Strength Of Screws Research Articles

Novel Polyethylene Terephthalate Screw Sleeve Implant: Salvage Treatment in a Case of Spine Instability after Vertebroplasty Failure

The management of osteoporotic fractures is sometimes rather challenging for spinal surgeons, and considering the longer life expectancy induced by improved living conditions, their prevalence is expected to increase. At present, the approaches to osteoporotic fractures differ depending on their severity, location, and the patient's age. State-of-the-art treatments range from vertebroplasty/kyphoplasty to hardware-based spinal stabilization in which screw augmentation with cement is the gold standard. We describe the case of a 74-year-old man with an L5 osteoporotic fracture. The patient underwent a vertebroplasty (VP) procedure, which was complicated by a symptomatic cement leakage in the right L4-L5 neuroforamen. We urgently decompressed the affected pedicle via hemilaminectomy. At that point, the column required stability. The extravasation of cement had ruled out the use of cement-augmented pedicle screws but leaving the pedicular screws alone was not considered sufficient to achieve stability. We decided to cover the screws with a polyethylene terephthalate sleeve (OGmend®) to avoid additional cement leakage and to reinforce the screw strength required by the poor bone quality. In the evolving technologies used for spinal surgery, screws sleeve implants such as OGmend® are a useful addition to the surgeon's armamentarium when an increased pull-out strength is required and other options are not available.

Postfusion effect on pullout strength of pedicle screws with expandablepeek shell and conventional screws.

The pullout performance of various pedicle screws after artificial fusion process was investigated in this study. Normal, cannulated (cemented), novel expandable and normal (cemented) pedicle screws were tested. Polyurethane foams (Grade 10 and Grade 40) produced by casting method were used as test materials. The instrumentation of pedicle screws has been carried out with production of foams, simultaneously. For cemented pedicle screws, 3D models were prepared with respect to the anteriosuperior and oblique radiographs by using PMMA before casting procedure. Pullout tests were performed in an Instron 3369 testing device. Load versus displacement graph was recorded and the ultimate force was defined as the pullout strength sustained before failure of screw. As expected, the pullout strengths of pedicle screws in postfusion are higher than before fusion. Pullout strengths increased significantly by artificial fusion in Grade 10 foams compared to Grade 40 foams. Additionally, while the pullout strengths of normal, cannulated and novel expandable pedicle screws increased by artificial fusion, cemented normal pedicle screws had lower pullout values than before fusion in Grade 40 foams. When the cemented normal pedicle screws are excluded, other screws have almost similar pullout strength level. On the other hand, the pedicle screws have different increasing behaviour also, there is no correlation between each other. As a result, the novel expandable pedicle screws can be used instead of normal and cannulated ones due to their performances in non-cemented usage.

Development of the design and technology of extrusion of metal-polymer mixtures for the production of feedstocks

The paper is devoted to the development of new equipment for the production of metal-polymer thread. 3D printing with metal-polymer thread is one of the advanced directions in the technology of manufacturing metal parts of complex shape. The proposed technology is an alternative to the currently existing metal injection molding (MIM) technology and selective laser melting printing technology. An important step in this work was to conduct computational experiments to determine the effect of screw rotation on the process pressure parameter and the design of the main assembly of the screw extruder. As a result of the research, the pressures on the metal-polymer composition were determined depending on the rotation speed of the screw. With a rotation of 30 rpm, the pressure reached 0.05 Pa and the maximum pressure was 0.18 MPa. The experiments were carried out in the CradelSFlow program. The computer calculation showed a margin of the screw strength coefficient k=1.8, and a maximum deflection of 2.8∙10–4 m, which meets the condition of static rigidity. To determine the correct value of the gap δ between the screw ridge and the extruder walls, an analysis of the rotor dynamics was carried out. The result of this study is the critical extruder rotation speed of 60 rpm at which the phenomenon of precession may occur. Amplitude-frequency characteristics ydin=7∙10–4 m. According to the results of the dynamic calculation, the screw dimensions were adjusted, the geometry was reduced by ∆=0.5 mm. The experiments made it possible to verify the optimal parameters of the technological process of metal-polymer mixture extrusion. The data obtained are important for the improvement and development of 3D printing technology for metal parts of complex geometric shape.

An Experimental Study on the Biomechanical Effectiveness of Bone Cement-Augmented Pedicle Screw Fixation with Various Types of Fenestrations.

To analyze the effects of the number and shape of fenestrations on the mechanical strength of pedicle screws and the effects of bone cement augmentation (BCA) on the pull-out strength (POS) of screws used in conventional BCA. For the control group, a conventional screw was defined as C1, a screw with cannulated end-holes was defined as C2, a C2 screw with six pinholes was defined as C3, and the control group type was set. Among the experimental screws, T1 was designed using symmetrically placed thru-hole type fenestrations with an elliptical shape, while T2 was designed with half-moon (HM)-shaped asymmetrical fenestrations. T3 and T4 were designed with single HM-shaped fenestrations covering three pitches and five pitches, respectively. T5 and T6 were designed with 0.6-mm and 1-mm wider fenestrations than T3. BCA was performed by injecting 3 mL of commercial bone cement in the screw, and mechanical strength and POS tests were performed according to ASTM F1717 and ASTM F543 standards. Synthetic bone (model #1522-505) made of polyurethane foam was used as a model of osteoporotic bone, and radiographic examinations were performed using computed tomography and fluoroscopy. In the fatigue test, at 75% ultimate load, fractures occurred 7781 and 9189 times; at 50%, they occurred 36122 and 82067 times; and at 25%, no fractures occurred. The mean ultimate load for each screw type was 219.1±52.39 N for T1, 234.74±15.9 N for T2, 220.70±59.23 N for T3, 216.45±32.4 N for T4, 181.55±54.78 N for T5, and 216.47±29.25 N for T6. In comparison with C1, T1, T2, T3, T4, and T6 showed significantly different ultimate load values (p<0.05). However, when the values for C2 and the fenestrated screws were evaluated with an unpaired t test, the ultimate load value of C2 significantly differed only from that of T2 (p=0.025). The ultimate load value of C3 differed significantly from those of T1 and T2 (C3 vs. T1 : p=0.048; C3 vs. T2 : p<0.001). Linear correlation analysis revealed a significant correlation between the fenestration area and the volume of bone cement (Pearson's correlation coefficient r=0.288, p=0.036). The bone cement volume and ultimate load significantly correlated with each other in linear correlation analysis (r=0.403, p=0.003). Fenestration yielded a superior ultimate load in comparison with standard BCA using a conventional screw. In T2 screws with asymmetrical two-way fenestrations showed the maximal increase in ultimate load. The fenestrated screws can be expected to show a stable position for the formation of the cement mass.

Biomechanical Strength of Screw Versus Suture Button Fixation in the Latarjet Procedure: A Cadaver Study.

We compared the strength of screw vs suture button fixation in the Latarjet procedure for shoulder dislocation through biomechanical testing in a cadaver model. Cadavers were assigned randomly to receive screw or suture button fixation (both groups, n=5). The anteroposterior radius of the glenoid was measured, and a bony defect was created on the anteroinferior rim of the glenoid, equal to 25% of the width of the anteroposterior radius of the glenoid surface. The coracoid process was transferred into the newly created bony defect of the glenoid and fixed with two 3.5-mm partially threaded cannulated screws or 2 surgical buttons. All samples underwent tensile testing in the anteroinferior direction. Statistical analysis was performed to compare mean forces at failure between groups (alpha=.05). The mean force at failure was higher in the screw group (295 N; range, 103-534 N) than in the suture button group (133 N; range, 74-270 N) (P=.045). We found no difference between groups in ability to withstand a force of 150 N, which is the reported mean daily force threshold borne by the shoulder (P=.52). Screw fixation withstood a higher failure load than suture button fixation, indicating that screw fixation is a biomechanically superior option in the Latarjet procedure. The fixation methods did not differ in their ability to withstand the mean force borne by the shoulder during activities of daily living; thus, suture button fixation should be considered as an option in the Latarjet procedure. [Orthopedics. 2022;45(6):e321-e325.].

Relationship between thread depth and fixation strength in cancellous bone screw

BackgroundClarifying the effect of each parameter of screw design on its fixation strength is critical in the development of any type of screw. The purpose of this study was to clarify the relationship between the thread depth and fixation strength of metal screws for cancellous bone. MethodsNine types of custom-made screws with the only changed variable being the thread depth were manufactured. Other elements were fixed at a major diameter of 4.5 mm, a thread region length of 15 mm, a pitch of 1.6 mm, and a thread width of 0.20 mm. The pull-out strength and insertion torque of each screw were measured for each of two foam-block densities (10 or 20 pcf). The correlation between the thread depth of the screw and the mechanical findings were investigated with single regression analysis. ResultsRegardless of the foam-block density, the pull-out strength significantly increased as the thread depth increased from 0.1 mm to 0.4 mm; after that, the increase was more gradual (p < 0.01, respectively). The relationship between the thread depth and insertion torque was similar. In addition, the insertion torque tended to be more strongly affected by screw depth than the pull-out strength (2.6 times at 20 pcf and 1.4 times at 10 pcf). ConclusionsThe pull-out strength of 4.5-mm-diameter metal screws in a cancellous bone model was found to be biphasic, although linearly correlated with the change in screw depth in both phases. The boundary of the correlation was 0.4 mm regardless of the density of the bone model, with the effect of screw depth on pull-out strength beyond that being small in comparison.

Predicting pullout strength of pedicle screws in broken bones from X-ray images

Pedicle screw fixation is one of the most common procedures used in spinal fusion surgery. The screw loosening is a major concern, which may be caused by broken pedicles. In vitro pullout tests or insertion torque are the main approaches for assessing the stability of the screw; however, direct evidence was lacking for clinical human spines. Here, we aim to provide a model that can predict the pullout strengths of pedicle screws in various pedicle conditions from X-ray images. A weighted embedded bone volume (EBV) model is proposed for pullout strengths prediction by considering the bone heterogeneity and confinement of the screw. We showed that the pullout strength is proportional to the EBV for homogeneous bone and the weighted EBV for layered composite bone. The proposed weighted EBV model is validated with in vitro Sawbones® pullout experiments. The results show that the model has better accuracy than the simple EBV model, with a coefficient of determination of 0.94. The proposed weighted EBV model can help assess the stability of a pedicle screw in a broken pedicle by simply examining 2D X-ray images.

Effects of merged holes, partial thread removal, and offset holes on fatigue strengths of titanium locking plates

BackgroundThis study investigated the effects of screw hole merging, thread removal, and screw hole offset on the mechanical properties of locking plates. MethodsFinite element models were used to develop the optimal design of the merged holes. Four titanium locking plates with different hole designs were analyzed. Type I had threaded round holes. Type II had merged holes. Type III had merged holes with partial thread removal. Type IV had threaded offset holes. Mechanical experiments similar to finite element analyses were conducted and compared. Screw bending tests were used to assess the screw holding power. FindingsFinite element analyses showed the optimal merging distance between two round screw holes was 3.5 mm with 2/3 circumferences in each hole. The stresses of types II and III were respectively 6.42% and 7.33%, lower than that of type I. The stress of type IV was 1.66% higher than that of type I. In the mechanical tests, the fatigue lives of types II and III were respectively 3.86 and 7.16 times higher than that of type I. The fatigue life of type IV was 37% lower than that of type I. The differences in the bending strengths of screws were insignificant. InterpretationMerging holes could mitigate screw hole stress and increase the fatigue lives of the plates significantly. Partial thread removal could further improve the fatigue life. Merging holes and thread removal did not decrease the screw holding power significantly. The fatigue lives were significantly decreased in plates with offset holes.

Mechanical and biological behaviour of additive manufactured biomimetic biodegradable orthopaedic cortical screws

PurposeThe complications caused by metallic orthopaedic bone screws like stress-shielding effect, screw loosening, screw migration, higher density difference, painful reoperation and revision surgery for screw extraction can be overcome with the bioabsorbable bone screws. This study aims to use additive manufacturing (AM) technology to fabricate orthopaedic biodegradable cortical screws to reduce the bone-screw-related-complications.Design/methodology/approachThe fused filament fabrication technology (FFFT)-based AM technique is used to fabricate orthopaedic cortical screws. The influence of various process parameters like infill pattern, infill percentage, layer height, wall thickness and different biological solutions were observed on the compressive strength and degradation behaviour of cortical screws.FindingsThe porous lattice structures in cortical screws using the rapid prototyping technique were found to be better as porous screws can enhance bone growth and accelerate the osseointegration process with sufficient mechanical strength. The compressive strength and degradation rate of the screw is highly dependent on process parameters used during the fabrication of the screw. The compressive strength of screw is inversely proportional to the degradation rate of the cortical screw.Research limitations/implicationsThe present study is focused on cortical screws. Further different orthopaedic screws can be modified with the use of different rapid prototyping techniques.Originality/valueThe use of rapid prototyping techniques for patient-specific bone screw designs is scantly reported. This study uses FFFT-based AM technique to fabricate various infill patterns and porosity of cortical screws to enhance the design of orthopaedic cortical screws.

Distribution of hounsfield unit values in the pelvic bones: a comparison between young men and women with traumatic fractures and older men and women with fragility fractures: a retrospective cohort study

BackgroundThe fixation strength of bone screws depends on bone mineral density (BMD), so it is important to evaluate bone strength at fracture sites. Few studies have investigated BMD in the pelvis. The aims of this study were to measure the regional Hounsfield unit (HU) values in the cancellous bone of the acetabulum and pelvic ring and to compare these values between young and older patients.MethodsThis study enrolled young patients with high-energy trauma (aged 20–44 years; young group) and older patients with low-energy trauma (aged 65–89 years; older group). Patients without pelvic computed tomography (CT) scans, those with pelvic bone implants, and those who died were excluded. The HU values on the contralateral (non-fractured) side of the pelvis were measured on CT scans. The CT data were divided into 7 areas: the pubic bone, the anterior and posterior walls and roof of the acetabulum, the ischial tuberosity, the body of the ilium, and the third lumbar vertebra. The HU values in each area were compared between the young and older groups.ResultsSixty-one young patients and 154 older patients were included in the study. The highest HU value was in the roof of the acetabulum regardless of age and sex. HU values were significantly higher in the ischial tuberosity and body of the ilium and lower in the pubic bone and anterior wall. The HU values in all pelvic areas were significantly lower in the older group than in the young group, especially in the anterior area.ConclusionsHU values in the 6 pelvic areas were not uniform and were strongly related to load distribution. The HU distribution and age-related differences could explain the characteristic causes and patterns of acetabular fractures in the older and may help in surgical treatment.

Withdrawal capacity and strength of self-tapping screws on cross-laminated timber

The goal of this study was to investigate withdrawal capacity and strength of self-tapping screws (STSs) on cross-laminated timber (CLT). Effects of wood density, diameter, and penetration length on withdrawal behaviors of STS on CLT were evaluated. An equation was proposed to predict the withdrawal capacity of STSs on CLT. With a higher density of CLT, the withdrawal capacity and strength increased from 19.7 to 57.3%. Beneficial effects of a higher wood density of CLT on withdrawal behavior were reduced when STSs had large diameters (9 mm or 11 mm) and long penetration lengths (110 mm or 130 mm). With an increment of STS diameter from 5 mm to 11 mm, the withdrawal capacity increased from 5.7 to 27.7%, while the withdrawal strength decreased from 10.2 to 29.1%. When the penetration length was increased from 10 mm to 57 mm, the withdrawal capacity was increased significantly from 16.1 to 124.0%, whereas the withdrawal strength did not change significantly. A new format of prediction equation for the withdrawal capacity of STSs on CLT was proposed based on test results. The proposed prediction well reflected the withdrawal capacity of STSs with all test configurations, showing an average difference of 4.64% between predicted and experimental values.

Evaluation of Bearing Strength of Self-Tapping Screws according to the Grain Direction of Domestic Pinus densiflora

To evaluate the bearing strength of red pine cross-laminated timber (CLT) with self-tapping screw (STS), which is widely used as a fastener for connection in CLT building, the bearing test was conducted. Accoring to the STS’s diameters (8, 10, 12 mm), the bearing test specimens with half hole were manufactured. Bearing strength was compared and reviewed in consideration of the configuration in STS and the loading direction to the grain of red pine. As a result of the bearing test on the STS’s diameter, the yield bearing load increases as the larger diameter of the STS in all directions of the red pine. The bearing strength of the thread part (thread + tip) was higher than the shank part (shank + shank cutter). In compared with the directions to the grain of red pine, the bearing strength of the cross section parallel to the loading direction was the highest, and the tangent section was the lowest bearing strength. The average bearing strength of the loading direction in parallel to the grain was 23.43 MPa, which was about 45% higher than the average 16.16 MPa in perpendicular to the grain. The predicted bearing strength calculated by Eurocode (EN) and Korean Building Code (KBC)’s equation was lower than the experimental value. It is nessesary to propose the neuations of bearing strength reflected the configuration information of STS.

How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study

PurposeOsteoporotic bone tissue appears to be an important risk factor for implant loosening, compromising the stability of surgical implants. However, it is unclear whether lumbar measured bone mineral density (BMD) is of any predictive value for stability of surgical implants at the pubic symphysis. This study examines the fixation strength of cortical screws in human cadaver specimens with different BMDs.MethodsThe lumbar BMD of ten human specimens was measured using quantitative computed tomography (qCT). A cut-off BMD was set at 120 mg Ca-Ha/mL, dividing the specimens into two groups. One cortical screw was drilled into each superior pubic ramus. The screw was withdrawn in an axial direction with a steady speed and considered failed when a force decrease was detected. Required force (N) and pull-out distance (mm) were constantly tracked.ResultsThe median peak force of group 1 was 231.88 N and 228.08 N in group 2. While BMD values differed significantly (p < 0.01), a comparison of peak forces between both groups showed no significant difference (p = 0.481).ConclusionHigher lumbar BMD did not result in significantly higher pull-out forces at the symphysis. The high proportion of cortical bone near the symphyseal joint allows an increased contact of pubic screws and could explain sufficient fixation. This condition is not reflected by a compromised lumbar BMD in a qCT scan. Therefore, site-specific BMD measurement could improve individual fracture management.

Insertional torque and pullout strength of pedicle screws versus titanium suture Anchors: Towards development of a novel proximal junctional kyphosis prevention technique

Proximal junctional kyphosis (PJK) is a common and devastating complication after spinal deformity surgery with a high need for revision surgery. PJK often leads to poor patient outcomes and large societal costs, which has led to the development of multiple prophylactic methods which have yet to eliminate PJK. A novel method for PJK prevention includes placing suture anchors, rather than pedicle screws, above the spinal construct to function as a tether. This biomechanical investigation examined the insertional torque and pullout strength of pedicle screws compared to suture anchors on 6 cadaveric vertebrae (12 pedicles). The mean insertional torque was 0.802 ± 0.477 N*m for pedicle screws and 0.368 ± 0.310 N*m for suture anchors (p = 0.047). The mean pullout strength was 973.16 ± 202.03 N for pedicle screws and 206.94 ± 181.78 N for suture anchors (p < 0.01). This study demonstrated that suture anchors had both less insertional torque and pullout strength compared to pedicle screws and may provide a more physiologic stress taper at the upper instrumented vertebrae of long-segment spinal constructs to help prevent proximal junctional kyphosis or catastrophic proximal junctional failure. Further research is needed to examine the biomechanics of this in long-segment constructs as well as in vivo performance of suture anchors as proximal junctional kyphosis prophylaxis.

Optimizing Lumbar Pedicle Screw Trajectory Utilizing a 3D-Printed Drill Guide to Ensure Placement of Pedicle Screws Into Higher Density Bone May Improve Pedicle Screw Pullout Resistance

Lower preoperative Hounsfield Unit (HU) values of vertebral body are associated with pedicle screw (PS) loosening after implantation with traditional trans-pedicular trajectory. However, the relationship between trajectory HU value and PS fixation quality remains unknown. This study aimed to investigate if 3-dimensionally (3D)-printed guider directed accurate implantationof pedicle screw could increase the anti-pulling properties of screws. 3D models of cadaveric spines were reconstructed by using computed tomography image and PS trajectories were designed for both sides of vertebra. The designed trajectories were divided into high HU group and low HU group. PS implantation with 3D-printed screw guide can be in complementary shape with target vertebra. Throughout 3D finite element analysis and biomechanical tests, the pull-out strength of screws in high or low trajectoryHU groups were compared. The HU value was 132 ± 13 (mean ± standard deviation) in low HU group and 189 ± 17 in high HU group. The distance between planned trajectories and actual trajectories was 1.69 ± 0.4 mm. Biomechanical tests showed that in the high trajectory HU group the pull-out strength of screws was 750.41 ± 80.65 N; compared with 655.83 ± 74.31 N in the low trajectory HU group, the difference was statistically significant. When simulated with the finite element method, the pull-out strength of low HU trajectory pedicle screws was lower than that of high HU trajectory pedicle screws. Preoperative computer-assisted trajectory design using a 3D-printed screw guide may direct more accurate implantation with optimal implantation trajectory, and may provide a new way to improve pedicle screw fixation.

Impact of Bone Cement Augmentation on the Fixation Strength of TFNA Blades and Screws.

Background and Objectives: Hip fractures constitute the most debilitating complication of osteoporosis with steadily increasing incidences in the aging population. Their intramedullary nailing can be challenging because of poor anchorage in the osteoporotic femoral head. Cement augmentation of Proximal Femoral Nail Antirotation (PFNA) blades demonstrated promising results by enhancing cut-out resistance in proximal femoral fractures. The aim of this study was to assess the impact of augmentation on the fixation strength of TFN-ADVANCEDTM Proximal Femoral Nailing System (TFNA) blades and screws within the femoral head and compare its effect when they are implanted in centre or anteroposterior off-centre position. Materials and Methods: Eight groups were formed out of 96 polyurethane low-density foam specimens simulating isolated femoral heads with poor bone quality. The specimens in each group were implanted with either non-augmented or cement-augmented TFNA blades or screws in centre or anteroposterior off-centre positions, 7 mm anterior or posterior. Mechanical testing was performed under progressively increasing cyclic loading until failure, in setup simulating an unstable pertrochanteric fracture with a lack of posteromedial support and load sharing at the fracture gap. Varus-valgus and head rotation angles were monitored. A varus collapse of 5° or 10° head rotation was defined as a clinically relevant failure. Results: Failure load (N) for specimens with augmented TFNA head elements (screw/blade centre: 3799 ± 326/3228 ± 478; screw/blade off-centre: 2680 ± 182/2591 ± 244) was significantly higher compared with respective non-augmented specimens (screw/blade centre: 1593 ± 120/1489 ± 41; screw/blade off-centre: 515 ± 73/1018 ± 48), p < 0.001. For both non-augmented and augmented specimens failure load in the centre position was significantly higher compared with the respective off-centre positions, regardless of the head element type, p < 0.001. Augmented off-centre TFNA head elements had significantly higher failure load compared with non-augmented centrally placed implants, p < 0.001. Conclusions: Cement augmentation clearly enhances the fixation stability of TFNA blades and screws. Non-augmented blades outperformed screws in the anteroposterior off-centre position. Positioning of TFNA blades in the femoral head is more forgiving than TFNA screws in terms of failure load.

Anatomical changes in vertebra in dystrophic scoliosis due to neurofibromatosis and its implications on surgical safety.

Detailed radiological analysis by multimodality imaging. To document anatomical changes jeopardizing instrumentation safety in Neurofibromatosis deformity correction surgeries. The apical and 3 adjacent vertebral segments above and below amounting to 70 segments in 10 NF scoliosis were studied by radiographs, CT and MRI. The changes in lamina, pedicle and vertebral body that could jeopardize pedicle screw and sublaminar wire placement were documented and changes were appropriately classified. Extensive anatomical changes were noted. These changes were more severe at the apex and independent of the curve severity. Both laminae were normal in only 36 (Type 1), rest had either gross asymmetry in length and shape (Type 2; 21) or also in sloping (Type 3; 13). Of the 140 pedicles, normal pedicles were found only in 48 (Type 1); while they were divergent (Type 2; 4) or abnormally elongated with only thinning (Type 3a; 26); or with sclerosis (3b; 34); or very curved and wavy (3c; 23) and even fractured or indistinct (Type 4; 5). It was notable that 92 of the 140 pedicles were unsuitable for pedicle screws. A unique phenomenon of body drift was identified in 29 segments which could jeopardize screw placement and rib dislocation into the canal was found in 18 segments. Gross anatomical changes jeopardizing both sublaminar wire strength and trajectory of pedicle screws were common in NF and independent of curve severity. Therefore, detailed preoperative assessment and planning by a 3D CT are essential.

Application of screw reinforcement in the slotted-in bamboo-steel-bamboo connections

This research presents the mechanical performance of self-tapping screw-reinforced slotted-in bamboo-steel-bamboo (BSB) connections and the corresponding capacity models. The yield strength of self-tapping screws (STS) and bolts commonly used in practical constructions were obtained through the three-point bending tests. The withdrawal tests of the screws from the engineered bamboo panels were reported. The BSB connections using STS reinforcement in different positions were studied, and the performance and mechanical parameters were compared with the connections without reinforcement. The test results show that STS application in the BSB connections can significantly improve its ductility and bearing capacity. Compared with the connection without STS reinforcement, the bearing capacity and ductility of the reinforced connection with STS reinforcement near the top were increased by 8% and 3.8 times. For STS application near the bottom and at both ends, the increased values were 26% and 4.3 times, 35% and 4.6 times, respectively. The brittle row shear failure mode of the unreinforced BSB connections can be changed to be the ductile yielding failure modes by applying STS reinforcement reported in this study. Based on the existing theoretical models, the capacity predictions of the BSB connections based on two different failure modes were calculated and compared with the test results. According to the experimental research conducted in this paper, it is strongly recommended that the STS reinforcement be used in the unidirectional bamboo connections to confirm the ductile failure modes, which can be estimated through the well-established European Yield Model (EYM) included the current design standards.

Evaluation of the Relation Between Preload Values and Pull-Out Force of the Cortical Screw Used in Bone Fracture.

This study aims to examine the relation between pull-out strength and preload values of the cortical screw used in bone fracture fixation. The research question is that "Does the pull-out strength of the cortical screw used in the bone fracture fixation change with the preload values of the screw change?". To perform this purpose, the finite element method was selected due to its ease to evaluate and calculate the stresses on the whole model. Models of a cortical screw, partial plate, and bone were created using the SolidWorks program. The material properties of the bone were selected orthotropic material type. The bone fixed on the distal and proximal ends. The pull-out forces were applied at the bottom of the plate. The screw that has been loaded ranges from 100 N-700 N as preload. The pull-out forces were determined 200-400-600 N as in the literature. The results show that the pull-out strength of the screw was changed when the preloaded values higher than 400 N. However, it was seen that the pull-out strength does not substantially change when the preload values were lower than 400 N. When the preload values were applied ≥500 N, the maximum von Mises stresses on the screw exceeded the critical strength of the screw material. In conclusion, the critical preload value was determined as 500 N for the optimum pull-out strength.

Pullout strength of pedicle screws using cadaveric vertebrae with or without artificial demineralization

OBJECTIVESTo evaluate the differences in the pullout strength and displacement of pedicle screws in cadaveric thoracolumbar vertebrae with or without artificial demineralization. METHODSFive human lumbar and five thoracic vertebrae from one cadaver were divided into two hemivertebrae. The left-side specimens were included in the simulated osteopenic model group and the right-side bones in a control group. In the model group, we immersed each specimen in HCl (1 N) solution for 40 minutes. We measured bone mineral density (BMD) using dual-energy X-ray absorptiometry and quantitative computerized tomography. We inserted polyaxial pedicle screws into the 20 pedicles of the cadaveric lumbar and thoracic spine after measuring the BMD of the 2 hemivertebrae of each specimen. We measured the pullout strength and displacement of the screws before failure in each specimen using an Instron system. RESULTSThe average pullout strength of the simulated osteopenic model group was 76% that of the control group. In the control and model groups, the pullout strength was 1678.87±358.96 N and 1283.83±341.97 N, respectively, and the displacement was 2.07±0.34 mm and 2.65±0.50 mm, respectively (p<.05). We detected positive correlations between pullout strength and BMD in the control group and observed a negative correlation between displacement and BMD in the model group. CONCLUSIONSBy providing an anatomically symmetric counterpart, the human cadaveric model with or without demineralization can be used as a test bed for pullout tests of the spine. In the simulated osteopenic model group, pullout strength was significantly decreased compared with the untreated control group. CLINICAL SIGNIFICANCEDecreased bone mineral density may significantly reduce the pullout strength of a pedicle screw, even though the range is osteopenic rather than osoteoporotic.