO type31-A2.1 in eight, A2.2 in 29, A2.3 in 17 patients, and 31-A3.1 in five, A3.2 in three, and A3.3 in two patients with an average age of 72 years (60 − 94 years of which 60 were available for final followup. PMMA augmentation of DHS was performed in all cases by injecting PMMA cement into the femoral head with a custommade gun designed by the authors. The clinical outcome was rated as per the Salvati and Wilson scoring system at the time of final followup of one year. Results were graded as excellent (score > 31, good (score 24 − 31, fair (score 16 − 23, and poor (score < 16. Results: Fracture united in all patients and the average time to union was 13.8 weeks (range 12 − 16 weeks. At an average followup of 18 months (range 12 − 24 months, no incidence of varus collapse or superior screw cut out was observed in any of the patients in spite of weightbearing ambulation from the early postoperative period. There was no incidence of avascular necrosis (AVN or cement penetration into the joint in our series. Most of the patients were able to regain their prefracture mobility status with a mean hip pain score of 8.6. Conclusion: Cement augmentation of DHS appears

  7. A rationale method for evaluating unscrewing torque values of prosthetic screws in dental implants

    Directory of Open Access Journals (Sweden)

    Felipe Miguel Saliba

    2011-02-01

    Full Text Available OBJECTIVES: Previous studies that evaluated the torque needed for removing dental implant screws have not considered the manner of transfer of the occlusal loads in clinical settings. Instead, the torque used for removal was applied directly to the screw, and most of them omitted the possibility that the hexagon could limit the action of the occlusal load in the loosening of the screws. The present study proposes a method for evaluating the screw removal torque in an anti-rotational device independent way, creating an unscrewing load transfer to the entire assembly, not only to the screw. MATERIAL AND METHODS: Twenty hexagonal abutments without the hexagon in their bases were fixed with a screw to 20 dental implants. They were divided into two groups: Group 1 used titanium screws and Group 2 used titanium screws covered with a solid lubricant. A torque of 32 Ncm was applied to the screw and then a custom-made wrench was used for rotating the abutment counterclockwise, to loosen the screw. A digital torque meter recorded the torque required to loosen the abutment. RESULTS: There was a significant difference between the means of Group 1 (38.62±6.43 Ncm and Group 2 (48.47±5.04 Ncm, with p=0.001. CONCLUSION: This methodology was effective in comparing unscrewing torque values of the implant-abutment junction even with a limited sample size. It confirmed a previously shown significant difference between two types of screws.

  8. Fracture resistance of abutment screws made of titanium, polyetheretherketone, and carbon fiber-reinforced polyetheretherketone

    Directory of Open Access Journals (Sweden)

    Eduardo Aloisio Fleck NEUMANN

    2014-08-01

    Full Text Available Fractured abutment screws may be replaced; however, sometimes, the screw cannot be removed and the entire implant must be surgically removed and replaced. The aim of this study was to compare the fracture resistance of abutment retention screws made of titanium, polyetheretherketone (PEEK and 30% carbon fiber-reinforced PEEK, using an external hexagonal implant/UCLA-type abutment interface assembly. UCLA-type abutments were fixed to implants using titanium screws (Group 1, polyetheretherketone (PEEK screws (Group 2, and 30% carbon fiber-reinforced PEEK screws (Group 3. The assemblies were placed on a stainless steel holding apparatus to allow for loading at 45o off-axis, in a universal testing machine. A 200 N load (static load was applied at the central point of the abutment extremity, at a crosshead speed of 5 mm/minute, until failure. Data was analyzed by ANOVA and Tukey’s range test. The titanium screws had higher fracture resistance, compared with PEEK and 30% carbon fiber-reinforced PEEK screws (p 0.05. Finally, visual analysis of the fractions revealed that 100% of them occurred at the neck of the abutment screw, suggesting that this is the weakest point of this unit. PEEK abutment screws have lower fracture resistance, in comparison with titanium abutment screws.

  9. Screw-worm eradication in the Americas - Overview

    International Nuclear Information System (INIS)

    Screw-worms (Cochliomyia hominivorax, Coquerel) are found only in the Americas, and are known, therefore, as the New World Screw-worm (NWS). The larval stages of the fly feed on the living flesh of their host. A screw-worm infestation can kill an adult animal in 7-10 days if not treated. All warm-blooded animals are affected including man. Although screw-worms had long been recognised as a severe pest of animals in the southwestern United States, they had never been detected east of the Mississippi River before 1933. In July 1933, screw-worms were transported on infested cattle to Georgia and became established east of the Mississippi River. Screw-worms spread quickly in the southeastern United States and were able to overwinter in southern Florida. Being new to the region, they were quickly recognised as a severe pest with a tremendous economic impact on livestock production. The livestock owners in the southeastern United States immediately noticed an increase in the number of animal deaths and increased costs of insecticides, veterinary medicines, veterinary services, inspection and handling. At the same time, they observed a decrease in animal weights and in milk production. Due to these observations, the livestock industry in the southeastern United States requested help in controlling screw-worms. Because of these requests, the research community became interested in control and eradication measures for this pest. Early work by Crushing and Patton in 1933 recognised that C. hominivorax was an obligatory animal parasite and different from the secondary blowfly, Cochliomyia macellaria. In 1934, the US Department of Agriculture (USDA), Agricultural Research Service (ARS) opened a research station in Valdosa, Georgia, and E.W. Laake and E.F. Knipling were assigned to work there. In September 1935, R.C. Bushland was hired by ARS to do research related to screw-worms at an ARS Research Laboratory in Dallas, Texas. Melvin and Bushland in 1936 developed artificial

  10. Changes in the surface of bone and acid-etched and sandblasted implants following implantation and removal

    Science.gov (United States)

    Eroglu, Cennet Neslihan; Ertugrul, Abdullah Seckin; Eskitascioglu, Murat; Eskitascioglu, Gurcan

    2016-01-01

    Objective: The aim of this study was to determine whether there are any changes in the surface of bone or implant structures following the removal of a screwed dental implant. Materials and Methods: For this, six individual samples of acid-etched and sandblasted implants from three different manufacturers’ implant systems were used. They were screwed in a D1 bovine bone, and they were removed after primary stabilization. The bone and implant surfaces are evaluated with scanning electron microscope. Results: Through examination of the surfaces of the bone prior to implantation and of the used and unused implant surfaces, it was found that inhomogeneity in the implant surface can cause microcracking in the bone. Conclusions: This is attributed to the stress induced during the implantation of self-tapping implants and suggests that a tap drill may be required in some instances to protect the implant surface. PMID:27011744

  11. Accuracy of robot-assisted pedicle screw placement for adolescent idiopathic scoliosis in the pediatric population.

    Science.gov (United States)

    Macke, Jeremy J; Woo, Raymund; Varich, Laura

    2016-06-01

    This is a retrospective review of pedicle screw placement in adolescent idiopathic scoliosis (AIS) patients under 18 years of age who underwent robot-assisted corrective surgery. Our primary objective was to characterize the accuracy of pedicle screw placement with evaluation by computed tomography (CT) after robot-assisted surgery in AIS patients. Screw malposition is the most frequent complication of pedicle screw placement and is more frequent in AIS. Given the potential for serious complications, the need for improved accuracy of screw placement has spurred multiple innovations including robot-assisted guidance devices. No studies to date have evaluated this robot-assisted technique using CT exclusively within the AIS population. Fifty patients were included in the study. All operative procedures were performed at a single institution by a single pediatric orthopedic surgeon. We evaluated the grade of screw breach, the direction of screw breach, and the positioning of the patient for preoperative scan (supine versus prone). Of 662 screws evaluated, 48 screws (7.2 %) demonstrated a breach of greater than 2 mm. With preoperative prone position CT scanning, only 2.4 % of screws were found to have this degree of breach. Medial malposition was found in 3 % of screws, a rate which decreased to 0 % with preoperative prone position scanning. Based on our results, we conclude that the proper use of image-guided robot-assisted surgery can improve the accuracy and safety of thoracic pedicle screw placement in patients with adolescent idiopathic scoliosis. This is the first study to evaluate the accuracy of pedicle screw placement using CT assessment in robot-assisted surgical correction of patients with AIS. In our study, the robot-assisted screw misplacement rate was lower than similarly constructed studies evaluating conventional (non-robot-assisted) procedures. If patients are preoperatively scanned in the prone position, the misplacement rate is further

  12. Accuracy of robot-assisted pedicle screw placement for adolescent idiopathic scoliosis in the pediatric population.

    Science.gov (United States)

    Macke, Jeremy J; Woo, Raymund; Varich, Laura

    2016-06-01

    This is a retrospective review of pedicle screw placement in adolescent idiopathic scoliosis (AIS) patients under 18 years of age who underwent robot-assisted corrective surgery. Our primary objective was to characterize the accuracy of pedicle screw placement with evaluation by computed tomography (CT) after robot-assisted surgery in AIS patients. Screw malposition is the most frequent complication of pedicle screw placement and is more frequent in AIS. Given the potential for serious complications, the need for improved accuracy of screw placement has spurred multiple innovations including robot-assisted guidance devices. No studies to date have evaluated this robot-assisted technique using CT exclusively within the AIS population. Fifty patients were included in the study. All operative procedures were performed at a single institution by a single pediatric orthopedic surgeon. We evaluated the grade of screw breach, the direction of screw breach, and the positioning of the patient for preoperative scan (supine versus prone). Of 662 screws evaluated, 48 screws (7.2 %) demonstrated a breach of greater than 2 mm. With preoperative prone position CT scanning, only 2.4 % of screws were found to have this degree of breach. Medial malposition was found in 3 % of screws, a rate which decreased to 0 % with preoperative prone position scanning. Based on our results, we conclude that the proper use of image-guided robot-assisted surgery can improve the accuracy and safety of thoracic pedicle screw placement in patients with adolescent idiopathic scoliosis. This is the first study to evaluate the accuracy of pedicle screw placement using CT assessment in robot-assisted surgical correction of patients with AIS. In our study, the robot-assisted screw misplacement rate was lower than similarly constructed studies evaluating conventional (non-robot-assisted) procedures. If patients are preoperatively scanned in the prone position, the misplacement rate is further

  13. DLS 5.0--the biomechanical effects of dynamic locking screws.

    Directory of Open Access Journals (Sweden)

    Stefan Döbele

    Full Text Available INTRODUCTION: Indirect reduction of dia-/metaphyseal fractures with minimally invasive implant application bridges the fracture zone in order to protect the soft-tissue and blood supply. The goal of this fixation strategy is to allow stable motion at the fracture site to achieve indirect bone healing with callus formation. However, concerns have arisen that the high axial stiffness and eccentric position of locked plating constructs may suppress interfragmentary motion and callus formation, particularly under the plate. The reason for this is an asymmetric fracture movement. The biological need for sufficient callus formation and secondary bone healing is three-dimensional micro movement in the fracture zone. The DLS was designed to allow for increased fracture site motion. The purpose of the current study was to determine the biomechanical effect of the DLS_5.0. METHODS: Twelve surrogate bone models were used for analyzing the characteristics of the DLS_5.0. The axial stiffness and the interfragmentary motion of locked plating constructs with DLS were compared to conventional constructs with Locking Head Screws (LS_5.0. A quasi-static axial load of 0 to 2.5 kN was applied. Relative motion was measured. RESULTS: The dynamic system showed a biphasic axial stiffness distribution and provided a significant reduction of the initial axial stiffness of 74.4%. Additionally, the interfragmentary motion at the near cortex increased significantly from 0.033 mm to 0.210 mm (at 200N. CONCLUSIONS: The DLS may ultimately be an improvement over the angular stable plate osteosynthesis. The advantages of the angular stability are not only preserved but even supplemented by a dynamic element which leads to homogenous fracture movement and to a potentially uniform callus distribution.

  14. The prognostic value of tip-to-apex distance (TAD index in intertrochanteric fractures fixed by dynamic hip screw

    Directory of Open Access Journals (Sweden)

    Ali Sadighi

    2012-11-01

    Full Text Available Intertrochanteric fractures (ITFs are the most common type of fractures requiring surgical intervention. They also have the highest surgical mortality among orthopedic operations. Among the many different techniques used for fixation of this type of fracture, use of the Dynamic Hip Screw (DHS has gained wide acceptance. This current study was designed to assess positive predictive value of tip-to-apex distance (TAD index in the prognosis of patients treated with DHS. The study was designed according to a descriptive-analytic protocol, made up of 100 cases of ITFs caused by falling, treated in the Shohada Orthopedic Center, Tabriz, Iran. All patients underwent lateral and antero-posterior hip X-ray to measure TAD index. The cohort was followed for three months after DHS placement. Of a total of 100 cases (53 male, 47 female with a mean age of 76.7 years (range 29-100 years, 43% had grade 4, 29% grade 3, 21% grade 5, 5% grade 2 and 2% grade 6 osteoporosis. The screw position was postero-inferior in 57%, central in 40% and superior in 3% of patients. Minimum and maximum TAD index were 20 and 28 mm, respectively. Mean TAD was 23.5 mm. There were no post-operative complications in 84% of cases. Screw failure was the most common complication in the remaining 16% of patients. The study shows a statistically significant correlation between TAD index and cut-off rate in patients with intertrochanteric fractures of femoral bone treated by DHS. This validates the use of TAD index in determining the prognosis of patients treated by DHS.

  15. The prognostic value of tip-to-apex distance (TAD index) in intertrochanteric fractures fixed by dynamic hip screw.

    Science.gov (United States)

    Sedighi, Ali; Sales, Jafar Ganjpour; Alavi, Sahar

    2012-11-01

    Intertrochanteric fractures (ITFs) are the most common type of fractures requiring surgical intervention. They also have the highest surgical mortality among orthopedic operations. Among the many different techniques used for fixation of this type of fracture, use of the Dynamic Hip Screw (DHS) has gained wide acceptance. This current study was designed to assess positive predictive value of tip-to-apex distance (TAD) index in the prognosis of patients treated with DHS. The study was designed according to a descriptive-analytic protocol, made up of 100 cases of ITFs caused by falling, treated in the Shohada Orthopedic Center, Tabriz, Iran. All patients underwent lateral and antero-posterior hip X-ray to measure TAD index. The cohort was followed for three months after DHS placement. Of a total of 100 cases (53 male, 47 female) with a mean age of 76.7 years (range 29-100 years), 43% had grade 4, 29% grade 3, 21% grade 5, 5% grade 2 and 2% grade 6 osteoporosis. The screw position was postero-inferior in 57%, central in 40% and superior in 3% of patients. Minimum and maximum TAD index were 20 and 28 mm, respectively. Mean TAD was 23.5 mm. There were no post-operative complications in 84% of cases. Screw failure was the most common complication in the remaining 16% of patients. The study shows a statistically significant correlation between TAD index and cut-off rate in patients with intertrochanteric fractures of femoral bone treated by DHS. This validates the use of TAD index in determining the prognosis of patients treated by DHS.

  16. Bold镙钉治疗Jones骨折%Treatment of 16 cases Jones fractures by open reduction and bold screw fixation

    Institute of Scientific and Technical Information of China (English)

    单宇; 蒋富贵; 张晓剑; 徐能

    2013-01-01

    Objective To evaluate the clinical effect of Bold screw fixation in the treatment of jones fracture.Method From March 2006 to May 2012,16 case of Jones fracture were treated by open reduction and Bold screw fixation.Result All the patients were obtained healing of bone reunion and followed up for 6~12 months,no residual pain and nonunion.According to Maryland foot scording system,9 cases were excellent,5 good,2 fair and the rate of excellent and good was 87.5 %.Conclusion Bold screw fixation is an effective therapy for Jones fracture of open reduction and it has the benefit of early exercise,no need to remove,fixed solid.%目的 探讨Bold螺钉内固定治疗Jones骨折的临床疗效.方法 2006年3月~2012年5月,采用切开复位Bold螺钉内固定治疗Jones骨折16例.结果 16例均获随访,随访时间6~12m,均获得骨性愈合,未残留疼痛或骨不愈合.按Maryland足部评分系统评分,优9例,良5例,可2例,优良率87.5%.结论 Bold螺钉治疗Jones骨折具有早期功能锻炼、无需取出、固定稳固等优点,是治疗Jones骨折的有效方法.

  17. Decompressive cervical laminectomy and lateral mass screw-rod arthrodesis. Surgical analysis and outcome

    Directory of Open Access Journals (Sweden)

    Obaidat Mouness H

    2011-05-01

    Full Text Available Abstract Background This study evaluates the outcome and complications of decompressive cervical Laminectomy and lateral mass screw fixation in 110 cases treated for variable cervical spine pathologies that included; degenerative disease, trauma, neoplasms, metabolic-inflammatory disorders and congenital anomalies. Methods A retrospective review of total 785 lateral mass screws were placed in patients ages 16-68 years (40 females and 70 males. All cases were performed with a polyaxial screw-rod construct and screws were placed by using Anderson-Sekhon trajectory. Most patients had 12-14-mm length and 3.5 mm diameter screws placed for subaxial and 28-30 for C1 lateral mass. Screw location was assessed by post operative plain x-ray and computed tomography can (CT, besides that; the facet joint, nerve root foramen and foramen transversarium violation were also appraised. Results No patients experienced neural or vascular injury as a result of screw position. Only one patient needed screw repositioning. Six patients experienced superficial wound infection. Fifteen patients had pain around the shoulder of C5 distribution that subsided over the time. No patients developed screw pullouts or symptomatic adjacent segment disease within the period of follow up. Conclusion decompressive cervical spine laminectomy and Lateral mass screw stabilization is a technique that can be used for a variety of cervical spine pathologies with safety and efficiency.

  18. Pedicle Screw Fixation Study in Immature Porcine Spines to Improve Pullout Resistance during Animal Testing.

    Science.gov (United States)

    Le Cann, Sophie; Cachon, Thibaut; Viguier, Eric; Miladi, Lotfi; Odent, Thierry; Rossi, Jean-Marie; Chabrand, Patrick

    2015-01-01

    The porcine model is frequently used during development and validation of new spinal devices, because of its likeness to the human spine. These spinal devices are frequently composed of pedicle screws with a reputation for stable fixation but which can suffer pullouts during preclinical implantation on young animals, leading to high morbidity. With a view to identifying the best choices to optimize pedicle screw fixation in the porcine model, this study evaluates ex vivo the impact of weight (age) of the animal, the level of the vertebrae (lumbar or thoracic) and the type of screw anchorage (mono- or bi-cortical) on pedicle screw pullouts. Among the 80 pig vertebrae (90- and 140-day-old) tested in this study, the average screw pullout forces ranged between 419.9N and 1341.2N. In addition, statistical differences were found between test groups, pointing out the influence of the three parameters stated above. We found that the the more caudally the screws are positioned (lumbar level), the greater their pullout resistance is, moreover, screw stability increases with the age, and finally, the screws implanted with a mono-cortical anchorage sustained lower pullout forces than those implanted with a bi-cortical anchorage. We conclude that the best anchorage can be obtained with older animals, using a lumbar fixation and long screws traversing the vertebra and inducing bi-cortical anchorage. In very young animals, pedicle screw fixations need to be bi-cortical and more numerous to prevent pullout. PMID:26451947

  19. Pedicle Screw Fixation Study in Immature Porcine Spines to Improve Pullout Resistance during Animal Testing.

    Directory of Open Access Journals (Sweden)

    Sophie Le Cann

    Full Text Available The porcine model is frequently used during development and validation of new spinal devices, because of its likeness to the human spine. These spinal devices are frequently composed of pedicle screws with a reputation for stable fixation but which can suffer pullouts during preclinical implantation on young animals, leading to high morbidity. With a view to identifying the best choices to optimize pedicle screw fixation in the porcine model, this study evaluates ex vivo the impact of weight (age of the animal, the level of the vertebrae (lumbar or thoracic and the type of screw anchorage (mono- or bi-cortical on pedicle screw pullouts. Among the 80 pig vertebrae (90- and 140-day-old tested in this study, the average screw pullout forces ranged between 419.9N and 1341.2N. In addition, statistical differences were found between test groups, pointing out the influence of the three parameters stated above. We found that the the more caudally the screws are positioned (lumbar level, the greater their pullout resistance is, moreover, screw stability increases with the age, and finally, the screws implanted with a mono-cortical anchorage sustained lower pullout forces than those implanted with a bi-cortical anchorage. We conclude that the best anchorage can be obtained with older animals, using a lumbar fixation and long screws traversing the vertebra and inducing bi-cortical anchorage. In very young animals, pedicle screw fixations need to be bi-cortical and more numerous to prevent pullout.

  20. Preload and torque removal evaluation of three different abutment screws for single standing implant restorations

    Directory of Open Access Journals (Sweden)

    Rafael Augusto Stüker

    2008-02-01

    Full Text Available Several authors still consider the mechanical problems of fracture and component loosening as the main causes of failure of implant-supported restorations. The purpose of this in vitro study was to compare the preload of three types of screw for transmucosal abutment attachment used in single implant-supported prosthesis through strain gauge and removal torque measurements. Three external hex fixtures were used, and each received a transmucosal abutment (Cera One®, which was fixed to the implant with its respective screw: Group A- gold screw, Group B- titanium screw and Group C- surface-treated titanium screw (Ti-Tite®. Ten screws of each type were attached applying a 30.07±0.28 Ncm torque force and maintained in position for 5 minutes. After this, the preload values were measured using strain gauges and a measurement cell. Gold screws presented higher preload values (131.72±8.98 N, followed by surface-treated titanium screws (97.78±4.68 N and titanium screws (37.03±5.69 N. ANOVA (p<0.05 and Tukey's test (p<0.05 were applied. Statistically significant differences were found among the groups for both preload and removal torque values. In conclusion, gold screws may be indicated to achieve superior longevity of the abutment-implant connection and, consequently, prosthetic restoration due to greater preload values yielded.

  1. PROSPECTS OF USE OF RELATIVE SCREW AND COMBINED REELS FOR MIXING BULKS

    Directory of Open Access Journals (Sweden)

    Marchenko A. Y.

    2015-11-01

    Full Text Available The article reveals a possibility of using equipment based on relative screw and combined drums for mixing of bulks. Change of relative positioning of flat elements of sidewalls of internal surfaces in relative screw drums allows operating the difficult and spatial movement of streams of bulks. In relative screw drums we have developed effective processes of mixing and sets of the equipment, which are characterized by that fact the difficult and spatial screw movement taking place in relative screw drums is dismembered on rather simple, in the kinematic relation, in the movements. The difficult and spatial screw movement with a big amplitude of 15-1000 mm and more, in the offered equipment constructions on the basis of relative screw or combined drums, is reported to bulks by elements of the relative screw or combined drums of various parameters and configurations which becomes complicated also screw lines on perimeter of a relative screw drum with various number of calling and the directions from each other or rounds of the springs fixed in the relative combined drums

  2. Application of USS screw rods system in the reconstruction of the stability of the lumbar sacrum after resection of sacrum tumor%骶骨肿瘤切除后腰骶关节稳定性重建中 USS钉棒系统的应用

    Institute of Scientific and Technical Information of China (English)

    颉强; 王臻; 王岭; 郭征; 刘继中; 戴先文

    2002-01-01

    Objective To introduce one operation method applied with USS (universal spine system) screw rods system for the reconstruction of the stability of the lumbar sacrum after resection of sacrum tumor and discuss indications and feasibility of the operation method.Methods 5 patients with sacrum tumor had accepted the clinical treatment of USS.Resect the sacrum tumor,insert pedicle screw into the normal pedicles (L3 or L4 or L5)above the region of laminectomy routinely,fix lower screw in the iliac plane,put metal rods,plant bone and put transverse links. Results There was no recurrence of sacrum tumor by MRI examination after 1~ 12 months follow up.The preoperative pain of lumbar- sacrum joint and roots of the spinal nerves relieved significantly.The patients turned to normal weight loading and movement.There were no fractures of the screw and rods and motion of the screw.X- ray examination hasn't found increase of screw passage,pelvic decrease, and L5 sinking.Conclusion The operation method applied with USS screw- rods system for the reconstruction of the stability of the lumbar- sacrum can reduce postoperative pain,promote early postoperative activity,and prevent pathologic fracture and paraplegia.

  3. A new harvest site for bone graft in anterior cruciate ligament revision surgery.

    Science.gov (United States)

    Franceschi, Francesco; Papalia, Rocco; Di Martino, Alberto; Rizzello, Giacomo; Allaire, Robert; Denaro, Vincenzo

    2007-05-01

    During revision anterior cruciate ligament (ACL) surgery, femoral interference screws frequently require removal. This may lead to significant tunnel widening and possible graft fixation failure as a result. Solutions include drilling the revision tunnel in a different location, using stacked interference screws, or using bone graft to fill the defect. Autogenous iliac crest graft and allograft are both used, but there are significant comorbidities associated with each. We developed a new technique for harvesting autogenous bone graft that avoids many of the complications associated with other graft sources. By use of the existing surgical incision from the initial harvest of the bone-patellar tendon-bone autograft, bone from the medial tibial metaphyseal safe zone is harvested via an OATS tube harvester (Arthrex, Naples, FL). A bone plug 1 mm larger in size than the femoral defect is harvested and arthroscopically inserted via a press-fit technique. At 3 months after bone grafting, patients undergo revision ACL reconstruction. The proximal tibial metaphysis is a safe bone graft harvest site in revision ACL surgery and offers an effective method for filling large bony defects, allowing anatomic reconstruction of the ACL after bone healing has occurred. Furthermore, it eliminates the problems associated with allograft or use of a remote graft donor site. PMID:17478290

  4. HA/UHMWPE Nanocomposite Produced by Twin-screw Extrusion

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    The HA/UHMWPE nanocomposite is compounded by twin-screw extrusion of the HA and UHMWPE powder mixture in paraffin oil and then compression molded to a sheet form. TGA measurement shows the HA weight loss after processing is about 1%-2% . FTIR spectra indicate the paraffin oil residue is trivial and UHMWPE is not oxidized. SEM reveals the HA nano particles are homogeneously dispersed by twin- screw extrusion and the inter-particle spaces are penetrated with UHMWPE fibrils by swelling treatment. HRTEM image indicates the HA particles and UHMWPE are intimately contacted by mechanical interlocking. Compared with the unfilled UHMWPE, stiffness of the composite with the HA volume fraction 0.23 was significantly enhanced to 9 times without detriment of the yield strength and the ductility.

  5. Detecting thrust bearing failure within a screw compressor

    International Nuclear Information System (INIS)

    A 3 1/2 mile ring of over 1000 superconducting magnets are needed to focus and drive the world's highest energy particle smasher. 24 Refrigerators supply liquid helium to the magnets; 34 high pressure oil flooded screw compressors supply 285 psig helium gas to the refrigerators. The 400 h.p. screws are reliable machines that use 45 gallons of oil per minute to seal and lubricate the rotors, lubricate the bearings, and remove the heat of compression. These machines are spaced out in seven buildings over four miles. A minimum of 28 machines must be operating at all times. A contingent of operators start, stop, and monitor any machine from a distant control room. The 34 compressors have an average of 32,000 hours; 9 machines have over 40,000 hours; the highest is 55,000 hours

  6. Accuracy of spinal navigation for Magerl-screws

    CERN Document Server

    Herz, T

    2001-01-01

    Study design: assessment of the accuracy of frameless stereotactic navigation at the second cervical vertebra. Objectives: to assess the influence of the protocol of preoperative CT-scan and the registration technique on the accuracy of navigation for implanting Magerl-screws. Summary of background data: the use of navigation systems for implanting Magerl-screws could help to decrease the risk of complications and to reduce the required skin incision. Two parameters conceivably affecting the accuracy are the protocol of the preoperative CT-scan and the registration technique. Methods: four cervical spine segments of human cadavers were scanned with two different protocols (3 mm slice thickness/2 mm table increment, 1 mm slice thickness/1 mm table increment). Registration was performed either based on anatomical landmarks or using a specially designed percutaneous registration device. For the accuracy-check, the pointer tip was exactly placed on markers. The distance between the pointer and the marker displaye...

  7. Numerical Simulation and Performance Analysis of Twin Screw Air Compressors

    Directory of Open Access Journals (Sweden)

    W. S. Lee

    2001-01-01

    Full Text Available A theoretical model is proposed in this paper in order to study the performance of oil-less and oil-injected twin screw air compressors. Based on this model, a computer simulation program is developed and the effects of different design parameters including rotor profile, geometric clearance, oil-injected angle, oil temperature, oil flow rate, built-in volume ratio and other operation conditions on the performance of twin screw air compressors are investigated. The simulation program gives us output variables such as specific power, compression ratio, compression efficiency, volumetric efficiency, and discharge temperature. Some of the above results are then compared with experimentally measured data and good agreement is found between the simulation results and the measured data.

  8. Modeling the Parker instability in a rotating plasma screw pinch

    CERN Document Server

    Khalzov, I V; Katz, N; Forest, C B; 10.1063/1.3684240

    2012-01-01

    We analytically and numerically study the analogue of the Parker (magnetic buoyancy) instability in a uniformly rotating plasma screw pinch confined in a cylinder. Uniform plasma rotation is imposed to create a centrifugal acceleration, which mimics the gravity required for the classical Parker instability. The goal of this study is to determine how the Parker instability could be unambiguously identified in a weakly magnetized, rapidly rotating screw pinch, in which the rotation provides an effective gravity and a radially varying azimuthal field is controlled to give conditions for which the plasma is magnetically buoyant to inward motion. We show that an axial magnetic field is also required to circumvent conventional current driven magnetohydrodynamic (MHD) instabilities such as the sausage and kink modes that would obscure the Parker instability. These conditions can be realized in the Madison Plasma Couette Experiment (MPCX). Simulations are performed using the extended MHD code NIMROD for an isothermal...

  9. A Biomechanical Study Comparing Helical Blade with Screw Design for Sliding Hip Fixations of Unstable Intertrochanteric Fractures

    Directory of Open Access Journals (Sweden)

    Qiang Luo

    2013-01-01

    Full Text Available Dynamic hip screw (DHS is a well-established conventional implant for treating intertrochanteric fracture. However, revision surgery sometimes still occurs due to the cutting out of implants. A helical blade instead of threaded screw (DHS blade was designed to improve the fixation power of the osteoporotic intertrochanteric fracture. In this study, the biomechanical properties of DHS blade compared to the conventional DHS were evaluated using an unstable AO/OTA 31-A2 intertrochanteric fracture model. Fifty synthetic proximal femoral bone models with such configuration were fixed with DHS and DHS blade in five different positions: centre-centre (CC, superior-centre (SC, inferior-center (IC, centre-anterior (CA, and centre-posterior (CP. All models had undergone mechanical compression test, and the vertical and rotational displacements were recorded. The results showed that DHS blade had less vertical or rotational displacement than the conventional DHS in CC, CA, and IC positions. The greatest vertical and rotational displacements were found at CP position in both groups. Overall speaking, DHS blade was superior in resisting vertical or rotational displacement in comparison to conventional DHS, and the centre-posterior position had the poorest performance in both groups.

  10. Enhancement of biodegradation and osseointegration of poly(ε-caprolactone)/calcium phosphate ceramic composite screws for osteofixation using calcium sulfate.

    Science.gov (United States)

    Wu, Chang-Chin; Hsu, Li-Ho; Tsai, Yuh-Feng; Sumi, Shoichiro; Yang, Kai-Chiang

    2016-04-01

    Internal fixation devices, which can stabilize and realign fractured bone, are widely used in fracture management. In this paper, a biodegradable composite fixator, composed of poly(ε-caprolactone), calcium phosphate ceramic and calcium sulfate (PCL/CPC/CS), is developed. The composition of CS, which has a high dissolution rate, was expected to create a porous structure to improve osteofixation to the composite fixator. PCL, PCL/CPC, and PCL/CPC/CS samples were prepared and their physical properties were characterized in vitro. In vivo performance of the composite screws was verified in the distal femurs of rabbits. Results showed that the PCL/CPC/CS composite had a higher compressive strength (28.55 ± 3.32 MPa) in comparison with that of PCL (20.64 ± 1.81 MPa) (p enhanced apatite formation of the PCL/CPC composite screw. This osteoconductive PCL/CPC/CS is a good candidate material for internal fixation devices. PMID:27041468

  11. Behaviour and Modelling of Flow-Drilling Screw Connections

    OpenAIRE

    Amundsen, Dan Hugo; Gustad, Jo Utne

    2014-01-01

    This thesis presents an experimental and numerical study on the behaviour of Flow-Drilling Screw (FDS) connections under various quasi-static loading conditions. The behaviour and fracture of the connections were closely studied by means of tests on simple coupons joined with a single connector and component tests. Single-connector tests were performed on both two- and three-layered specimens. Cross tests in three loading directions, lap-joint tests and peeling tests were conducted for both c...

  12. Modern posterior screw techniques in the pediatric cervical spine

    OpenAIRE

    Hedequist, Daniel J

    2014-01-01

    Treatment of children with cervical spine disorders requiring fusion is a challenging endeavor for a variety of reasons. The size of the patients, the corresponding abnormal bony anatomy, the inherent ligamentous laxity of children, and the relative rarity of the disorders all play a part in difficulty of treatment. The benefits of modern posterior cervical instrumentation in children, defined as rigid screw-rod systems, have been shown to be many including: improved arthrodesis rates, dimini...

  13. Rancang Bangun Mesin Pemeras Santan Sistem Screw Press

    OpenAIRE

    Sinaga, Febrina Medyanti Br

    2015-01-01

    Until now,obtain coconut milk was still obtain using conventional method which is handpressed. Later on, manual coconut milk extractor is develop using hydrolic press system. With the development of science and technology in this modern age, people trying to create or make a new, more efficient and practical equipment.Therefore, in this research, the author tried to ease theextraction of coconut milk by designing coconut milk extractor with screw press system which has larger capacity which b...

  14. [Bone diseases].

    Science.gov (United States)

    Uebelhart, Brigitte; Rizzoli, René

    2016-01-13

    Calcium intake shows a small impact on bone mineral density and fracture risk. Denosumab is a more potent inhibitor of bone resorption than zoledronate. Abaloparatide, PTHrP analog, increases bone mineral density and decreases fracture incidence. Teriparatide could be delivered via a transdermic device. Romosozumab and odanacatib improve calculated bone strength. Sequential or combined treatments with denosumab and teriparatide could be of interest, but not denosumab followed by teriparatide. Fibrous dysplasia, Paget disease and hypophosphatasia are updated, as well as atypical femoral fracture and osteonecrosis of the jaw. PMID:26946704

  15. Fluid Flow Phenomenon in a Three-Bladed Power-Generating Archimedes Screw Turbine

    Directory of Open Access Journals (Sweden)

    Tineke Saroinsong

    2016-05-01

    Full Text Available Experimental studies of the Archimedes screw turbine are applied as a micro hydro power plant for low head focused on the fluid flow. Fluid flow on a screw turbine is not completely filled water flow there is still a free surface between the water fluid and atmospheric air. Except the screw geometry, the turbine screw free surface allows the flow phenomena that are important in the process of turbine screw power generation. The Archimedes screw turbine main driving force is the fluid-gravity weight, which is affected by the inflow depth, inflow velocity and the turbine shaft’s slope. The dimensionless parameter Froude number (Fr is connected to analyze the screw turbine efficiency. The purpose of this study is to figure out the fluid flow role when power generated by a three blades Archimedes screw turbine observed visualized, and also observed the turbine rotation and torque. The observed parameters are varied in inflow depth as the characteristic length (y of Froude Number, inflow velocity (co, and the turbine shaft slope (α. The screw turbine model, were made under a laboratory scale and made from acrylic material. The geometric form is the three bladed screws which have seven screw respectively, the number of helix turns is 21, the angle of screw blade is 30°, radius ratio of 0.54 with a pitch distance of 2,4 Ro. The result from this study revealed a phenomenon of fluid flow between the screw blades a whirlpool wave occurs or vortex due to the linear momentum in a form of the hydrostatic force against the blade screw which occurs in two opposite directions and the effect of the turbine shaft angular momentum. The vortex would affect the screw turbine power generation process as most of the kinetic energy that goes into the screw turbine sucked into the vortex between the screw blades, but this phenomenon can be reduced by reducing the turbine shaft slope. The highest turbine efficiency of 89% occurred in the turbine shaft’s slope of 25

  16. Twin screw wet granulation: the study of a continuous twin screw granulator using Positron Emission Particle Tracking (PEPT) technique.

    Science.gov (United States)

    Lee, Kai T; Ingram, Andy; Rowson, Neil A

    2012-08-01

    In this paper, Positron Emission Particle Tracking (PEPT) techniques are utilised to track the trajectory of single particles through the mixing and conveying zones of a Twin Screw Granulator (TSG). A TSG consisting of conveying zones and mixing zones is used in this study. The mixing zones are arranged with kneading discs at an angle of 30°, 60° or 90°. Experiments were carried out using different mixing configurations with various screw speed and total mass flow rate. The PEPT data obtained were then utilised to obtain the residence time distribution (RTD) and the Peclet number in an attempt to gain some insight into the mixing of the process. The fill level of the granulator was also estimated to study the mechanism of granulation. As might be expected, it was shown that the residence time of the granulation process increases with decreasing screw speed. It also increases with increasing angle of the arrangement of kneading blocks in the mixing zones, but will decreases when powder feed rate is increased. The fill level of the mixing zone in particular increases when the screw speed decreases or when powder feed rate increases. Furthermore, the fill level of the granulator will increase when the mixing zone configuration changes from 30° to 90°. It is shown that the granulator is never fully filled, even using 90° mixer elements implying limited compaction which may explain why the granules produced are porous compared with those from a high shear mixer. Interestingly, the RTD analysis reveals that the extent of axial mixing in the mixing zone of the granulator does not change significantly for different configurations and process conditions. There is evidence of a tail in the RTD which implies some material hold up and channelling. PMID:22561951

  17. Decompressive cervical laminectomy and lateral mass screw-rod arthrodesis. Surgical analysis and outcome

    OpenAIRE

    Obaidat Mouness H; Dabbas Waleed F; Qudsieh Tareq M; Obeidat Moutasem M; Audat Ziad A; Al Barbarawi Moh'd M; Malkawi Anas A

    2011-01-01

    Abstract Background This study evaluates the outcome and complications of decompressive cervical Laminectomy and lateral mass screw fixation in 110 cases treated for variable cervical spine pathologies that included; degenerative disease, trauma, neoplasms, metabolic-inflammatory disorders and congenital anomalies. Methods A retrospective review of total 785 lateral mass screws were placed in patients ages 16-68 years (40 females and 70 males). All cases were performed with a polyaxial screw-...

  18. Comparison of Apical Axial Derotation between Adolescent Idiopathic and Neuromuscular Scoliosis with Pedicle Screw Instrumentation

    OpenAIRE

    Modi, Hitesh N.; Suh, Seung-Woo; Srinivasalu, S.; Mehta, Satyen; Yang, Jae-Hyuk

    2008-01-01

    Study Design A retrospective study. Purpose To compare outcomes of apical derotation with pedicle screws in idiopathic and neuromuscular scoliosis (NMS). Overview of Literature No information about apical derotation in NMS with pedicle screws is available. Methods We performed deformity correcting surgery using pedicle screw constructs on 12 adolescent idiopathic scoliosis (AIS) patients (mean age 14.1 years) and 16 NMS patients (mean age 16.5 years). Preoperative, postoperative, and final fo...

  19. A Comparison of Functional Outcomes After Metallic and Bioabsorbable Interference Screw Fixations in Arthroscopic ACL Reconstructions

    OpenAIRE

    Hegde, Atmananda S; Rai, Deepak K; Kannampilly, Antony J

    2014-01-01

    Introduction: Anterior Cruciate Ligament (ACL) is as one of the most frequently injured ligaments in the modern contact sports scenario. Graft fixations can be achieved during anterior cruciate ligament (ACL) reconstructions by using either bioabsorbable screws or metal screws. The objective of this study was to compare the functional outcomes after bioabsorbable and metallic interference screw fixations in arthroscopic anterior cruciate ligament reconstructions done by using hamstring grafts.

  20. Deforming grid generation and CFD analysis of variable geometry screw compressors

    OpenAIRE

    Rane, S.; Kovacevic, A.; Stosic, N.; Kethidi, M.

    2014-01-01

    The most common type of twin screw machines are twin screw compressors. These normally contain rotors of uniform pitch and profile along the rotor length. However, in some cases such as in twin screw vacuum pumps with very large pressure ratios, the variable pitch rotors are often used to improve efficiency. The limited use of rotors with variable pitch and/or section profile is mainly due to manufacturing constraints. In order to analyse the performance of such machines by means of Computati...

  1. Extraction of Coriander Oil Using Twin‑Screw Extrusion: Feasibility Study and Potential Press Cake Applications

    OpenAIRE

    Uitterhaegen, Evelien; Nguyen, Quang Hung; Sampaio, Klicia; Stevens, Chris; Merah, Othmane; Talou, Thierry; Rigal, Luc; Evon, Philippe

    2015-01-01

    This study presents an assessment of the vegetable oil extraction from coriander fruits through mechanical pressing, more specifically twin-screw extrusion. This comprises an evaluation of the oil recovery obtained and its respective quality, as well as the specific mechanical energy, representing an economical point of view. With regard to the extrusion optimization, the screw configuration, the device’s filling coefficient and the pressing temperature were varied. The screw configuration wa...

  2. INVESTIGATION ON KANE DYNAMIC EQUATIONS BASED ON SCREW THEORY FOR OPENCHAIN MANIPULATORS

    Institute of Scientific and Technical Information of China (English)

    LIU Wu-fa; GONG Zhen-bang; WANG Qin-que

    2005-01-01

    First, screw theory, product of exponential formulas and Jacobian matrix are introduced. Then definitions are given about active force wrench, inertial force wrench, partial velocity twist, generalized active force, and generalized inertial force according to screw theory. After that Kane dynamic equations based on screw theory for open-chain manipulators have been derived. Later on how to compute the partial velocity twist by geometrical method is illustrated. Finally the correctness of conclusions is verified by example.

  3. 螺旋输送机螺旋体优化设计%Optimization Design of Screw in Screw Conveyor

    Institute of Scientific and Technical Information of China (English)

    王铁流; 郭晓梅; 陈仙明

    2012-01-01

    The process of finite element analysis and optimization design of screw for screw conveyor with the Pro/Engineer is discussed, the main steps and methods are also introduced. Subject to the requirements of the structural parameters and design objectives, the optimal design is realized efficiently and rapidly. A practical method is improved for the design quality of screw.%应用Pro/Engineer软件,研究了螺旋输送机螺旋体的有限元分析和优化设计方法和过程,介绍了设计过程的主要步骤和方法.在满足结构参数和设计目标要求的前提下,快捷、有效地实现了优化设计,提高了设计质量,为螺旋体的设计提供了一种有效的方法.

  4. Talking Bones.

    Science.gov (United States)

    Johnson, Jaclyn; Kassing, Sharon

    2002-01-01

    Describes cooperation with the Saint Louis Zoo to provide opportunities for elementary school students to learn about bones, how animals move, what they eat, and how much they grow. Uses biofacts which include bones, skulls, and other parts to make the laboratory a hands-on experience for students. (YDS)

  5. Bone Markers

    Science.gov (United States)

    ... bone turnover: C-telopeptide (C-terminal telopeptide of type 1 collagen (CTx)) – a marker for bone resorption. It is ... resorption include: N-telopeptide (N-terminal telopeptide of type 1 collagen (NTx)) – a peptide fragment from the amino terminal ...

  6. Bone densitometry

    DEFF Research Database (Denmark)

    Ravn, Pernille; Alexandersen, P; Møllgaard, A

    1999-01-01

    The bisphosphonates have been introduced as alternatives to hormone replacement therapy (HRT) for the treatment and prevention of postmenopausal osteoporosis. The expected increasing application in at clinical practice demands cost-effective and easily handled methods to monitor the effect on bone....... The weak response at the distal forearm during antiresorptive treatment has restricted the use of bone densitometry at this region. We describe a new model for bone densitometry at the distal forearm, by which the response obtained is comparable to the response in other regions where bone densitometry...... is much more expensive and technically complicated. By computerized iteration of single X-ray absorptiometry forearm scans we defined a region with 65% trabecular bone. The region was analyzed in randomized, double-masked, placebo- controlled trials: a 2-year trial with alendronate (n = 69), a 1-year...

  7. Two inhomogeneities of irregular shape with internal uniform stress fields interacting with a screw dislocation

    Science.gov (United States)

    Wang, Xu; Schiavone, Peter

    2016-07-01

    Using complex variable methods and conformal mapping techniques, we demonstrate rigorously that two inhomogeneities of irregular shape interacting with a screw dislocation can indeed maintain uniform internal stress distributions. Our analysis indicates that while the internal uniform stresses are independent of the existence of the screw dislocation, the shapes of the two inhomogeneities required to achieve this uniformity depend on the Burgers vector, the location of the screw dislocation, and the size of the inhomogeneities. In addition, we find that this uniformity of the internal stress field is achievable also when the two inhomogeneities interact with an arbitrary number of discrete screw dislocations in the matrix.

  8. Arthroscopic Bony Bankart Repair Using Double-Threaded Headless Screw: A Case Report

    Directory of Open Access Journals (Sweden)

    Takeshi Kokubu

    2012-01-01

    Full Text Available We present a case of arthroscopic fixation for bony Bankart lesion using a double-threaded cannulated screw. A 39-year-old man sustained a left shoulder injury from a motorcycle accident. Radiographs showed bony Bankart lesion and CT revealed 40% defect of glenoid articular surface. Arthroscopic fixation was performed using double-threaded cannulated screw after the bony fragment was reduced by suturing the labrum at the edge with a suture anchor. Arthroscopic bony Bankart repair using double-threaded cannulated screw fixation is effective because compression force could be applied between bony fragments and the screw head is not exposed in the glenohumeral joint.

  9. Feasibility study on posterior laminar screw fixation techniques in the axis

    Institute of Scientific and Technical Information of China (English)

    HU Yong; HE Xian-feng; GU Yong-jie; XU Rong-ming; MA Wei-hu; RUAN Yong-ping; Lin Rong

    2010-01-01

    Objective: To get morphologic param-eters of Chinese adults through observation and measure-ment on axial laminas, to evaluate the feasibility of placing axial laminar screws and to introduce the technique.Methods: Relative parameters of 28 sets of fresh Chi-nese adults' axial specimens, including distance from the superior and inferior entry points of axial laminar screws to the superior margins of axial laminas, superior, middle, infe-rior thickness and height of the axial laminas, length and angle of the axial laminar screw trajectories, distance from the entry points of axial laminar screws to the transverse foramen and central points of the inferior articular process, were measured with a digital caliper and a goniometer.Data were statistically analyzed.Results: Averagely, distance from the superior and inferior entry points of axial laminar screws to the superior margins of axial laminas was 5 mm and 9 ram, superior, middle, inferior thickness and the height of the axial laminas were 3.2 mm, 6.7 ram, 5.5 nun and 12.8 mm respectively, and the length of the superior and inferior axial laminar screw trajectories was 26.2 mm and 25.5 mm, respectively.Conclusions: It is feasible and reliable to apply poste-rior laminar screw fixation techniques to the axes of Chinese adults.Also the C_2 laminar screw fixation technique can be taken as a supplementary to conventional posterior screw fixations of C_2.

  10. Percutaneous kyphoplasty combined with the posterior screw-rod system in treatment of osteoporotic thoracolumbar fractures

    Directory of Open Access Journals (Sweden)

    Jiang Wu

    2013-01-01

    Materials and Methods: Twenty six patients (65 years of age or older with the single spine fractures included in study. The preoperative bone mineral density was measured by dual-energy X-ray. The PKP was done in all the cases. Decompression was done if neurological symptoms were present. Results: The results demonstrated osteoporosis with BMD T value ≤ −2.5; injured posterior vertebral body (3 cases had shown the whole damage accompanied by neurological symptoms through X-ray or CT. After 2 days, the remaining patients of back pain symptoms were relieved or disappeared except for three cases of patients with decompression incision. VAS score and Cobb angle changed from preoperative 8.23 ± 0.17 and 28.7 ± 0.33° respectively to postoperative 3.77 ± 0.44 and 3.8 ± 0.2° respectively. Conclusion: Treatment of rupture of the posterior vertebral osteoporotic thoracolumbar fractures by means of kyphoplasty combined with posterior screw-rod system is a safe, effective procedure.

  11. Fixation of metatarsal fracture with bone plate in a dromedary heifer

    Directory of Open Access Journals (Sweden)

    S. Hashmi

    2013-03-01

    Full Text Available An oblique fracture of the distal third of the right metatarsus in a three-year-old dromedary heifer weighing about 300 kilograms was immobilized with a 4.5 mm broad-webbed 12-hole dynamic compression bone plate and two interfragmental compression screws. The animal showed slight lameness after 16 weeks of surgery that disappeared after removal of the plate. The result was quite encouraging and the fracture healed in 16 weeks without major complications. It is concluded that the fracture of this bone can be successfully handled with bone plating at least in young, light weight animals.

  12. New Technique for C1 Double-Door Laminoplasty Using Allograft Spacers and Titanium Miniplate Screw Fixation: Technical Report.

    Science.gov (United States)

    Kim, Seok Woo; Lee, Jae-Hoo; Lee, Ho-Won; Oh, Jae-Keun; Kwak, Yoon-Hae

    2016-03-01

    Although conventional C1 laminectomy is the gold standard for decompression at the atlas, it provides little space for the bone graft to fuse. The fusion area can be extended cranially up to the occipital bone, but it requires sacrificing the function of the craniocervical junction. To date, no reports have focused on surgical techniques for successful decompression and fusion without disruption of the posterior C1 arch while providing enough room for the bone graft to fuse. This study introduces a new technique for C1-C2 fusion and C1 double-door laminoplasty in patients with C1-C2 instability, canal stenosis, and cervical spondylotic myelopathy. A 66-year-old man who had undergone C1-C2 fusion at a local clinic 2 years earlier visited our hospital due to progressive myelopathy. A preoperative computed tomography (CT) scan showed the tip of the odontoid process, extending into the spinal canal. On the axial view of T2-weighted magnetic resonance images, the tip of the odontoid process significantly compressed the spinal cord on the left side. The atlantodental interval was 7 mm on radiography; however, C1-C2 instability was not evident on flexion-extension X-rays due to the previous screw fixation. The patient underwent C1-C2 decompression and fusion surgery with our new surgical technique. The segmental screws were repositioned at C1 and C2, and we performed C1 double-door laminoplasty augmented with an allograft spacer and a titanium miniplate. A marked reduction was seen at postoperative radiograph and CT scan. Neurologic symptoms were relieved dramatically after surgery without any discomfort. No complications were noted. We introduced a new surgical technique that allows bone grafting, decompression, and fusion to be performed without disruption of the posterior C1 arch in the event of C1-C2 canal stenosis combined with instability. This technique may be indicated for other conditions that cause instability and stenosis at the C1-C2 area. PMID:26689563

  13. RESEARCH OF A HIGH EFFICIENCY SLIDING SCREW DRIVER

    Institute of Scientific and Technical Information of China (English)

    Hu Xiaowei; Lu Huailiang; Huang Shuhuai

    2004-01-01

    A high efficiency sliding screw driver is introduced. It can improve driving efficiency obviously. As the material strength of the nut in this structure is low and the nut is the most dangerous part, so it is important to master the structure's characters of deformation and stress. The deformation and stress of this structure are researched by finite element method(FEM), and the changing law of stress concentration coefficient of the structure is gained. So the exact stress of nut teeth with highest load can be calculated directly based on this result.

  14. Pedicle Screw-Based Posterior Dynamic Stabilization: Literature Review

    Directory of Open Access Journals (Sweden)

    Dilip K. Sengupta

    2012-01-01

    Full Text Available Posterior dynamic stabilization (PDS indicates motion preservation devices that are aimed for surgical treatment of activity related mechanical low back pain. A large number of such devices have been introduced during the last 2 decades, without biomechanical design rationale, or clinical evidence of efficacy to address back pain. Implant failure is the commonest complication, which has resulted in withdrawal of some of the PDS devices from the market. In this paper the authors presented the current understanding of clinical instability of lumbar motions segment, proposed a classification, and described the clinical experience of the pedicle screw-based posterior dynamic stabilization devices.

  15. A novel magnetic lead screw active suspension system for vehicles

    DEFF Research Database (Denmark)

    Berg, Nick Ilsø; Holm, Rasmus Koldborg; Rasmussen, Peter Omand

    2014-01-01

    This paper encompasses a detailed study of the redesign of a novel Magnetic Lead Screw (MLS) active suspension system for possible regeneration of the energy dispatched in the suspension system and active control of vehicle body movement. The MLS converts a low speed high force linear motion...... of a translator into a high speed low torque rotational motion of a rotor through helically shaped magnets. The paper describes the drawback of the first MLS prototype v1.0 developed for active suspension system, which lead to a new design of the MLS prototype named v1.5. Furthermore the paper introduces detailed...

  16. Power Characteristics of a Screw Agitator in a Tube

    Directory of Open Access Journals (Sweden)

    F. Rieger

    2001-01-01

    Full Text Available Screw agitators rotating in tubes are very efficient tools for mixing and pumping viscous liquids. The power characteristic of the agitator-tube assembly must be known to enable its power consumption in a given configuration to be calculated. The dimensionless power characteristic is described by Eq. (6. An estimate of power consumption from the power characteristic is schematically shown in Fig. 1. The dependence of the coefficients in Eq. (6 on the Reynolds number is shown in Fig. 5. The power characteristics for selected Reynolds number values are shown in Figs. 6- 9.

  17. Your Bones

    Science.gov (United States)

    ... a fall! If you play sports like football, soccer, lacrosse, or ice hockey, always wear all the ... to strengthen your bones is through exercise like running, jumping, dancing, and playing sports. Take these steps ...

  18. 寰枢椎椎弓根钉内固定重建上颈椎不稳%Atlanto-axial pedicle screw internal fixation to reconstruct upper cervical spine instability

    Institute of Scientific and Technical Information of China (English)

    杨飞; 武永刚; 赵敏; 贾卫斗; 云得才; 王建华

    2010-01-01

    目的 探讨寰枢椎椎弓根钉内固定融合重建上颈椎不稳的临床疗效.方法 采用寰枢椎椎弓根钉内固定自体髂骨植骨治疗上颈椎不稳患者21例,其中Ⅱ型齿状突骨折13例,齿状突不连5例,横韧带损伤3例.在寰枢椎后弓间植骨融合,使寰枢椎复合体得到稳定.结果 共置入84枚螺钉,术中2枚螺钉穿破寰椎左侧椎弓根外侧壁,未发生脊髓、椎动脉损伤.所有患者X线片示寰椎完全复位,枢椎齿状突骨折处复位良好.CT片示螺钉与椎动脉及脊髓位置关系良好.按JOA评分标准,优15例,良3例,可2例,差1例,优良率85.71%(18/21).17例患者获得随访,随访时间12~26(12.83±4.23)个月,均获得骨性融合,未发现钉板断裂.结论 寰枢椎椎弓根螺钉结合钉板系统固定重建上颈椎不稳能显著增强寰枢椎间生物力学稳定性,植骨融合率高,该术式在寰枢椎融合术中具有较高的推广应用价值.%Objective To explore the clinical effect of the atlanto-axial pedicle screw internal fixation to reconstruct upper cervical spine instability. Methods Using atlanto-axial pedicle screw and internal fixation system combined with autogenous iliac bone graft to treat 21 patients with upper cervical spine instability. Type Ⅱ odontoid process old fracture was 13 patients, odontoid process nonunion was 5 patients, injury of the transverse ligament was 3 patients. They were placed in 84 atlanto-axial pedicle screws, autogenous bones were placed in the posterior arch of atlas and axis to fusion, so that atlanto-axial complex got stabilized. Results The left lateral cortical bone of atlas vertebral pedicle was broken by screws in 2 patients, but the spinal cord and vertebral artery was intact. X-ray film showed the atlas and the fracture of dens of axis was completely replaced in all patients. The position of screw and vertebral artery or spinal cord was good in CT image. According to JOA score standard, 15 cases of all were

  19. Functional results of osteosynthesis with mini-plate and screws in metacarpal fractures

    Institute of Scientific and Technical Information of China (English)

    Hakan Başar; Betül Başar; Abdullah Kırbız

    2014-01-01

    Objectives:To evaluate the radiological and functional results of osteosynthesis with mini-plate and screws in metacarpal fractures. Methods:In our study43 patients who were operated between2009 and2012 were included. The patients were followed-up for(19.76±5.61) months.The mean age of patients was(31.11±7.81) years(7 females,36 males).The fracture types were oblique for19 patients, spiral for15 patients and transverse for9 patients.The patients were operated after a mean of3.4 d(range3 h-6 d) after the fracture had occurred.Patients were immobilized for2 weeks with a splint after surgery. Passive joint movements were started on the third days, and active joint movements were started in the second week.Rehabilitation of all patients was done in the same center with supervision of the same physiotherapist.The patients were assessed by total joint range of movement of the finger, grasping strength andQuick-DASH scores. Results:No significant differences were detected between fingers of the operated hand with same finger of the healthy hand according to total joint range of movement.Total joint range of movement values were measured perfect for38 patients, good for4 patients and medium for 1 patient.There were no significant differences with the corresponding finger on the opposite healthy side according to grasping strength.Soiling in the wound dressing was observed in1 patient but there was no active drainage.Soiling of the wound dressing disappeared after3-5 d of treatment with antimicrobial agent.Bone union was observed in all patients in a mean of6 weeks (range5-7 weeks).The time to return to work was(31.6±8.9) d after the surgical treatment of the fracture. Conclusions:Mini-plate and screws fixation of unstable metacarpal fractures produces anatomical reduction of fractures with stabilization that is rigid enough to allow early mobilization, thereby preventing stiffness and hence good functional results.

  20. Evaluation of the implantation position of mini-screws for orthodontic treatment in the maxillary molar area by a micro CT

    International Nuclear Information System (INIS)

    The interalveolar septum between the upper first molar and the second premolar of the separated human maxillary bone was three-dimensionally observed by micro CT to evaluate the appropriate mini-screw type implant placement position by considering the relationship between the tooth roots and the maxillary sinus. After taking micro CTs of 5 human maxillary bones, horizontally sectioned images of the interalveolar septum area 2, 4, 6, 8, 10, and 12 mm deep from the crest of the alveolar ridge were reconstructed by three-dimensional reconstruction software. The bucco-lingual and mesio-distal lengths and area in each sectioned interalveolar septum were measured using digital image measurement software. Using the results, the interalveolar septum area between the upper first molar and the second premolar approximately 6-8 mm deep from the alveolar crest in the tooth root apical direction was determined to be the safest position for mini-screw implantation. Furthermore, lateral implantation from the palatal side was deduced to be the safest approach. (author)

  1. Management of adult diaphyseal both-bone forearm fractures.

    Science.gov (United States)

    Schulte, Leah M; Meals, Clifton G; Neviaser, Robert J

    2014-07-01

    Simultaneous diaphyseal fractures of the radius and ulna, often referred to as both-bone forearm fractures, are frequently encountered by orthopaedic surgeons. Adults with this injury are typically treated with open reduction and internal fixation because of the propensity for malunion of the radius and ulna and the resulting loss of forearm rotation. Large case series support the use of plate and screw fixation for simple fractures. More complex fractures are managed according to strain theory, with the intention of controlling rather than eliminating motion at the fracture site. This can be achieved with flexible plate and screw constructs or intramedullary nails. In general, results of surgical fixation have been good, with only modest losses of forearm strength and rotation. Notable complications include nonunion, malunion, and refracture after device removal. PMID:24966250

  2. Suitability of polylactide bone plates and screws for fixation of mandibular fractures

    NARCIS (Netherlands)

    Tams, Jan

    1998-01-01

    Stabiele fixatie van mandibulafracturen is nodig om een ongestoorde botgenezing mogelijk te maken. Tegenwoordig wordt bij de behandeling van mandibulafracturen meestal gebruik gemaakt van metalen botplaten en schroeven. Dit type fixatie geeft veelal een ongestoorde botgenezing met een geringe kans o

  3. Screw-System-Based Mobility Analysis of a Family of Fully Translational Parallel Manipulators

    Directory of Open Access Journals (Sweden)

    Ernesto Rodriguez-Leal

    2013-01-01

    Full Text Available This paper investigates the mobility of a family of fully translational parallel manipulators based on screw system analysis by identifying the common constraint and redundant constraints, providing a case study of this approach. The paper presents the branch motion-screws for the 3-RP̲C-Y parallel manipulator, the 3-RCC-Y (or 3-RP̲RC-Y parallel manipulator, and a newly proposed 3-RP̲C-T parallel manipulator. Then the paper determines the sets of platform constraint-screws for each of these three manipulators. The constraints exerted on the platforms of the 3-RP̲C architectures and the 3-RCC-Y manipulators are analyzed using the screw system approach and have been identified as couples. A similarity has been identified with the axes of couples: they are perpendicular to the R joint axes, but in the former the axes are coplanar with the base and in the latter the axes are perpendicular to the limb. The remaining couples act about the axis that is normal to the base. The motion-screw system and constraint-screw system analysis leads to the insightful understanding of the mobility of the platform that is then obtained by determining the reciprocal screws to the platform constraint screw sets, resulting in three independent instantaneous translational degrees-of-freedom. To validate the mobility analysis of the three parallel manipulators, the paper includes motion simulations which use a commercially available kinematics software.

  4. Foreign body reaction after PLC reconstruction caused by a broken PLLA screw.

    Science.gov (United States)

    Kim, Tae-Kwon; Jeong, Tae-Wan; Lee, Dae-Hee

    2014-12-01

    Foreign body reactions may occur in patients who receive bioabsorbable implants during orthopedic surgery for fractures and ligament repair. The authors describe a 34-year-old man who presented with a palpable tender mass on the lateral aspect of the left knee of 1 month's duration. He underwent posterior cruciate ligament and posterolateral corner reconstruction 3 years earlier. Physical examination showed a 1×1-cm soft, nontender mass without localized warmth on the lateral epicondyle of the distal femur. Magnetic resonance imaging showed a broken screw fragment surrounded by a cyst-like mass. Under general anesthesia, the surgeon excised the screw fragment and the fibrotic mass, enclosing it in the subcutaneous tissue at the lateral epicondyle, the site at which a poly-L-lactic acid bioabsorbable screw had been inserted to fix the graft for posterolateral corner reconstruction. Histologic evaluation showed a foreign body reaction to the degraded screw particles. To the authors' knowledge, this report is the first description of a patient presenting with a delayed foreign body reaction to a broken poly-L-lactic acid bioabsorbable screw at the lateral femoral epicondyle after posterolateral corner reconstruction. Because delayed foreign body reactions can occur at any site of poly-L-lactic acid bioabsorbable screw insertion, care should be taken to avoid screw protrusion during ligament reconstruction because it can lead to screw breakage and delayed foreign body reaction.

  5. Screwing or unscrewing device for studs or bolls of big dimension

    International Nuclear Information System (INIS)

    The device for screwing or unscrewing large studs or bolts has a system determining the optimun screwing position and orientation of the bolt, a variable speed bidirectional drive a pin holding the bolt axially and system compensating the weight of the bolt with an hydraulic jack with a pressure detector to which the drive is slaved

  6. Non-invasive ultrasound based temperature measurements at reciprocating screw plastication units: Methodology and applications

    Science.gov (United States)

    Straka, Klaus; Praher, Bernhard; Steinbichler, Georg

    2015-05-01

    Previous attempts to accurately measure the real polymer melt temperature in the screw chamber as well as in the screw channels have failed on account of the challenging metrological boundary conditions (high pressure, high temperature, rotational and axial screw movement). We developed a novel ultrasound system - based on reflection measurements - for the online determination of these important process parameters. Using available pressure-volume-temperature (pvT) data from a polymer it is possible to estimate the density and adiabatic compressibility of the material and therefore the pressure and temperature depending longitudinal ultrasound velocity. From the measured ultrasonic reflection time from the screw root and barrel wall and the pressure it is possible to calculate the mean temperature in the screw channel or in the chamber in front of the screw (in opposition to flush mounted infrared or thermocouple probes). By means of the above described system we are able to measure axial profiles of the mean temperature in the screw chamber. The data gathered by the measurement system can be used to develop control strategies for the plastication process to reduce temperature gradients within the screw chamber or as input data for injection moulding simulation.

  7. Comparison of two-transsacral-screw fixation versus triangular osteosynthesis for transforaminal sacral fractures.

    Science.gov (United States)

    Min, Kyong S; Zamorano, David P; Wahba, George M; Garcia, Ivan; Bhatia, Nitin; Lee, Thay Q

    2014-09-01

    Transforaminal pelvic fractures are high-energy injuries that are translationally and rotationally unstable. This study compared the biomechanical stability of triangular osteosynthesis vs 2-transsacral-screw fixation in the repair of a transforaminal pelvic fracture model. A transforaminal fracture model was created in 10 cadaveric lumbopelvic specimens. Five of the specimens were stabilized with triangular osteosynthesis, which consisted of unilateral L5-to-ilium lumbopelvic fixation and ipsilateral iliosacral screw fixation. The remaining 5 were stabilized with a 2-transsacral-screw fixation technique that consisted of 2 transsacral screws inserted across S1. All specimens were loaded cyclically and then loaded to failure. Translation and rotation were measured using the MicroScribe 3D digitizing system (Revware Inc, Raleigh, North Carolina). The 2-transsacral-screw group showed significantly greater stiffness than the triangular osteosynthesis group (2-transsacral-screw group, 248.7 N/mm [standard deviation, 73.9]; triangular osteosynthesis group, 125.0 N/mm [standard deviation, 66.9]; P=.02); however, ultimate load and rotational stiffness were not statistically significant. Compared with triangular osteosynthesis fixation, the use of 2 transsacral screws provides a comparable biomechanical stability profile in both translation and rotation. This newly revised 2-transsacral-screw construct offers the traumatologist an alternative method of repair for vertical shear fractures that provides biplanar stability. It also offers the advantage of percutaneous placement in either the prone or supine position.

  8. 29 CFR 1926.305 - Jacks-lever and ratchet, screw, and hydraulic.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 8 2010-07-01 2010-07-01 false Jacks-lever and ratchet, screw, and hydraulic. 1926.305... Power § 1926.305 Jacks—lever and ratchet, screw, and hydraulic. (a) General requirements. (1) The... secured at once. (ii) Hydraulic jacks exposed to freezing temperatures shall be supplied with an...

  9. Mixing and transport during pharmaceutical twin-screw wet granulation: Experimental analysis via chemical imaging

    DEFF Research Database (Denmark)

    Kumar, Ashish; Vercruysse, Jurgen; Toiviainen, Maunu;

    2014-01-01

    Twin-screw granulation is a promising continuous alternative for traditional batch high shear wet gran- ulation (HSWG). The extent of HSWG in a twin screw granulator (TSG) is greatly governed by the resi- dence time of the granulation materials in the TSG and degree of mixing. In order to determi...

  10. Thoracic Pedicle Screw Placement Guide Plate Produced by Three-Dimensional (3-D) Laser Printing.

    Science.gov (United States)

    Chen, Hongliang; Guo, Kaijing; Yang, Huilin; Wu, Dongying; Yuan, Feng

    2016-01-01

    BACKGROUND The aim of this study was to evaluate the accuracy and feasibility of an individualized thoracic pedicle screw placement guide plate produced by 3-D laser printing. MATERIAL AND METHODS Thoracic pedicle samples of 3 adult cadavers were randomly assigned for 3-D CT scans. The 3-D thoracic models were established by using medical Mimics software, and a screw path was designed with scanned data. Then the individualized thoracic pedicle screw placement guide plate models, matched to the backside of thoracic vertebral plates, were produced with a 3-D laser printer. Screws were placed with assistance of a guide plate. Then, the placement was assessed. RESULTS With the data provided by CT scans, 27 individualized guide plates were produced by 3-D printing. There was no significant difference in sex and relevant parameters of left and right sides among individuals (P>0.05). Screws were placed with assistance of guide plates, and all screws were in the correct positions without penetration of pedicles, under direct observation and anatomic evaluation post-operatively. CONCLUSIONS A thoracic pedicle screw placement guide plate can be produced by 3-D printing. With a high accuracy in placement and convenient operation, it provides a new method for accurate placement of thoracic pedicle screws. PMID:27194139

  11. Reduction in radiation (fluoroscopy while maintaining safe placement of pedicle screws during lumbar spine fusion

    Directory of Open Access Journals (Sweden)

    Christopher D. Chaput

    2013-01-01

    Full Text Available OBJECTIVE: The purpose of this study is to report the results using PediGuard (electrical conductivity device to reduce radiation exposure while drilling the pilot hole for pedicle screw placement. METHOD: Eighteen patients diagnosed with a degenerative lumbar spine, that required a posterior spinal fusion. Average age of the patients were 55 ± 12 years. Patients received postoperative CT scans of all screws. Scans were reviewed by an independent reviewer grading 'in' 2 mm of breach. In a randomized fashion, the surgeon created pilot holes with either his standard technique or by using the PediGuard. Fluoroscopy was used for each drilling as necessary. Once the pilot hole was created, the surgeon inserted titanium screws into the pedicle pilot holes. A total of 78 screws (39 standard probe and 39 PediGuard were analyzed. RESULTS: 78 screws (39 standard probe and 39 PediGuard were analyzed. No significant difference in breach rate > 2mm by either method (p=1.000, with one screw out in each group. Fluoroscopy shots averaged 5.2 (range, 0 to 15, average decrease of 2.3 (30% per screw in the PediGuard group vs. 7.5 (range, 2 to 17 in the standard group (p< .001. CONCLUSION: This trial to assess pedicle probe location within the pedicle and vertebral body showed the number of fluoroscopy shots were reduced by 30%, compared to a standard probe while maintaining a 97.5% screw placement accuracy.

  12. Foreign body reaction after PLC reconstruction caused by a broken PLLA screw.

    Science.gov (United States)

    Kim, Tae-Kwon; Jeong, Tae-Wan; Lee, Dae-Hee

    2014-12-01

    Foreign body reactions may occur in patients who receive bioabsorbable implants during orthopedic surgery for fractures and ligament repair. The authors describe a 34-year-old man who presented with a palpable tender mass on the lateral aspect of the left knee of 1 month's duration. He underwent posterior cruciate ligament and posterolateral corner reconstruction 3 years earlier. Physical examination showed a 1×1-cm soft, nontender mass without localized warmth on the lateral epicondyle of the distal femur. Magnetic resonance imaging showed a broken screw fragment surrounded by a cyst-like mass. Under general anesthesia, the surgeon excised the screw fragment and the fibrotic mass, enclosing it in the subcutaneous tissue at the lateral epicondyle, the site at which a poly-L-lactic acid bioabsorbable screw had been inserted to fix the graft for posterolateral corner reconstruction. Histologic evaluation showed a foreign body reaction to the degraded screw particles. To the authors' knowledge, this report is the first description of a patient presenting with a delayed foreign body reaction to a broken poly-L-lactic acid bioabsorbable screw at the lateral femoral epicondyle after posterolateral corner reconstruction. Because delayed foreign body reactions can occur at any site of poly-L-lactic acid bioabsorbable screw insertion, care should be taken to avoid screw protrusion during ligament reconstruction because it can lead to screw breakage and delayed foreign body reaction. PMID:25437089

  13. Confocal laser scanning microscopy in study of bone calcification

    Energy Technology Data Exchange (ETDEWEB)

    Nishikawa, Tetsunari, E-mail: tetsu-n@cc.osaka-dent.ac.jp [Department of Oral Pathology, Osaka Dental University, Osaka (Japan); Kokubu, Mayu; Kato, Hirohito [Department of Oral Pathology, Osaka Dental University, Osaka (Japan); Imai, Koichi [Department of Biomaterials, Osaka Dental University, Osaka (Japan); Tanaka, Akio [Department of Oral Pathology, Osaka Dental University, Osaka (Japan)

    2012-12-01

    Highlights: Black-Right-Pointing-Pointer High-magnification images with depth selection, and thin sections were observed using CLSM. Black-Right-Pointing-Pointer The direction and velocity of calcification of the bone was observed by administration of 2 fluorescent dyes. Black-Right-Pointing-Pointer In dog femora grafted with coral blocks, newly-formed bone was observed in the coral block space with a rough surface. Black-Right-Pointing-Pointer Twelve weeks after dental implant was grafted in dog femora, the space between screws was filled with newly-formed bones. - Abstract: Bone regeneration in mandible and maxillae after extraction of teeth or tumor resection and the use of rough surface implants in bone induction must be investigated to elucidate the mechanism of calcification. The calcified tissues are subjected to chemical decalcification or physical grinding to observe their microscopic features with light microscopy and transmission electron microscopy where the microscopic tissue morphology is significantly altered. We investigated the usefulness of confocal laser scanning microscopy (CLSM) for this purpose. After staggering the time of administration of calcein and alizarin red to experimental rats and dogs, rat alveolar bone and dog femur grafted with coral as scaffold or dental implants were observed with CLSM. In rat alveolar bone, the calcification of newly-formed bone and net-like canaliculi was observed at the mesial bone from the roots progressed at the rate of 15 {mu}m/day. In dog femur grafted with coral, newly-formed bones along the space of coral were observed in an orderly manner. In dog femur with dental implants, after 8 weeks, newly-formed bone proceeded along the rough surface of the implants. CLSM produced high-magnification images of newly-formed bone and thin sections were not needed.

  14. Digital placement and clinical application of lumbar pedicle screws based on 3D printing%基于3D打印的腰椎椎弓根螺钉数字化置入及临床应用

    Institute of Scientific and Technical Information of China (English)

    陈宣煌; 许卫红; 黄文华; 林海滨; 张国栋; 吴长福; 陈旭; 余正希

    2015-01-01

    BACKGROUND:3D printing to prepare individualized navigation template-assisted screw placement can elevate screw placement accuracy of spinal pedicle screw,and have good prospects for clinical application.OBJECTIVE:To investigate the method of lumbar pedicle screw navigation placement using digital design of Mimics software combined with 3D printing module,and to explore its feasibility and accuracy.METHODS:From February 2012 to August 2013,a total of 60 patients with lumbar diseases underwent 3D printing module-assisted lumbar pedicle screw navigation placement.Al patients received continuous thin slice CT scan.We colected Dicom format images.Mimics software was used for 3D reconstruction to design screw channel and the supporting column of lumbar pedicle screw placement and to divide strippable bone surface,to design navigation module with screw channel,and then to carry out 3D printing.Navigation module was utilized for navigation screw placement during the surgery.The position and replacement of screw were observed.X-ray and CT scan were applied to assess the outcomes of screw placement.The patients were folowed up for (12.17±3.21) months.Oswestry Disability Index was employed to evaluate the improvement of lumbar function.Japanese Orthopaedic Association (low back pain) scoring system was used to assess the therapeutic effects.RESULTS AND CONCLUSION:253 navigation modules were made and 253 screws were implanted.Screw channel and postoperative bone surrounding the vertebral body were observed,and no breakage was found.Postoperative X-ray and CT scan revealed that the direction of eight pedicle screws was migrated compared with preoperative design,but their positions were stil satisfactory.The placement site,direction and length of 245 pedicle screws were consistent with the desired site,direction and length in Mimics software,with an accuracy of 96.84%.The navigation module was tightly connected to bone structure in front of the corresponding vertebral body

  15. [An experimental study of the effects of stress-relaxation plate on bone remodeling].

    Science.gov (United States)

    Dai, M; Dai, K; Qui, S

    1995-11-01

    An ideal bone plate would provide rigid fixation to ensure stabilization of bone fragments at the early stage after fracture, while at the late stage osteoporosis induced by stress shielding effect of the plate should be prevented. However, there is no report of such a plate that could meet with all these requirements. Twenty-eight adult New Zealand rabbits were used in this experiment. Ordinary stainless-steel plate (no washer plate) and similar plate padded with ultrahigh molecular polyethylene washers in its screw holes (washer plate) were fixed respectively on mid-shelf of each side of tibiae. The animals were killed at 2, 4, 8, 12, 16, 20 and 24 weeks after operation, and the fixed bone segments of both tibiae were removed for light microscopy, polarized light microscopy and fluoroscopy. The results showed that the tibiae fixed with plate fixation both appeared bone resorption, but there was more severe resorption in bone with no washer plate fixation than that with washer plate fixation. Cancelization of cortical bone was seen in the former but not in the latter at 12 weeks postopertively. This demonstrated that the washer might creep and damage with fixation time, resulting in gradual decrease in the rigidity of the plate-screw system and thus reducing bone resorption as caused by stress shielding. PMID:8731919

  16. Connection of Screw Instability with Electric Current in an Accretion Disc around a Black Hole

    Institute of Scientific and Technical Information of China (English)

    LAN Xiao-Xia; WANG Ding-Xiong; GAN Zhao-Ming

    2005-01-01

    @@ The screw instability of the magnetic field is discussed based on its poloidal configuration generated by a single toroidal electric current flowing in the equatorial plane of a Kerr Mack hole (BH). The rotation of the BH relative to the disc induces an electromotive force, which in turn results in a poloidal electric current. By using Ampere's law, we calculate the toroidal component of the magnetic field and derive a criterion for the screw instability of the magnetic field connecting the rotating BH with its surrounding disc. It is determined that the screw instability is related to two parameters: the radius of the disc and the BH spin. The occurrence of screw instability is depicted in a parameter space. In addition, we discuss the effect of the screw instability on magnetic extraction of energy from the rotating BH.

  17. Design and Analysis of Single Screw Extruder for Jatropha Seeds Using Finite Element Method

    Directory of Open Access Journals (Sweden)

    Ali Nurrakhmad Siregar

    2014-03-01

    Full Text Available Mechanical extraction is commonly used to extract oils from vegetable seeds and a single screw extruder has been successfully reported to separate oil and cake from Jatropha curcas seeds. In this study, a single screw extruder was designed and analyzed using Finite Element Method (FEM and Computational Fluid Dynamics (CFD. Three different geometrical dimensions of screw extruder were designed and analyzed using FEM and CFD with software ANSYS POLYFLOW to study simulation of the flow and the behavior of Jatropha dough through of a single screw extruder. In a preliminary study, this study focused to simulate the velocity profile and local shear rate indie section with a power law model. The result obtained revealed that three important are as in designing a single screw extruder were gap area (clearance in the range of 0.5-1.0 mm, chamber area (normal pitch in the range 17-22 mm and root area.

  18. A three-dimensional anatomic study on placement of occipital condyle screws%枕骨髁螺钉固定的三维解剖学研究

    Institute of Scientific and Technical Information of China (English)

    杨文玖; 邹云雯; 褚言琛; 王进; 杨慧英; 侯庆先; 李学森

    2013-01-01

    Objective To evaluate the safety and feasibility of implanting occipital condyle screws in cadavers.Methods Screws of 3.5 mm in diameter and 20.0 mm in length were implanted into the ambilateral occipital condyles in 10 cadaveric specimens.CT scanning was performed after the procedure on the occipitocervical region for three-dimensional reconstruction of the region.In the three-dimensional occipitocervical models,relationships between the occipital condyle screw and its important surrounding tissues,like vertebral artery,spinal cord and hypoglossal canal,were measured.The length,upper and inside tilting angles of the screw,and distances between the screw and the hypoglossal canal and between the condylar entry point and the medial wall of the occipital condyle were also measured.Results Three-dimensional reconstruction models showed that all the occipital condyle screws were successfully implanted into the 20 occipital condyles in 10 cadaveric specimens.There was no injury to the spinal cord,nerve root,hypoglossal nerve or vertebral artery.At the left occipital bone,the average length,upper tilting angle and inside tilting angle of the condylar screws were respectively 20.96 ± 0.87 mm,31.00° ± 1.59° and 11.24° ± 0.71 °; the distances averaged 4.84 ±.0.52 mm between the condylar screw and the hypoglossal canal and 5.13 ±.0.79 mm between the condylar entry point and the medial wall of the occipital condyle.At the right occipital bone,the average length,upper tilting angle and inside tilting angle of the condylar screws were respectively 20.59±0.54 mm,30.85° ± 0.97° and 11.11 °±0.61°; the distances averaged 4.70±0.27 mm between the condylar screw and the hypoglossal canal and 5.04 ± 0.68 mm between the condylar entry point and the medial wall of the occipital condyle.Conclusions A surgeon who is familiar with the anatomy and skillful in operation can use occipital condyle screws in occipitocervical fusion without any injury to the important

  19. Prosopis pubescens (screw bean mesquite) seedlings are hyperaccumulators of copper.

    Science.gov (United States)

    Zappala, Marian N; Ellzey, Joanne T; Bader, Julia; Peralta-Videa, Jose R; Gardea-Torresdey, Jorge

    2013-08-01

    Due to health reasons, toxic metals must be removed from soils contaminated by mine tailings and smelter activities. The phytoremediation potential of Prosopis pubescens (screw bean mesquite) was examined by use of inductively-coupled plasma optical emission spectroscopy. Transmission electron microscopy was used to observe ultrastructural changes of parenchymal cells of leaves in the presence of copper. Elemental analysis was used to localize copper within leaves. A 600-ppm copper sulfate exposure to seedlings for 24 days resulted in 31,000 ppm copper in roots, 17,000 ppm in stems, 11,000 in cotyledons and 20 ppm in the true leaves. For a plant to be considered a hyperaccumulator, the plant must accumulate a leaf-to-root ratio <1. Screw bean mesquite exposed to copper had a leaf-to-root ratio of 0.355 when cotyledons were included. We showed that P. pubescens grown in soil is a hyperaccumulator of copper. We recommend that this plant should be field tested.

  20. Energy consumption analysis for a single screw extruder

    Energy Technology Data Exchange (ETDEWEB)

    Deng, Jing; Harkin-Jones, Eileen; Price, Mark; Karnachi, Nayeem [Queen' s Univ., Belfast (United Kingdom). School of Mechanical and Aerospace Engineering; Li, Kang [Queen' s Univ., Belfast (United Kingdom). School of Electronics, Electrical Engineering and Computer Science; Fei, Minrui [Shanghai Univ. (China). School of Mechatronic Engineering and Automation

    2013-07-01

    Polymer extrusion is regarded as an energy intensive production process, the real-time monitoring of both thermal energy and motor drive energy consumption becomes necessary for the development of energy efficient management system. The use of power meter is a simple and easy way to achieve this, however the cost sometimes can be high. Mathematical models based on the process settings provide an affordable alternative, but the resultant models cannot be easily extended to other extruders with different geometry. In this paper, simple and accurate energy real-time monitoring methods are developed for the analysis of energy consumption of the thermal heating and motor drive respectively. This is achieved by looking inside the controller, and use the control variables to calculate the power consumption. The developed methods are then adopted to study the effects of operating settings on the energy efficiency. These include the barrel heating temperature, water cooling temperature, and screw speed. The experimental results on Killion KTS-100 extruder show that the barrel heating temperature has a negative effect on energy efficiency, while the water cooling setting affects the energy efficiency positively but insignificantly. Undoubtedly, screw speed has the most significant effect on energy efficiency.

  1. Analysis of Third-Grade Fluid in Helical Screw Rheometer

    Directory of Open Access Journals (Sweden)

    M. Zeb

    2013-01-01

    Full Text Available The steady flow of an incompressible, third-grade fluid in helical screw rheometer (HSR is studied by “unwrapping or flattening” the channel, lands, and the outside rotating barrel. The geometry is approximated as a shallow infinite channel, by assuming that the width of the channel is large as compared to the depth. The developed second-order nonlinear coupled differential equations are reduced to single differential equation by using a transformation. Using Adomian decomposition method, analytical expressions are calculated for the the velocity profiles and volume flow rates. The results have been discussed with the help of graphs as well. We observed that the velocity profiles are strongly dependant on non-Newtonian parameter (β~, and with the increase in β~, the velocity profiles increase progressively, which conclude that extrusion process increases with the increase in β~. We also observed that the increase in pressure gradients in x- and z-direction increases the net flow inside the helical screw rheometer, which increases the extrusion process. We noticed that the flow increases as the flight angle increase.

  2. Prevention of arthrofibrosis after arthroscopic screw fixation of tibial spine fracture in children and adolescents.

    Science.gov (United States)

    Parikh, Shital N; Myer, David; Eismann, Emily A

    2014-01-01

    Arthrofibrosis is a major complication of tibial spine fracture treatment in children, potentially resulting in knee pain, quadriceps weakness, altered gait, decreased function, inability to return to sports, and long-term osteoarthritis. Thus, prevention rather than treatment of arthrofibrosis is desirable. The purpose of this study was to evaluate an aggressive postoperative rehabilitation and early intervention approach to prevent permanent arthrofibrosis after tibial spine fracture treatment and to compare epiphyseal and transphyseal screws for fixation. A consecutive series of 24 patients younger than age 18 with displaced type II and III tibial spine fractures who underwent arthroscopic reduction and screw fixation between 2006 and 2011 were retrospectively reviewed. Final range of motion was compared between patients with epiphyseal (n=12) and transphyseal (n=9) screws. One-third (4 of 12) of patients with epiphyseal screws underwent arthroscopic debridement and screw removal approximately 3 months postoperatively; 3 patients lacked 5° to 15° of extension, 1 experienced pain with extension, and 1 had radiographic evidence of screw pullout, loss of reduction, and resultant malunion. In the transphyseal screw group, 3 patients had 10° loss of extension, and all corrected after arthroscopic debridement and screw removal. The two groups did not significantly differ in time to hardware removal or return to sports or final range of motion. No growth disturbances were identified in patients after transphyseal screw removal. An aggressive approach of postoperative rehabilitation and early intervention after arthroscopic reduction and screw fixation of tibial spine fractures in children was successful in preventing permanent arthrofibrosis. PMID:24683658

  3. Posterior thoracic segmental pedicle screw instrumentation: Evolving methods of safe and effective placement

    Directory of Open Access Journals (Sweden)

    Zeiller S

    2005-01-01

    Full Text Available The use of pedicle screw instrumentation in the spine has evolved over the last two decades. The initial use of pedicle screws began in the lumbar spine. As surgeons have become more comfortable with the complex anatomy required for accurate screw placement, the use of pedicle instrumentation has evolved to include their use in the thoracolumbar and thoracic spine. The impetus behind their increased use is a result of the many advantages that pedicle screw anchorage offers over traditional hook and rod constructs. Improved deformity correction and overall construct rigidity are two important advantages of pedicle screw instrumentation due its three-column control over the spinal elements. First, pedicle screw instrumentation obviates the need to place instrumentation within the spinal canal with its inherent risk of neurologic injury. Second, the placement of pedicle screws is independent of facet or laminar integrity and thus has been extremely useful in traumatic, neoplastic, and degenerative conditions. The benefits of pedicle screws in the thoracic spine has been tempered by the potential for catastrophic neurological or soft tissue injuries due to the close proximity of these structures. The narrow and inconsistent shape of the thoracic pedicles, especially in spinal deformity, makes their placement technically challenging. As a result, surgeons have employed a number of techniques to ensure the safe and efficacious placement of thoracic pedicle screws. Detailed anatomic landmarks used to determine pedicle location, intraoperative imaging including navigation, and neurophysiological monitoring are some of the techniques currently used by surgeons. The implementation of these techniques and a thorough understanding of the complex three-dimensional anatomy have allowed surgeons to successfully place thoracic and thoracolumbar pedicle screws.

  4. Cause analysis of the screw loosening after the internal fixation with thoracolumbar vertebral pedicle screw in the elderly%老年人胸腰椎椎弓根螺钉内固定术后螺钉松动原因分析

    Institute of Scientific and Technical Information of China (English)

    张思萌; 李放; 刘秀梅; 王崇伟; 王秀红

    2015-01-01

    the screws, patients were divided into fixtion-loose and-well groups.The operation time and blood loss volume in the two groups were recorded.Visual analogue scale (VAS), Oswestry disability index (ODI), the rate of screw loosening were compared at 6 months after operation and the last follow-up.The causes of screw loosening were analyzed.Results The main causes for the thoracic and lumbar pedicle screw internal fixation were thoracolumbar kyphoscoliosis, fractures,spondylolisthesis, cancer and degenerative diseases, etc.Patients were followed up for an average of (35.2±8.7) months.13 patients (7.0%) were found screw loosening, 5 males and 8 females, with the mean age of (78.4 ± 3.5) years.The screw loosening occurred 3 months to 1 year after the surgery, (7.6±3.7) months on average.Among the 13 patients with screw loosening, 1 patient suffered screw loosening in single segment, 3 patients in two segments, and 9 patients in three segments or above.Osteoporosis combined with screw loosening.appeared in 10 patients VAS and ODI scores in all subjects had statistically differences at 6 months after operation and the last follow up versus preoperation (P<0.05 for all), but no statistical difference versus the last follow-up(P> 0.05).There were significant differences in gender and preoperative osteoporosis rate between the two groups (P<0.05 for both).Conclusions Osteoporosis is one of the reasons for the screw loosening in elderly patients after pedicle screw internal fixation.The increased probability of the screw loosening in long segment may be related with the change of the older spine mechanics.Further randomized controlled trials are still required to confirm whether elderly osteoporosis patients need to receive bone cement augmentation treatment.

  5. Pedicle screw placement combined with filler for lumbar vertebra fractures%椎弓根置钉固定联合填充材料修复腰椎骨折

    Institute of Scientific and Technical Information of China (English)

    周纲; 甘子明; 黄卫民; 王成伟

    2015-01-01

    BACKGROUND:Conventional cross-segment pedicle screw fixation wil cause some complications such as kyphosis and loss of corrective angle. Fixation of pedicle screw placement of the injured vertebral body improves the disadvantages of conventional posterior screw placement, and obtains ideal outcomes. OBJECTIVE: To investigate the clinical application value of pedicle screw placement combined with filer for lumbar vertebra fracture. METHODS: Clinical data of patients with pedicle screw placement combined with filer for lumbar vertebra fracture were retrospectively analyzed. They were repaired with pedicle screw placement combined with bone graft as wel as pedicle screw placement combined with bone cement. The ratio of anterior border to posterior border of the injured vertebral body after surgery and changes in Cobb angle were observed. Patients were folowed up and results were compared. RESULTS AND CONCLUSION: Pedicle screw placement combined with filer has many advantages, and obtained good outcomes in the treatment of lumbar vertebral fracture. However, the extensive application has some problems and disputes. Clinical physicians should pay more attention on choice of surgical indications, prevention and treatment of perioperative and long-term complications and postoperative treatment of osteoporosis. The pedicle screw fixation combined with calcium phosphate bone cement has a broad prospect, can maintain the effect of spine reduction, and is worth to spread in the clinical treatment of lumbar fractures.%背景:传统的跨节段椎弓根螺钉内固定会引发后凸畸形和丢失矫正角度等并发症,而伤椎椎弓根置钉固定改善了传统后路置钉技术的不足,联合填充材料治疗腰椎骨折取得较为理想的恢复效果。目的:探讨椎弓根置钉联合填充材料在腰椎骨折治疗中的临床应用价值。方法:回顾性分析椎弓根置钉联合填充材料修复腰椎骨折患者的临床资料,分别实施椎

  6. Bone marrow transplant

    Science.gov (United States)

    Transplant - bone marrow; Stem cell transplant; Hematopoietic stem cell transplant; Reduced intensity nonmyeloablative transplant; Mini transplant; Allogenic bone marrow transplant; Autologous bone marrow transplant; Umbilical ...

  7. Bone mineral content and bone metabolism in young adults with severe periodontitis

    DEFF Research Database (Denmark)

    Wowern von, N.; Westergaard, J.; Kollerup, G.

    2001-01-01

    Bone loss, bone markers, bone metabolism, bone mineral content, osteoporosis, severe periodontitis......Bone loss, bone markers, bone metabolism, bone mineral content, osteoporosis, severe periodontitis...

  8. Contact between the acetabulum and dome of a Kerboull-type plate influences the stress on the plate and screw.

    Science.gov (United States)

    Hara, Katsutoshi; Kaku, Nobuhiro; Tabata, Tomonori; Tsumura, Hiroshi

    2015-07-01

    We used a three-dimensional finite element method to investigate the conditions behind the Kerboull-type (KT) dome. The KT plate dome was divided into five areas, and 14 models were created to examine different conditions of dome contact with the acetabulum. The maximum stress on the KT plate and screws was estimated for each model. Furthermore, to investigate the impact of the contact area with the acetabulum on the KT plate, a multiple regression analysis was conducted using the analysis results. The dome-acetabulum contact area affected the maximum equivalent stress on the KT plate; good contact with two specific areas of the vertical and horizontal beams (Areas 3 and 5) reduced the maximum equivalent stress. The maximum equivalent stress on the hook increased when the hardness of the bone representing the acetabulum varied. Thus, we confirmed the technical importance of providing a plate with a broad area of appropriate support from the bone and cement in the posterior portion of the dome and also proved the importance of supporting the area of the plate in the direction of the load at the center of the cross-plate and near the hook. PMID:25749753

  9. [Bone transplant].

    Science.gov (United States)

    San Julián, M; Valentí, A

    2006-01-01

    We describe the methodology of the Bone and Soft Tissue Bank, from extraction and storage until use. Since the year 1986, with the creation of the Bone Bank in the University Clinic of Navarra, more than 3,000 grafts have been used for very different types of surgery. Bone grafts can be classified into cortical and spongy; the former are principally used in surgery to save tumour patients, in large post-traumatic reconstructions and in replacement surgery where there are massive bone defects and a structural support is required. The spongy grafts are the most used due to their numerous indications; they are especially useful in filling cavities that require a significant quantity of graft when the autograft is insufficient, or as a complement. They are also of special help in treating fractures when there is bone loss and in the treatment of delays in consolidation and pseudoarthrosis in little vascularized and atrophic zones. They are also used in prosthetic surgery against the presence of cavity type defects. Allografts of soft tissues are specially recognised in multiple ligament injuries that require reconstructions. Nowadays, the most utilised are those employed in surgery of the anterior cruciate ligament although they can be used for filling any ligament or tendon defect. The principal difficulties of the cortical allografts are in the consolidation of the ends with the bone itself and in tumour surgery, given that these are patients immunodepressed by the treatment, the incidence of infection is increased with respect to spongy grafts and soft tissues, which is irrelevant. In short, the increasingly widespread use of allografts is an essential therapeutic weapon in orthopaedic surgery and traumatology. It must be used by expert hands.

  10. [Bone transplant].

    Science.gov (United States)

    San Julián, M; Valentí, A

    2006-01-01

    We describe the methodology of the Bone and Soft Tissue Bank, from extraction and storage until use. Since the year 1986, with the creation of the Bone Bank in the University Clinic of Navarra, more than 3,000 grafts have been used for very different types of surgery. Bone grafts can be classified into cortical and spongy; the former are principally used in surgery to save tumour patients, in large post-traumatic reconstructions and in replacement surgery where there are massive bone defects and a structural support is required. The spongy grafts are the most used due to their numerous indications; they are especially useful in filling cavities that require a significant quantity of graft when the autograft is insufficient, or as a complement. They are also of special help in treating fractures when there is bone loss and in the treatment of delays in consolidation and pseudoarthrosis in little vascularized and atrophic zones. They are also used in prosthetic surgery against the presence of cavity type defects. Allografts of soft tissues are specially recognised in multiple ligament injuries that require reconstructions. Nowadays, the most utilised are those employed in surgery of the anterior cruciate ligament although they can be used for filling any ligament or tendon defect. The principal difficulties of the cortical allografts are in the consolidation of the ends with the bone itself and in tumour surgery, given that these are patients immunodepressed by the treatment, the incidence of infection is increased with respect to spongy grafts and soft tissues, which is irrelevant. In short, the increasingly widespread use of allografts is an essential therapeutic weapon in orthopaedic surgery and traumatology. It must be used by expert hands. PMID:16998521

  11. Augmented PMMA distribution: improvement of mechanical property and reduction of leakage rate of a fenestrated pedicle screw with diameter-tapered perforations.

    Science.gov (United States)

    Tan, Quan-Chang; Wu, Jian-Wei; Peng, Fei; Zang, Yuan; Li, Yang; Zhao, Xiong; Lei, Wei; Wu, Zi-Xiang

    2016-06-01

    OBJECTIVE This study investigated the optimum injection volume of polymethylmethacrylate (PMMA) to augment a novel fenestrated pedicle screw (FPS) with diameter-tapered perforations in the osteoporotic vertebral body, and how the distribution characteristics of PMMA affect the biomechanical performance of this screw. METHODS Two types of FPSs were designed (FPS-A, composed of 6 perforations with an equal diameter of 1.2 mm; and FPS-B, composed of 6 perforations each with a tapered diameter of 1.5 mm, 1.2 mm, and 0.9 mm from tip to head. Each of 28 human cadaveric osteoporotic vertebrae were randomly assigned to 1 of 7 groups: FPS-A1.0: FPS-A+1.0 ml PMMA; FPS-A1.5: FPS-A+1.5 ml PMMA; FPS-A2.0: FPS-A+2.0 ml PMMA; FPS-B1.0: FPS-B+1.0 ml PMMA; FPS-B1.5: FPS-B+1.5 ml PMMA; FPS-B2.0: FPS-B+2.0 ml PMMA; and conventional pedicle screws (CPSs) without PMMA. After the augmentation, 3D CT was performed to assess the cement distribution characteristics and the cement leakage rate. Axial pullout tests were performed to compare the maximum pullout force thereafter. RESULTS The CT construction images showed that PMMA bone cement formed a conical mass around FPS-A and a cylindrical mass around FPS-B. When the injection volume was increased from 1.0 ml to 2.0 ml, the distribution region of the PMMA cement was enlarged, the PMMA was distributed more posteriorly, and the risk of leakage was increased. When the injection volume reached 2.0 ml, the risk of cement leakage was lower for screws having diameter-tapered perforations. The pullout strengths of the augmented FPS-A groups and FPS-B groups were higher than that of the CPS group (p cement. The diameter-tapered design enabled PMMA to form larger bone-PMMA interfaces and achieve a relatively higher pullout strength, although statistical significance was not reached. Study results indicated 1.5-ml of PMMA was a conservative volume for PMMA augmentation; more cement injection would significantly increase the risk of cement leakage

  12. What Is Bone?

    Science.gov (United States)

    ... by your browser. Home Bone Basics What Is Bone? Publication available in: PDF (57 KB) Related Resources ... Men, and Osteoporosis Osteoporosis Prevention For Your Information Bone Remodeling Throughout life, bone is constantly renewed through ...

  13. Calcium and bones

    Science.gov (United States)

    Bone strength and calcium ... calcium (as well as phosphorus) to make healthy bones. Bones are the main storage site of calcium in ... your body does not absorb enough calcium, your bones can get weak or will not grow properly. ...

  14. Facts about Broken Bones

    Science.gov (United States)

    ... White House Lunch Recipes The Facts About Broken Bones KidsHealth > For Kids > The Facts About Broken Bones ... through the skin . continue What Happens When a Bone Breaks? It hurts to break a bone! It's ...

  15. Bone biopsy (image)

    Science.gov (United States)

    A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it ... examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone ...

  16. Bone lesion biopsy

    Science.gov (United States)

    Bone biopsy; Biopsy - bone ... is sent to a lab for examination. Bone biopsy may also be done under general anesthesia to ... remove the bone can be done if the biopsy exam shows that there is an abnormal growth ...

  17. A comparison of unilateral and bilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion for lumbar degenerative diseases

    Institute of Scientific and Technical Information of China (English)

    Yang Xiaoming; Wang Hong; Zhao Quanlai; Xu Hongguang; Liu Ping; Jin Yuelong

    2014-01-01

    Background Bilateral transpedicular screw fixation in conjunction with interbody fusion is widely used to treat lumbar degenerative diseases; however,there are some disadvantages of using this fixation system.This study comparatively analyzes the results of unilateral and bilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion (TLIF) for one-level lumbar degenerative diseases.Methods Sixty-six cases with one-level lumbar degenerative diseases were studied.The patients were divided according to surgical approach into a unilateral group (Group A) and a bilateral group (Group B).The patients were evaluated for pain by visual analog scale (VAS) and Oswestry Disability Index (ODI).Operating time,blood loss,duration of hospitalization,and complication rate were also evaluated.Patients were examined at 1,3,6,and 12 months postoperatively and every year thereafter.Results Group A patients' average preoperative VAS and ODI scores were 7.03 ± 0.98 and (64.22±6.38)%,respectively,significantly decreased to 2.91 ± 0.88 and (14.42±2.08)%,respectively,at the last follow-up (P =0.000).In Group B,the average preoperative VAS and ODI scores were 6.79±0.86 and (63.22±4.70)%,respectively,significantly decreased to 3.12±0.96 and (14.62±2.08)%,respectively,at the last follow-up (P=0.000).No significant difference in the duration of hospitalization was found between groups.Operating time and blood loss of (125.9±13.0) minutes and (211.4±28.3) ml,respectively,in Group A were significantly less than (165.2±15.3) minutes and (258.6±18.3) ml,respectively,in Group B (P=-0.000).All patients achieved good bone union and had no pseudarthrosis at the last follow-up.Conclusions There are no clinical differences between unilateral and bilateral pedicle screw fixation combined with TLIF for one-level lumbar degenerative diseases.Unilateral fixation reduces operating time,bleeding,and cost of hospitalization.

  18. Biomechanical Evaluation of the Fixation Methods for Transcondylar Fracture of the Humerus:ONI Plate Versus Conventional Plates and Screws

    Directory of Open Access Journals (Sweden)

    Shimamura,Yasunori

    2010-04-01

    Full Text Available

    We biomechanically evaluated the bone fixation rigidity of an ONI plate (Group I during fixation of experimentally created transcondylar humerus fractures in cadaveric elbows, which are the most frequently observed humeral fractures in the elderly, and compared it with the rigidity achieved by 3 conventional fixation methods:an LCP reconstruction plate 3.5 using a locking mechanism (Group II, a conventional reconstruction plate 3.5 (CRP with a cannulated cancellous screw (Group III, and a CRP with 2 cannulated cancellous screws (CS in a crisscross orientation (Group IV. In the axial loading test, the mean failure loads were:Group I, 98.9+/-32.6;Group II, 108.5+/-27.2;Group III, 50.0+/-7.5;and Group IV, 34.5+/-12.2 (N. Group I fixations failed at a significantly higher load than those of Groups III and IV (p0.05. In the extension loading test, the mean failure loads were:Group I, 34.0+/-12.4;Group II, 51.0+/-14.8;Group III, 19.3+/-6.0;and Group IV, 14.7+/-3.1 (N. Group IV fixations showed a significantly lower failure load than those of Group I (p0.05. The fixation rigidities against mechanical loading by the ONI plate and LCP plate were comparable. These results suggested that an ONI system might be superior to the CRP and CS method, and comparable to the LCP method in terms of fixation rigidity for distal humerus fractures.

  19. Study on pedicle screw fixation of cervical spine assisted CT-based navigation system compared with the individual cervical peddle screws placement technique

    International Nuclear Information System (INIS)

    Objective: To explore a safe and effective method for placing the cervical pedicle screws. Methods: There were ten adult cadaver specimens of cervica spine (C1-C7) with intact structures including ligament and perivertebral muscles. The spiral computed tomography scan (Elscint CT Twin flash) at the section of 1 mm and three-dimensional reconstruction of all 10 cervical specimens were taken. By CT scan, the parameters of the cervical pedicles were measure,Then taking randomly 5 cervical specimens, according to the CT measurements, an appropriate screw was inserted into pedicle individually. In the other 5 human cadaver cervical vertebraes, Φ3.5 mm screws were inserted into the C2-C7 pedicles by assisted by CT-based navigation system. Cortical integrity of every sample was examined by anatomic dissection, the spiral computed tomography scan and arrows,and coronal reconstruction. Results: Sixty screws was inserted into pedicle individually, and the achievement ratio was 90%, the perfectness ratio was 75%, 60 screws was placed into pedicle assisted by CT-based navigation system, and the achievement ratio was 96.6%, the perfectness ratio was 90%. By chi-square test for statistical analysis, there were no statistical significance between the accuracy rate of two methods(P>0.05). However there was statistical significance between the perfectness ratio between two methods(P<0.05). Conclusion: Compared with the individual cervical peddle screws placement technique, the perfectness ratio of pedicle screw fixation of cervical spine assisted by CT-based navigation system is higher, but there are no significant difference in accuracy. (authors)

  20. Factors influencing success of cement versus screw-retained implant restorations: a clinical review

    Directory of Open Access Journals (Sweden)

    Ahmad Manawar

    2012-10-01

    Full Text Available Aim: As more and more dental practitioners are focusing on implant-supported fixed restorations, some clinicians favor the use of cement retained restorations while others consider screw retained prosthesis to be the best choice. Discussion: In screw-retained restorations, the fastening screw provides a solid joint between the restoration and the implant abutment, while in cement-retained prostheses the restorative screw is eliminated to enhance esthetics, occlusal stability, and passive fit of the restorations. The factors that influence the type of fixation of the prostheses to the implants like passivity of the framework, ease of fabrication, occlusion, esthetics, accessibility, retention and retrievability are discussed in this article with scientific studies demonstrating superior outcomes of one technique over another. Screwretained implant restorations have an advantage of predictable retention, retrievability and lack of potentially retained subgingival cement. However, a few disadvantages exist such as precise placement of the implant for optimal and esthetic location of the screw access hole and obtaining passive fit. On the other hand, cement retained restorations eliminate unesthetic screw access holes, have passive fit of castings, reduced complexity of clinical and lab procedures, enhanced esthetics, reduced cost factors and non disrupted morphology of the occlusal table. Conclusion: This article compares the advantages, potential disadvantages and limitations of screw and cement retained restorations and their specific implications in the most common clinical situation.

  1. Investigation of a Ball Screw Feed Drive System Based on Dynamic Modeling for Motion Control

    Directory of Open Access Journals (Sweden)

    Yi-Cheng Huang

    2017-06-01

    Full Text Available This paper examines the frequency response relationship between the ball screw nut preload, ball screw torsional stiffness variations and table mass effect for a single-axis feed drive system. Identification for the frequency response of an industrial ball screw drive system is very important for the precision motion when the vibration modes of the system are critical for controller design. In this study, there is translation and rotation modes of a ball screw feed drive system when positioning table is actuated by a servo motor. A lumped dynamic model to study the ball nut preload variation and torsional stiffness of the ball screw drive system is derived first. The mathematical modeling and numerical simulation provide the information of peak frequency response as the different levels of ball nut preload, ball screw torsional stiffness and table mass. The trend of increasing preload will indicate the abrupt peak change in frequency response spectrum analysis in some mode shapes. This study provides an approach to investigate the dynamic frequency response of a ball screw drive system, which provides significant information for better control performance when precise motion control is concerned.

  2. Mechanical Comparison of Headless Screw Fixation and Locking Plate Fixation for Talar Neck Fractures.

    Science.gov (United States)

    Karakasli, Ahmet; Hapa, Onur; Erduran, Mehmet; Dincer, Cemal; Cecen, Berivan; Havitcioglu, Hasan

    2015-01-01

    For talar neck fractures, open reduction and internal fixation have been thought to facilitate revascularization and prevent osteonecrosis. Newer screw systems allow for placement of cannulated headless screws, which provide compression by virtue of a variable pitch thread. The present study compared the biomechanical fixation strength of cannulated headless variable-pitch screw fixation and locking plate fixation. A reproducible talar neck fracture was created in 14 fresh cadaver talar necks. Talar head fixation was then performed using 2 cannulated headless variable-pitch 4-mm/5-mm diameter (4/5) screws (Acutrak; Acumed, Hillsboro, OR) and locking plate fixation. Headless variable-pitch screw fixation had lower failure displacement than did locking plate fixation. No statistically significant differences were found in failure stiffness, yield stiffness (p = .655), yield load (p = .142), or ultimate load between the 2 fixation techniques. Cannulated headless variable-pitch screw fixation resulted in better failure displacement than locking plate fixation in a cadaveric talus model and could be considered a viable option for talus fracture fixation. Headless, fully threaded, variable-pitch screw fixation has inherent advantages compared with locking plate fixation, because it might cause less damage to the articular surface and can compress the fracture for improved reduction. Additionally, plate fixation can increase the risk of avascular necrosis owing to the wider incision and dissection of soft tissues.

  3. Evaluations of Flow and Mixing Efficiency in the Kneading Disks of a Novel Tri-Screw Extruder

    Directory of Open Access Journals (Sweden)

    X. Z. Zhu

    2016-01-01

    Full Text Available The forward or backward stagger angles of the kneading disks have great effects on configures of the special center region along axial length in a novel tri-screw extruder. In this paper, the flow and mixing of a nonNewtonian polyethylene in kneading disks of a tri-screw extruder were simulated using three-dimensional finite element modeling based on mesh superposition technique. Three types of kneading disks, neutral stagger, staggered 30° forward and staggered 30° reverse were considered for the tri-screw extruder. The effects of stagger angles of kneading disks on the flow pattern in the tri-screw extruder were investigated. Moreover, at different stagger angles, the dispersive and distributive mixing efficiencies in the kneading disks of the tri-screw extruder and the twin-screw extruder were calculated and compared by means of mean shear rate, stretching rates, maximal stress magnitudes, mixing index, residence time distribution (RTD and logarithm of area stretch. It is found that increasing the stagger angles decreases the axial velocities of polymer melt in the center region for the tri-screw extruder. The staggered 30° reverse is relatively reasonable for the tri-screw extruder and neutral stagger for the twin-screw extruder for the mixing efficiency. In comparison, the kneading disks in the tri-screw extruder have higher distributive and dispersive mixing efficiencies than those in the twin-screw extruder with the same stagger angles.

  4. Simultaneous implant placement with ridge augmentation using an autogenous bone ring transplant.

    Science.gov (United States)

    Omara, M; Abdelwahed, N; Ahmed, M; Hindy, M

    2016-04-01

    The severely defective socket, in which implant placement within the remaining bone will result in a significantly off-axis implant position, precludes immediate implant placement and requires bone grafting as an initial surgical intervention. The aims of this study were to evaluate autogenous chin bone ring consolidation after the augmentation of severely defective sockets and the clinical application of these rings in the premolar-molar region with simultaneous implant placement in a one-stage procedure. Ten patients with 12 defective sockets were included. Sockets were prepared with a trephine bur. Bone rings with a tapped implant osteotomy were harvested from the chin with a larger trephine bur. Bone rings were fitted in the prepared sockets. An implant drill was used to prepare the bone apical to the ring through its central osteotomy. Implants were screwed through the rings and the apical bone. Patients were examined clinically and radiographically immediately and at 6 months postoperative. Crestal bone changes were measured and evaluated statistically. All grafted sockets showed bone healing with no significant crestal bone resorption and no infection; only one ring showed dehiscence, which healed during the follow-up period. All implants showed radiographic evidence of osseointegration. The autogenous chin bone ring augmentation technique was found to be a reliable alternative method for the management of severely defective sockets. PMID:26644216

  5. The Mechanical Effect of Rod Contouring on Rod-Screw System Strength in Spine Fixation

    Science.gov (United States)

    Karakasli, Ahmet; Karaarslan, Ahmet A.; Ozcanhan, Mehmet Hilal; Ertem, Fatih; Erduran, Mehmet

    2016-01-01

    Objective Rod-screw fixation systems are widely used for spinal instrumentation. Although many biomechanical studies on rod-screw systems have been carried out, but the effects of rod contouring on the construct strength is still not very well defined in the literature. This work examines the mechanical impact of straight, 20° kyphotic, and 20° lordotic rod contouring on rod-screw fixation systems, by forming a corpectomy model. Methods The corpectomy groups were prepared using ultra-high molecular weight polyethylene samples. Non-destructive loads were applied during flexion/extension and torsion testing. Spine-loading conditions were simulated by load subjections of 100 N with a velocity of 5 mm min-1, to ensure 8.4-Nm moment. For torsional loading, the corpectomy models were subjected to rotational displacement of 0.5° s-1 to an end point of 5.0°, in a torsion testing machine. Results Under both flexion and extension loading conditions the stiffness values for the lordotic rod-screw system were the highest. Under torsional loading conditions, the lordotic rod-screw system exhibited the highest torsional rigidity. Conclusion We concluded that the lordotic rod-screw system was the most rigid among the systems tested and the risk of rod and screw failure is much higher in the kyphotic rod-screw systems. Further biomechanical studies should be attempted to compare between different rod kyphotic angles to minimize the kyphotic rod failure rate and to offer a more stable and rigid rod-screw construct models for surgical application in the kyphotic vertebrae. PMID:27651858

  6. Bacterial adherence to titanium, poly-L-lactic acid, and composite hydroxyapatite and poly-L-lactic acid interference screws.

    Science.gov (United States)

    Masini, Brendan D; Stinner, Daniel J; Waterman, Scott M; Wenke, Joseph C; Gerlinger, Tad L

    2012-01-01

    This study investigates a potential site of bacterial adherence, the implant surface, comparing titanium, poly-L-lactic acid (PLLA), and composite hydroxyapatite and poly-L-lactic acid (PLLA-HA) interference screws using a bioluminescent in vitro model. Interference screws of three materials, titanium (Arthrex, Naples, FL), bioabsorbable poly-L-lactic acid (BIORCI, Smith & Nephew, Andover, MA), and bioabsorbable composite hydroxyapatite and poly-L-lactic acid (BIORCI-HA, Smith & Nephew, Andover, MA) were immersed in a broth of bioluminescent Staphylococcus aureus. The screws were irrigated and then imaged with a photon-capturing camera system yielding a total photon count correlating with residual adherent bacteria. The titanium screws had the lowest mean total bacterial counts followed by the PLLA-HA screws and with the PLLA screws having the highest mean total counts. The difference in means between the titanium group and the PLLA group was statistically significant (p bacterial adherence than comparable bioabsorbable PLLA screws.

  7. Structural and torsional vibration analysis of a dry screw compressor

    Science.gov (United States)

    Willie, J.; Sachs, R.

    2015-08-01

    This paper investigates torsional vibration and pulsating noise in a dry screw compressor. The compressor is designed at Gardner Denver (GD) and is oil free and use for mounting on highway trucks. They are driven using a Power Take-Off (PTO) transmission and gear box on a truck. Torque peak fluctuation and noise measurements are done and their sources are investigated and reported in this work. To accurately predict the torsional response (frequency and relative angular deflection and torque amplitude), the Holzer method is used. It is shown that the first torsional frequency is manifested as sidebands in the gear train meshing frequencies and this can lead to noise that is the result of amplitude modulation. Sensitivity analysis of the drive train identifies the weakest link in the drive train that limits the first torsional frequency to a low value. Finally, the significance of higher mode shapes on inter-lobe clearance distribution of the rotors is investigated.

  8. Rotating Optical Tubes: An Archimedes' Screw for Atoms

    CERN Document Server

    Rsheed, Anwar Al; Aldossary, Omar M; Lembessis, Vassilis E

    2016-01-01

    The classical dynamics of a cold atom trapped inside a vertical rotating helical optical tube (HOT) is investigated by taking also into account the gravitational field. The resulting equations of motion are solved numerically. The rotation induces a vertical motion for an atom initially at rest. The motion is a result of the action of two inertial forces, namely the centrifugal force and the Coriolis force. Both inertial forces force the atom to rotate in a direction opposite to that of the angular velocity of the HOT. The frequency and the turning points of the atom's global oscillation can be controlled by the value and the direction of the angular velocity of the HOT. However, at large values of the angular velocity of the HOT the atom can escape from the global oscillation and be transported along the axis of the HOT. In this case, the rotating HOT operates as an Optical Archimedes' Screw (OAS) for atoms.

  9. Atomistic simulations of jog migration on extended screw dislocations

    DEFF Research Database (Denmark)

    Vegge, T.; Leffers, T.; Pedersen, O.B.;

    2001-01-01

    We have performed large-scale atomistic simulations of the migration of elementary jogs on dissociated screw dislocations in Cu. The local crystalline configurations, transition paths. effective masses. and migration barriers for the jogs are determined using an interatomic potential based...... on the Effective Medium Theory, The minimum energy path through configuration space and the corresponding transition state energy are obtained using the Nudged Elastic Band path technique. We find very similar migration properties for elementary jogs on the (110){110} octahedral slip systems and the (110){110} non......-octahedral slip systems. with energy barriers in the 15-19 meV range. (C) 2001 Elsevier Science B.V. All rights reserved....

  10. Screw dislocations and microtwinning in vanadium and its solid solutions

    International Nuclear Information System (INIS)

    Investigated were the deformation strengthening curves, the slippage geometry and the evolution of the dislocation structure of single crystals of vanadium and of solid solution V + 5 at. % Ta, subjected to single-axis tension along the direction [11O] at rates of 10-2 and 1.6x10-3 s-1. It was found that on changing from pure vanadium to the solid solution the extent of the 1-st stage decreases and the coefficient of strengthening at the 2-nd and the 3-rd stages of the deformation strengthening curve increases. The increase in the degree of deformation gives rise to a non-uniform distribution of screw dislocations in the dislocation structure. A greater rate of deformation induces micro-twinning in solid-solution single crystals

  11. Assessment of a percutaneous iliosacral screw insertion simulator

    CERN Document Server

    Tonetti, J; Girard, P; Dubois, M; Merloz, P; Troccaz, Jocelyne; 10.1016/j.otsr.2009.07.005

    2009-01-01

    BACKGROUND: Navigational simulator use for specialized training purposes is rather uncommon in orthopaedic and trauma surgery. However, it reveals providing a valuable tool to train orthopaedic surgeons and help them to plan complex surgical procedures. PURPOSE: This work's objective was to assess educational efficiency of a path simulator under fluoroscopic guidance applied to sacroiliac joint percutaneous screw fixation. MATERIALS AND METHODS: We evaluated 23 surgeons' accuracy inserting a guide-wire in a human cadaver experiment, following a pre-established procedure. These medical trainees were defined in three prospective respects: novice or skilled; with or without theoretical knowledge; with or without surgical procedure familiarity. Analysed criteria for each tested surgeon included the number of intraoperative X-rays taken in order to achieve the surgical procedure as well as an iatrogenic index reflecting the surgeon's ability to detect any hazardous trajectory at the time of performing said procedu...

  12. Bone graft revascularization strategies

    NARCIS (Netherlands)

    W.F. Willems

    2014-01-01

    Reconstruction of avascular necrotic bone by pedicled bone grafting is a well-known treatment with little basic research supporting its application. A new canine model was used to simulate carpal bone avascular necrosis. Pedicled bone grafting proved to increase bone remodeling and bone blood flow,

  13. Type II Intertrochanteric Fractures: Proximal Femoral Nailing (PFN Versus Dynamic Hip Screw(DHS

    Directory of Open Access Journals (Sweden)

    Cyril Jonnes

    2016-01-01

    Full Text Available Background: Intertrochanteric fracture is one of the most common fractures of the hip especially in the elderly with osteoporotic bones, usually due to low-energy trauma like simple falls. Dynamic Hip Screw (DHS is still considered the gold standard for treating intertrochanteric fractures by many. Not many studies compare the DHS with Proximal femoral nail (PFN, in Type II intertrochanteric fractures (Boyd and Griffin classification. This study was done to compare the functional and radiological outcome of PFN with DHS in treatment of Type II intertrochanteric fractures.   Methods: From October 2012 to March 2015, a prospective comparative study was done where 30 alternative cases of type II intertrochanteric fractures of hip were operated using PFN or DHS. Intraoperative complications were noted. Functional outcome was assessed using Harris Hip Score and radiological findings were compared at 3, 6, and 12 months postoperatively. Results: The average age of the patients was 60 years. In our series we found that patients with DHS had increased intraoperative blood loss (159ml, longer duration of surgery (105min, and required longer time for mobilization while patients who underwent PFN had lower intraoperative blood loss (73ml, shorter duration of surgery (91min, and allowed early mobilization. The average limb shortening in DHS group was 9.33 mm as compared with PFN group which was only 4.72 mm. The patients treated with PFN started early ambulation as they had better Harris Hip Score in the early post-op period. At the end of 12th month, there was not much difference in the functional outcome between the two groups. Conclusion: PFN is better than DHS in type II inter-trochanteric fractures in terms of decreased blood loss, reduced duration of surgery, early weight bearing and mobilization, reduced hospital stay, decreased risk of infection and decreased complications.

  14. Sapphire screws and strength test on them at liquid nitrogen temperature

    Science.gov (United States)

    Hirose, Eiichi; Sakakibara, Yusuke; Igarashi, Yukihiko; Ishii, Takashi

    2014-10-01

    We fabricated several sapphire screw threads and performed a strength test on them at the liquid nitrogen temperature of 77 K. The screw threads were subjected to and withstood a 3000 N load. To the best of our knowledge, this is the first strength test of sapphire screw threads at a cryogenic temperature. The result suggests a new way of connecting sapphire components. Although sapphire is already used in many applications, the result may provide a new way to use the material as a structural element in even more applications.

  15. Stiffness and Strength of Single Shear Cold-Formed Steel Screw-Fastened Connections

    OpenAIRE

    Pham, Hong S.; Moen, Cristopher Dennis

    2015-01-01

    Results are presented from an experimental program on single shear cold-formed steel-to-steel through-fastened screw connections, including documentation of the complete load-deformation response and stiffness degradation. Ply thicknesses from 0.88mm to 2.58mm and screw diameters of 4.17mm to 5.49mm were tested to cover the practical range of applications common to cold-formed steel framing. A custom non-contact optical technique measured steel ply relative displacements and screw tilting ang...

  16. Metal Artifacts Reduction of Pedicle Screws on Spine Computed Tomography Images Using Variable Thresholding Technique

    International Nuclear Information System (INIS)

    Metal artifacts are one of significant problems in computed tomography (CT). The streak lines and air gaps arise from metal implants of orthopedic patients, such as prosthesis, dental bucket, and pedicle screws that cause incorrect diagnosis and local treatment planning. A common technique to suppressed artifacts is by adjusting windows, but those artifacts still remain on the images. To improve the detail of spine CT images, the variable thresholding technique is proposed in this paper. Three medical cases of spine CT images categorized by the severity of artifacts (screws head, one full screw, and two full screws) were investigated. Metal regions were segmented by k-mean clustering, then transformed into a sinogram domain. The metal sinogram was identified by the variable thresholding method, and then replaced the new estimated values by linear interpolation. The modified sinogram was reconstructed by the filtered back- projection algorithm, and added the metal region back to the modified reconstructed image in order to reproduce the final image. The image quality of the proposed technique, the automatic thresholding (Kalender) technique, and window adjustment technique was compared in term of noise and signal to noise ratio (SNR). The propose method can reduce metal artifacts between pedicle screws. After processing by our proposed technique, noise in the modified images is reduced (screws head 121.15 to73.83, one full screw 160.88 to 94.04, and two full screws 199.73 to 110.05 from the initial image) and SNR is increased (screws head 0.87 to 1.88, one full screw 1.54 to 2.82, and two full screws 0.32 to 0.41 from the initial image). The variable thresholding technique can identify the suitable boundary for restoring the missing data. The efficiency of the metal artifacts reduction is indicated on the case of partial and full pedicle screws. Our technique can improve the detail of spine CT images better than automatic thresholding (Kalender) technique, and

  17. The effect of Dirac phase on acoustic vortex in media with screw dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Torabi, Reza, E-mail: rezatorabi@aut.ac.ir; Rezaei, Zahra

    2013-10-15

    We study acoustic vortex in media with screw dislocation using the Katanaev–Volovich theory of defects. It is shown that the screw dislocation affects the beam's orbital angular momentum and changes the acoustic vortex strength. This change is a manifestation of topological Dirac phase and is robust against fluctuations in the system. - Highlights: • We study acoustic vortex in media with screw dislocation. • We use the framework of geometric theory of defects. • Presence of dislocation changes the acoustic vortex strength. • There is a similarity with the Aharonov–Bohm effect. • Change of the acoustic vortex strength is robust against fluctuations.

  18. Computer-Aided Design System for CP Single-Screw Compressor

    Institute of Scientific and Technical Information of China (English)

    SHEN Jing-feng; YAO Fu-sheng

    2006-01-01

    To design various optimum parameters and simulate the working process of CP single-screw compressor,the Computer-Aided Design(CAD)system for the CP singlescrew compressor has been established.A new method based on computer graphics technology,database technology,object-oriented programming technology,and visual simulation technology has been adopted in this CAD system.The system has integrated solid modeling function with parameterization design function and animator simulation function based on analyzing the working principle of the CP single-screw compressor.The experimental results show fhat the CAD system for the CP single-screw compressor is practical and feasible.

  19. Pedicale screw system plus ACPC perfusion to treat fractures of thoracolumbar vertebrae

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@In recent years the pedicle screw system has been widely used in treating thoracolumbar vertebral fractures. The effect to recover the injured vertebrae height, the spinal physiological curve and to decompress vertebral canal has been confirmed. But the problems of internal fixation bending, loosening and breaking, which result in the loss of the vertebral height and spinal angulation deformity, are quite common and cause a lot of difficulties for surgeons. To solve these problems and decrease the sequelae from treating thoracolumbar vertebrae fractures with vertebral pedicle screw system, we have tried using vertebral pedicle screw system plus ACPC perfusion to treat 18patients with thoracolumbar vertebral fractures.Satisfactory results have been obtained.

  20. Biomechanical properties of a novel pourable cement pedicle screw and its application to osteoporotic lumbar degeneration%新型可灌注骨水泥椎弓根螺钉的生物力学性能及在骨质疏松性腰椎退变中的应用

    Institute of Scientific and Technical Information of China (English)

    刘扬; 刘丹; 肖运祥; 陈海丹; 赵红卫

    2016-01-01

    背景:老年性骨质疏松患者由于机体骨质的脆弱,容易造成椎弓根螺钉固定能力得到进一步削弱。因此骨质疏松性腰椎退变患者采用椎弓根螺钉修复时骨水泥渗漏以及螺钉取出量等问题难以解决。目的:探讨新型可灌注骨水泥椎弓根螺钉的生物力学性能及在骨质疏松性腰椎退变患者中的应用效果。方法:选取完整浸润腰椎标本(T11-L5)6具,平均年龄(72.9±4.2)岁,共42个椎体,平均骨密度为0.696 g/cm2。所有椎体任意选取一侧椎弓根置入可灌注骨水泥椎弓根螺钉,采用水泥推杆和灌注筒在X射线透视下灌注2 mL骨水泥;在椎体标本对侧置入相同数目常规螺钉。对2种螺钉进行三点弯曲实验,对选取椎体进行最大轴向拔出力实验及最大旋出力矩实验,观察椎体的破坏情况及螺钉置入效果。结果与结论:①新型可灌注骨水泥椎弓根螺钉极限强度、屈服载荷均显著大于常规螺钉(P<0.05);极限位移和屈服位移均显著小于常规螺钉(P<0.05);②新型可灌注骨水泥椎弓根螺钉的轴向拔出力及最大旋出力矩均显著高于常规螺钉(P<0.05);③综上所述,新型可灌注骨水泥椎弓根螺钉操作简单,能够有效的控制骨水泥渗透,提高螺钉在骨质疏松椎体内的稳定性,且治疗后螺钉取出相对方便,不会对椎体和钉道产生明显的破坏,促进机体早期恢复。%BACKGROUND:Fragile bone in senile osteoporosis patients easily weakened pedicle screw fixation capacity. Therefore, bone cement leakage and screw removal cannot be solved during pedicle screw repair in osteoporotic patients with degenerative lumbar spine. OBJECTIVE:To investigate the biomechanical properties of novel pourable pedicle screws and bone cement application effect in osteoporotic patients with degenerative lumbar spine. METHODS:Six lumbar specimens (T11-L5) at the mean age of (72.9±4.2) years

  1. Management of a Congenitally Missing Lateral Incisor with Orthodontics, Bone Grafting (a New Method and Single-Tooth Implant: A Case Report

    Directory of Open Access Journals (Sweden)

    Hamid Reza Arab

    2014-03-01

    Full Text Available Careful treatment planning, space management, augmentation of bone and attention to the details of implant surgical and prosthetic techniques are important factors when treating anterior maxilla specially replacement of missing teeth. This case report addresses a chair-side ridge augmentation procedure using autograft bone harvested with trephine drills and placed without using screws and the fundamental considerations related to replacement of a congenitally missing lateral incisor by a team approach

  2. Odontoid cannulated screw fixation using digital navigation based on three-dimensional printing technique%基于3D打印齿状突空心钉置入的数字化导航

    Institute of Scientific and Technical Information of China (English)

    陈宣煌; 张国栋; 吴长福; 林海滨; 陈旭; 余正希; 孙宇庆

    2015-01-01

    BACKGROUND:Odontoid fracture is very common in cervical spine injuries, the special position of odontoid process, which is adjacent to important anatomic structure, makes screw placement difficult, and a slight discrepancy in position and orientation of the inserted screw leads to a decrease in intensity of internal fixation, even invalid internal fixation. Therefore, it is very necessary to develop an individualized treatment protocol by which screws can be precisely and safely placed and which is worthy of clinical popularization. OBJECTIVE:To study the navigation of Mimics software and three dimensional (3D)-printed module in anterior odontoid cannulated screw fixation and to investigate its feasibility and accuracy. METHODS:Sixteen human cadaveric cervical spines were scanned by a continuous thin-slice CT scanner. Original DICOM CT images were three-dimensional y reconstructed using Mimics software. The screw channel and support column were designed for C2 vertebra odontoid cannulated screw fixation for odontoid fracture. Segmentation of bone surface was performed. Navigation modules with screw channel were built using 3D printing technique. Navigation modules were used to aid screw placement. Screw fitting and placement were evaluated using X-ray and CT scan. RESULTS AND CONCLUSION:Total y 16 navigation modules were built and 22 screws were implanted. During and after screw placement, the cortical bone along screw channel and surrounding the vertebral body was not cracked. Postoperative X-ray and CT scans showed that some factors regarding screw placement such as entry point, orientation and depth of placement were consistent with those ideal factors simulated by Mimics software. The navigation modules were closely attached to the corresponding bony structure in front of the vertebral body, with a satisfactory gomphosis. Screw fitting and stability were good during application. These results verify that with the aid of navigation module, anterior odontoid

  3. Novo sistema para acoplamento de parafusos de interferência: ensaio biomecânico de torção New coupling system for interference screws: biomechanical resistance to torsion

    Directory of Open Access Journals (Sweden)

    Aloísio Fernandes Bonavides Júnior

    2011-01-01

    Full Text Available OBJETIVO: Apresentar um novo sistema de acoplamento solidário entre chave e parafuso de interferência, assim como ensaios biomecânicos que avaliem a segurança de sua utilização. MÉTODOS: O novo sistema foi submetido a ensaios biomecânicos de torção. Foram realizados dois tipos de análise: torque máximo de inserção manual dos parafusos em osso bovino; ensaios destrutivos de torção do sistema em máquina INSTRON 55MT. Os mesmos testes foram realizados em um grupo controle utilizando um sistema de acoplamento já disponível no mercado. (Acufex® RESULTADOS: Nos ensaios de inserção em fêmures bovinos as médias de valores aferidos com torquímetro digital foram 1,958 N/m para Acufex® e 2,563 N/m para FMRP. Considerando p0,05. Ao avaliar a deformação angular, não houve diferença significativa entre os grupos de parafuso (p=0,15. CONCLUSÃO: O novo sistema de acoplamento para parafusos de interferência desenvolvido na FMRP-USP revelou resistência à torção comparável a sistema já disponível no mercado e regulamentado para uso internacional.OBJECTIVE: To introduce a new coupling system between screw driver and interference screw, and biomechanical tests that validate the safety of its application. METHODS: The new system was submitted to biomechanical torsion assays. Two types of analysis were performed: maximum torque of manual insertion of the screws into bovine bone; destructive assays of torsion of the system using an INSTRON 55MT machine. The same tests were also performed on a control group, using a commercially available interference screw coupling system (Acufex®. RESULTS: In the tests on manual insertion of screws in bovine femurs, the average values found with a digital torque meter were 1.958 N/m for Acufex® and 2.563 N/m for FMRP. Considering p>0.05, there were no statistical differences between the two groups (p=0.02 in the values for maximum torque of insertion, in the two systems studied. The average

  4. The intensification study of heat exchange in pipes with the knurled screw

    International Nuclear Information System (INIS)

    The study results of heat exchange intensification in the tubes with double-thread knurled screw are presented. The Reynolds number range and knurl parameters at which optimum heat exchange intensification is provided are established