A biomechanical comparison of headless tapered variable pitch compression and ao cortical bone screws for fixation of a simulated midbody transverse fracture of the proximal sesamoid bone in horses.
OBJECTIVE
To compare mechanical properties and failure characteristics of 2 methods of fixation for repair of a transverse, midbody fracture of the proximal sesamoid bone (PSB): 4.5-mm AO cortical bone screw (AO) placed in lag fashion and 4/5-mm Acutrak (AT) self-compressing screw.


METHODS
An in vitro biomechanical evaluation of intact forelimb preparations and forelimb preparations with a simulated midbody PSB fracture stabilized by a bone screw.


METHODS
Sixteen paired and 8 unilateral cadaveric equine forelimbs.


METHODS
A midbody transverse osteotomy was created in the medial PSB of bilateral forelimbs of 8 equine cadavers. The osteotomized PSB in 1 forelimb from each cadaver was repaired with an AO screw. The osteotomized PSB in each contralateral limb was repaired with an AT screw. Eight unilateral intact control limbs were also studied. Mechanical properties were determined from axial compression, single cycle to failure, load-deformation curves. Failure characteristics were determined by evaluation of video images and radiographs.


RESULTS
No statistically significant differences were found between repair groups. Both AO and AT groups had significantly lower mechanical properties than intact limbs except for stiffness.


CONCLUSIONS
AO and AT constructs were mechanically comparable when used to stabilize a simulated midbody fracture of the medial PSB. Both constructs were mechanically inferior to intact limbs. Clinical Relevance- The AT screw should be considered for clinical use because of the potential for less soft tissue impingement and superior biocompatibility compared with the stainless-steel AO screw. However, postoperative external coaptation is necessary to augment initial fracture stability for either fixation method, and to maintain a standing metacarpophalangeal joint dorsiflexion angle between 150 degrees and 155 degrees.
Eddy
Alison L
AL
J. D. Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, University of California-Davis, One Shields Avenue, Davis, CA 95616, USA.
Galuppo
Larry D
LD
Stover
Susan M
SM
Taylor
Kenneth T
KT
Jensen
David G
DG
D000818:Animals; D001696:Biomechanical Phenomena; D001863:Bone Screws / Q000662:veterinary*; D005260:Female; D005593:Fracture Fixation, Internal / Q000662:veterinary*; D050723:Fractures, Bone / Q000601:surgery / Q000662:veterinary*; D006736:Horses / Q000293:injuries / Q000601:surgery; D008297:Male; D012716:Sesamoid Bones / Q000293:injuries / Q000601:surgery*