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Syed Bokhari, Saifullah Hadi, Fahad Hossain, Bernd Ketzer
INTRODUCTION: We report the outcome of using a novel technique of minimally invasive internal fixation and distal radius bone grafting using the Jamishidi Trephine needle and biopsy/graft capture device. METHODS: The technique utilises a 8 mm incision at the distal pole of the scaphoid. The non-union is excavated using the standard Acutrak drill. An 8 gauge Jamshidi trephine needle is used to harvest bone graft from the distal radius which is impacted into the scaphoid and fixed with an Acutrak screw...
March 15, 2018: Open Access Macedonian Journal of Medical Sciences
Robin Z Cheng, Adam M Wegner, Anthony W Behn, Derek F Amanatullah
BACKGROUND: Horizontal medial malleolus fractures are caused by the application of rotational force through the ankle joint in several orientations. Multiple techniques are available for the fixation of medial malleolar fractures. METHODS: Horizontal medial malleolus osteotomies were performed in eighteen synthetic distal tibiae and randomized into two fixation groups: 1) two parallel unicortical cancellous screws or 2) two Acutrak 2 headless compression screws...
March 27, 2018: Clinical Biomechanics
Chen-Chiang Lin, Kang-Ping Lin, Chuan-Ching Huang, Wen-Chuan Chen, Hung-Wen Wei, Cheng-Lun Tsai, Kun-Jhih Lin
Headless compression screws (HCSs) are commonly used to fixate small bones and articular fractures. Understanding the biomechanical efficacy of different HCS designs can help surgeons make proper interfragmentary compression when a specific implant is chosen. HCSs with three different central shaft designs (unthreaded, fully threaded, and partially threaded) were studied: the Herbert-Whipple, Mini-Acutrak 2, and headless reduction (HLR). Polyurethane foam blocks were machined with a simulated fracture gap of 0...
January 2018: Journal of Orthopaedic Surgery
Austin J Roebke, Logan J Roebke, Kanu S Goyal
PURPOSE: Fully threaded, variable-pitch, headless screws are used in many settings in surgery and have been extensively studied in this context, especially in regard to scaphoid fractures. However, it is not well understood how screw parameters such as diameter, length, and pitch variation, as well as technique parameters such as depth of drilling, affect gap closure. METHODS: Acutrak 2 fully threaded variable-pitch headless screws of various diameters (Standard, Mini, and Micro) and lengths (16-28 mm) were inserted into polyurethane blocks of "normal" and "osteoporotic" bone model densities using a custom jig...
November 21, 2017: Journal of Hand Surgery
Simon M Donald, Rui Niu, Christopher W Jones, Belinda J Smith, Elizabeth C Clarke, Richard D Lawson
PURPOSE: This study investigates the loss of compression when 3 commonly used headless compression screws are backed out (reversed), and assesses the ability to re-establish compression with screws of greater diameter. METHODS: Two investigators tested 3 screw designs (Acutrak 2, Synthes HCS, Medartis SpeedTip CCS) in 2 diameters and lengths. Each design had 10 test cycles in a polyurethane foam bone model with compression recorded using a washer load cell. A 28-mm screw of the narrower diameter was inserted until 2 mm recessed and then reversed 30°, 60°, 90°, 180°, 270°, 360°, and 720°...
February 2018: Journal of Hand Surgery
Morgan M Swanstrom, Kyle W Morse, Joseph D Lipman, Krystle A Hearns, Michelle G Carlson
Background  Central and perpendicular (PERP) screw orientations have each been described for scaphoid fracture fixation. It is unclear, however, which orientation produces greater compression. Questions/Purposes  This study compares compression in scaphoid waist fractures with screw fixation in both PERP and pole-to-pole (PTP) configurations. PERP orientation was hypothesized to produce greater compression than PTP orientation. Methods  Ten preoperative computed tomography scans of scaphoid waist fractures were classified by fracture type and orientation in the coronal and sagittal planes...
August 2017: Journal of Wrist Surgery
Markus Riedl, Richard R Glisson, Takumi Matsumoto, Stefan G Hofstaetter, Mark E Easley
BACKGROUND: Subtalar joint arthrodesis is a common operative treatment for symptomatic subtalar arthrosis. Because excessive relative motion between the talus and calcaneus can delay or prohibit fusion, fixation should be optimized, particularly in patients at risk for subtalar arthrodesis nonunion. Tapered, fully-threaded, variable pitch screws are gaining popularity for this application, but the mechanical properties of joints fixed with these screws have not been characterized completely...
June 2017: Clinical Biomechanics
E S Tan, I S Mat Jais, S Abdul Rahim, S C Tay
We investigated the effect of an interfragmentary gap on the final compression force using the Acutrak 2 Mini headless compression screw (length 26 mm) (Acumed, Hillsboro, OR, USA). Two blocks of solid rigid polyurethane foam in a custom jig were separated by spacers of varying thickness (1.0, 1.5, 2.0 and 2.5 mm) to simulate an interfragmentary gap. The spacers were removed before full insertion of the screw and the compression force was measured when the screw was buried 2 mm below the surface of the upper block...
January 2018: Journal of Hand Surgery, European Volume
Clare E Griffis, Cara Olsen, Leon Nesti, C Frank Gould, Michael Frew, Patricia McKay
BACKGROUND: Studies of hardware protrusion into joint spaces following fracture fixation have been performed to address whether or not there is discrepancy between the actual and radiographic appearance of screw prominence. The purpose of our study was to prove that, with respect to the scaphoid, prominence as visualized on CT scan is real and not a result of metal artifact. METHODS: Forty-two cadaveric wrists were separated into four allotted groups with 21 control specimens and 21 study specimens...
April 2017: Archives of Orthopaedic and Trauma Surgery
Mei-Ming Xie, Kang Xia, Hong-Xin Zhang, Hong-Hui Cao, Zhi-Jin Yang, Hai-Feng Cui, Shang Gao, Kang-Lai Tang
BACKGROUND: Screw fixation is a typical technique for isolated talonavicular arthrodesis (TNA), however, no consensus has been reached on how to select most suitable inserted position and direction. The study aimed to present a new fixation technique and to evaluate the clinical outcome of individual headless compression screws (HCSs) applied with three-dimensional (3D) image processing technology to isolated TNA. METHODS: From 2007 to 2014, 69 patients underwent isolated TNA by using double Acutrak HCSs...
January 23, 2017: Journal of Orthopaedic Surgery and Research
Adam Hart, Edward J Harvey, Reza Rabiei, Francois Barthelat, Paul A Martineau
To promote a quicker return to function, an increasing number of patients are treated with headless screws for acute displaced and even non-displaced scaphoid fractures. Therefore, it is imperative to understand and optimize the biomechanical characteristics of different implants to support the demands of early mobilization. The objective of this study was to evaluate the biomechanical fixation strength of 4 headless compression screws under distracting and bending forces. The Acutrak Standard, Acutrak Mini, Synthes 3...
October 2016: Medical Engineering & Physics
Stephanie K Rigot, Rafael Diaz-Garcia, Richard E Debski, John Fowler
BACKGROUND: The biomechanical performance of distal interphalangeal joint (DIPJ) fixation techniques in response to cyclic and load-to-failure bending loads is generally unknown. The purpose of this study is to assess the performance of 4 commonly used techniques for DIP arthrodesis. METHODS: Phalanges were fixed by one of the following techniques: (1) 2 parallel Kirschner wires (K-wires), (2) 1 longitudinal K-wire and 1 oblique K-wire, (3) an Acutrak® 2 Micro headless compression screw, or (4) 90-90 wiring...
June 2016: Hand: Official Journal of the American Association for Hand Surgery
Chen-Chiang Lin, Kun-Jhih Lin, Wen-Chuan Chen, Hung-Wen Wei, Kang-Ping Lin, Cheng-Lun Tsai
Headless compression screws (HCSs) are commonly utilized devices for small bone fracture fixation. The Mini-Acutrak 2 and headless reduction (HLR) screws are the newer version types, in which both have fully threaded and variable pitch design. Specifically, the HLR is characterized by two thread runouts to facilitate implantation. With the thread runouts, the holding strength of the screw may be compromised. To the best of our knowledge, no study has examined the pullout force of the global sizes of a HCS. We sought to determine the pullout strength of the HLR and compare the strength of this screw with that of the Mini-Acutrak 2...
May 24, 2017: Biomedizinische Technik. Biomedical Engineering
Marcio Aurélio Aita, Paulo Augusto Castro Mos, Gisele de Paula Cardoso Marques Leite, Rafael Saleme Alves, Marcos Vinicius Credídio, Eduardo Fernandes da Costa
OBJECTIVE: To analyze the clinical-functional parameters and quality of life of patients undergoing minimally invasive surgical treatment for extra-articular fractures of the proximal phalanx, using an intramedullary screw (Acutrak(®)). METHODS: Between January 2011 and September 2014, a prospective study was conducted on 41 patients (48 fingers) with unstable extra-articular fractures of the proximal phalanx, who underwent minimally invasive surgical treatment using an intramedullary screw (Acutrak(®))...
January 2016: Revista Brasileira de Ortopedia
Satoru Atsumi, Yuji Arai, Ko Kato, Akinobu Nishimura, Shigeto Nakazora, Shuji Nakagawa, Kazuya Ikoma, Hiroyoshi Fujiwara, Akihiro Sudo, Toshikazu Kubo
Among stress fractures associated with sports activities, patellar stress fracture is rare. Regarding patella stress fractures, so far only distal transverse or lateral longitudinal fractures have been reported, but there are no reports of transverse fractures occurring in the proximal patella. We describe an extremely rare case of transverse stress fracture of proximal patella in a 9-year-old athlete.A 9-year old boy, who participated in sports (sprints and Kendo) presented with left knee pain without any external injury...
February 2016: Medicine (Baltimore)
Andrew Max Somberg, William K Whiteside, Erik Nilssen, Daniel Murawski, Wei Liu
BACKGROUND: Many types of screws, plates, and strut grafts have been utilized for ankle arthrodesis. Biomechanical testing has shown that these constructs can have variable stiffness. More recently, headless compression screws have emerged as an evolving method of achieving compression in various applications but there is limited literature regarding ankle arthrodesis. The aim of this study was to determine the biomechanical stability provided by a second generation fully threaded headless compression screw compared to a standard headed, partially threaded cancellous screw in a cadaveric ankle arthrodesis model...
March 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Daniel Schneider Ibanez, Fabio Lucas Rodrigues, Rafael Salmeron Salviani, Fernando Augusto Reginatto Roberto, Jose Roberto Pengo Junior, Marcio Aurelio Aita
OBJECTIVE: To compare the mechanical parameters between two methods for stabilization through compression: 1.5 mm axial compression plate versus conical compression screw used as an intramedullary tutor. METHODS: Polyurethane models (Sawbone(®)) that simulated transverse fractures of the proximal phalanx were used. The models were divided into three groups: lateral plate, conical screw and no implant. RESULTS: Greater force was needed to result in fatigue in the synthesis using an intramedullary plate...
September 2015: Revista Brasileira de Ortopedia
Onur Hapa, Ahmet Karakaşlı, Cemal Dinçer, Vadym Zhamilov, Mustafa Güvencer, Hasan Havitçioğlu
OBJECTIVE: Posterior-to-anterior directed screws are stronger than anterior-to-posterior directed screws for coronoid fracture fixation. Anterior approaches that facilitate direct reduction and fixation of coronoid fractures have been described. The present study was based on the hypothesis that anterior-to-posterior headless screw (Acutrak Mini® 3.5 mm × 26 mm, Acumed, Hillsboro, Oregon, USA) fixation of coronoid fractures would be as strong as posterior-to-anterior 2.7 mm Association for Osteosynthesis (AO) cortical screw fixation...
2015: Acta Orthopaedica et Traumatologica Turcica
Jiwei Wu, Shian Chao Tay, Alexander Y Shin
BACKGROUND: The purpose of this study is to compare the outcome of the conical fully threaded headless screw to that of a smooth shaft headless screw in a series of scaphoid nonunions requiring screw fixation to determine if screw design had an influence on union rates. METHODS: We retrospectively reviewed 104 cases of surgically treated scaphoid nonunions. After eliminating cases with our exclusion criteria, the study cohort had 40 cases for analysis. A comparison and analysis of union rates was undertaken between the fully threaded Acutrak 2 mini screw and the smooth shaft Herbert screw...
2015: Hand Surgery
Güvenir Okcu, Nadir Özkayın, Serkan Erkan, H Koray Tosyali, Kemal Aktuğlu
INTRODUCTION: Operative treatment consisting of fracture reduction and fixation, or arthroplasty to permit early patient mobilization, continues to be the treatment of choice for most femoral neck fractures. Options for internal fixation have included a variety of implants; however most recent reports and textbooks cite parallel multiple cancellous screws as the surgical technique of choice. METHODS: The study was prospective, randomized and IRB approved. Inclusion criteria included skeletal maturity, closed femoral neck fracture without concomitant fractures or injuries with complete charts and adequate radiographs obtained from the initial injury till the last follow-up...
July 2015: Injury
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