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Screw stripping and its prevention in the hexagonal socket of 3.5-mm titanium locking screws

There have been several reports about the difficulties in removing 3.5-mm titanium locking screws from plates due to the stripping or rounding of the hexagonal screw socket. We investigated whether stripping the locking screw sockets can be prevented by using different screwdrivers or interposing ma...

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Autores principales: Lee, Hyo-Jin, Park, Young Uk, Kim, Sung Jae, Kim, Hyong Nyun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556383/
https://www.ncbi.nlm.nih.gov/pubmed/34716380
http://dx.doi.org/10.1038/s41598-021-00720-w
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author Lee, Hyo-Jin
Park, Young Uk
Kim, Sung Jae
Kim, Hyong Nyun
author_facet Lee, Hyo-Jin
Park, Young Uk
Kim, Sung Jae
Kim, Hyong Nyun
author_sort Lee, Hyo-Jin
collection PubMed
description There have been several reports about the difficulties in removing 3.5-mm titanium locking screws from plates due to the stripping or rounding of the hexagonal screw socket. We investigated whether stripping the locking screw sockets can be prevented by using different screwdrivers or interposing materials into the socket during removal. We overtightened 120 3.5-mm titanium locking screws (Depuy Synthes, Paoli, PA) equally into locking plates on sawbone tibia models, applying a uniform torque of 4.5 Nm, exceeding the recommended torque of 1.5 Nm. Twenty screws each were removed using a straight-handle 2.5-mm screwdriver, T-handle screwdriver, hex key wrench, and straight-handle screwdriver with a non-dominant hand. In addition, 20 screws were removed using foil from a suture packet inserted into the screw socket or using parts of a latex glove inserted into the screw socket. The incidence rates of screw stripping using the straight-handle screwdriver, T-handle screwdriver, hex key wrench, non-dominant hand, foil interposition, and latex glove interposition were 75%, 40%, 35%, 90%, 60%, and 70%, respectively. When a T-handle screwdriver or hex key wrench was used, the probability of screw stripping was 4.50 times (odds ratio = 4.50, 95% confidence interval = 1.17 to 17.37, p = 0.03) and 5.57 times (odds ratio = 5.57, 95% confidence interval = 1.42 to 21.56, p = 0.01) lower than that with the straight-handle screwdriver, respectively. Foil or latex glove interpositions did not prevent screw stripping. Thus, in the current experimental study, T-handle screwdriver or hex key wrench usage decreased the incidence rate of screw stripping during removal compared to straight-handle screwdriver use.
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spelling pubmed-85563832021-11-03 Screw stripping and its prevention in the hexagonal socket of 3.5-mm titanium locking screws Lee, Hyo-Jin Park, Young Uk Kim, Sung Jae Kim, Hyong Nyun Sci Rep Article There have been several reports about the difficulties in removing 3.5-mm titanium locking screws from plates due to the stripping or rounding of the hexagonal screw socket. We investigated whether stripping the locking screw sockets can be prevented by using different screwdrivers or interposing materials into the socket during removal. We overtightened 120 3.5-mm titanium locking screws (Depuy Synthes, Paoli, PA) equally into locking plates on sawbone tibia models, applying a uniform torque of 4.5 Nm, exceeding the recommended torque of 1.5 Nm. Twenty screws each were removed using a straight-handle 2.5-mm screwdriver, T-handle screwdriver, hex key wrench, and straight-handle screwdriver with a non-dominant hand. In addition, 20 screws were removed using foil from a suture packet inserted into the screw socket or using parts of a latex glove inserted into the screw socket. The incidence rates of screw stripping using the straight-handle screwdriver, T-handle screwdriver, hex key wrench, non-dominant hand, foil interposition, and latex glove interposition were 75%, 40%, 35%, 90%, 60%, and 70%, respectively. When a T-handle screwdriver or hex key wrench was used, the probability of screw stripping was 4.50 times (odds ratio = 4.50, 95% confidence interval = 1.17 to 17.37, p = 0.03) and 5.57 times (odds ratio = 5.57, 95% confidence interval = 1.42 to 21.56, p = 0.01) lower than that with the straight-handle screwdriver, respectively. Foil or latex glove interpositions did not prevent screw stripping. Thus, in the current experimental study, T-handle screwdriver or hex key wrench usage decreased the incidence rate of screw stripping during removal compared to straight-handle screwdriver use. Nature Publishing Group UK 2021-10-29 /pmc/articles/PMC8556383/ /pubmed/34716380 http://dx.doi.org/10.1038/s41598-021-00720-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Lee, Hyo-Jin
Park, Young Uk
Kim, Sung Jae
Kim, Hyong Nyun
Screw stripping and its prevention in the hexagonal socket of 3.5-mm titanium locking screws
title Screw stripping and its prevention in the hexagonal socket of 3.5-mm titanium locking screws
title_full Screw stripping and its prevention in the hexagonal socket of 3.5-mm titanium locking screws
title_fullStr Screw stripping and its prevention in the hexagonal socket of 3.5-mm titanium locking screws
title_full_unstemmed Screw stripping and its prevention in the hexagonal socket of 3.5-mm titanium locking screws
title_short Screw stripping and its prevention in the hexagonal socket of 3.5-mm titanium locking screws
title_sort screw stripping and its prevention in the hexagonal socket of 3.5-mm titanium locking screws
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556383/
https://www.ncbi.nlm.nih.gov/pubmed/34716380
http://dx.doi.org/10.1038/s41598-021-00720-w
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