title: Stability at the half pin-frame interface on external fixation constructs.
abstract: A mechanical study investigating the use of two different methods (grub and bolt screws) to secure external fixation half pins to circular frames. A four part experiment: (1) Grub and bolt screws were used to secure half pins in Taylor Spatial frames. Loosening torques were measured using a calibrated torque wrench. (2) Using universal testing machine (UTM), axial loading was applied to establish thresholds for loosening in grub and bolt screw constructs. (3) We established the application torque to produce failure at the head-driver interface using these two methods. (4) Grub and bolt screw constructs were created controlling torque. Using UTM, axial loading was applied to establish thresholds for loosening. Statistical analysis was conducted using SPSS v20.0.0. (1) Higher torque is employed when bolt rather than grub screws is used to secure half pins on Rancho cubes (p < 0.05). (2) Loading threshold for loosening is higher in bolt screw constructs when the torque applied to secure the constructs is not controlled (p < 0.05). (3) Torque required for failure at the head-driver interface was 5.3 Nm for grub screws and 9.9 Nm for bolts. (4) Loading threshold for loosening is higher in grub screw constructs when the same torque was applied to secure them (p < 0.05). Bolt screws can be employed to secure the half pin-frame interface. They offer good stability and reduce failure at the head-driver interface. Further research is needed to determine the mechanical properties of such constructs in vivo.
authors.affiliation: Limb Reconstruction Unit, Royal National Orthopaedic Hospital NHS, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK. alexiliadis@mail.com.
authors.forename: Alexios Dimitrios
authors.initials: AD
authors.lastname: Iliadis
authors.affiliation: Limb Reconstruction Unit, Royal National Orthopaedic Hospital NHS, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
authors.forename: Parag Kumar
authors.initials: PK
authors.lastname: Jaiswal
authors.affiliation: University College London - Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital (RNOH), Brockley Hill, Stanmore, HA7 4LP, UK.
authors.forename: Jay
authors.initials: J
authors.lastname: Meswania
authors.affiliation: University College London - Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital (RNOH), Brockley Hill, Stanmore, HA7 4LP, UK.
authors.forename: Gordon
authors.initials: G
authors.lastname: Blunn
authors.affiliation: Limb Reconstruction Unit, Royal National Orthopaedic Hospital NHS, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
authors.forename: David
authors.initials: D
authors.lastname: Goodier
authors.affiliation: Limb Reconstruction Unit, Royal National Orthopaedic Hospital NHS, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Calder
keywords: Bolt screws; External fixation constructs; Grub screws; Half pin–frame interface; Stability