{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:28:54Z","timestamp":1790278134191,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,1,16]],"date-time":"2019-01-16T00:00:00Z","timestamp":1547596800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:label\/><jats:p>Migration profile of helical blades differs from conventional screw design. Tip\u2010apex distance (TAD) greater than 25\u2009mm is associated with early failure in hip screws. This study investigates the effect of a reduced TAD on helical blade fixation. Six pairs of human femoral heads were used. Bone mineral density (BMD) was determined by pQCT. Local bone quality was evaluated by breakaway torque. Helical blades were implanted with TAD of 20\u2009mm (normal) and 6\u2009mm (reduced). Specimens were cyclically tested under progressively increasing physiologic loading at 2\u2009Hz with starting peak force of 1\u2032000N, increasing by 0.1N\/cycle. Implant migration was monitored by radiographs every 250 cycles. Paired Student's <jats:italic>t<\/jats:italic>\u2010test and Spearman rank correlation coefficient were used for statistical evaluation (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Mean BMD was 246.7\u2009mgHA\/cm<jats:sup>3<\/jats:sup> SD48.7 (normal), 244.3\u2009mgHA\/cm<jats:sup>3<\/jats:sup> SD47.6 (reduced); <jats:italic>p<\/jats:italic>\u2009=\u20090.93. Mean breakaway torque was 3.59\u2009Nm SD2.11 (normal), 3.72\u2009Nm SD1.83 (reduced); <jats:italic>p<\/jats:italic>\u2009=\u20090.91. Number of cycles to failure (1\u2009mm vertical migration) was 16\u2032416 SD7972 (normal), 20\u2032000 SD5232 (reduced); <jats:italic>p<\/jats:italic>\u2009=\u20090.38. They correlated significantly with BMD (<jats:italic>p<\/jats:italic>\u2009=\u20090.01;<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.91) and breakaway torque (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.049; <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.814) (normal). Breakaway torque correlated significantly with BMD (<jats:italic>p<\/jats:italic>\u2009=\u20090.02; <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.898) (normal). In reduced TAD these parameters did not correlate significantly. Normal TAD resulted in failure in varus collapse (<jats:italic>n<\/jats:italic>\u2009=\u20096), whereas reduced TAD showed blade perforation (<jats:italic>n<\/jats:italic>\u2009=\u20093), rotation (<jats:italic>n<\/jats:italic>\u2009=\u20092), varus collapse (<jats:italic>n<\/jats:italic>\u2009=\u20091). Fixation stability of helical blades correlates with bone quality when implants are fixed in cancellous bone. Near cortical blade fixation might increase the risk of intraarticular blade perforation. \u00a9 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. 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