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The aim was to design an apparatus to mimic the physiological conditions and test stability with 1S, 2S, and a headless compression screw (HCS) for osteosynthesis of artificially created type II odontoid fractures. The apparatus was mounted on a Zwick materials\u00a0testing machine. A total of 18 C1\u20132 specimens were stratified into three groups (1S, 2S, HCS). Odontoid fractures were artificially created, and osteosynthesis was performed. Each specimen was tested at loads increasing from 1 to 40 N. Screw loosening was observed visually, by fatigue data, and by a camera tracking system. Analysis of the Zwick data and the camera data revealed a significant higher stability after 2S compared to 1S and HCS treatment (Zwick data: p\u2009=\u20090.021, camera data: p\u2009&lt;\u20090.001), while visible screw loosening showed a superiority of the 2S only over HCS (p\u2009=\u20090.038). The developed apparatus allowed the dynamic study of the atlantoaxial joint with a high approximation to physiological conditions. The results demonstrated superiority of the 2S over the 1S and HCS in biomechanical stability in the treatment of type II odontoid fractures.<\/jats:p>","DOI":"10.1038\/s41598-024-69905-3","type":"journal-article","created":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T11:02:19Z","timestamp":1723719739000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Two-screw osteosynthesis is biomechanically superior to single-screw osteosynthesis for type II odontoid fractures"],"prefix":"10.1038","volume":"14","author":[{"given":"Paul Jonathan","family":"Roch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Salge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Angel Bravo","family":"Cabrera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friederike Sophie","family":"Klockner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc-Pascal","family":"Meier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"J\u00e4ckle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Lehmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Weiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,15]]},"reference":[{"key":"69905_CR1","doi-asserted-by":"publisher","first-page":"366","DOI":"10.3171\/jns.1998.89.3.0366","volume":"89","author":"JD Jenkins","year":"1998","unstructured":"Jenkins, J. 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