{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T06:57:37Z","timestamp":1767164257493,"version":"build-2238731810"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","funder":[{"DOI":"10.13039\/100007307","name":"Arthrex","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007307","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000070","name":"National Institute of Biomedical Imaging and Bioengineering","doi-asserted-by":"crossref","award":["R01EB029207"],"award-info":[{"award-number":["R01EB029207"]}],"id":[{"id":"10.13039\/100000070","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>A variable pitch locking screw is intended to provide interfragmentary compression combined with fixed angle stability of locking plate constructs. The objective of this study was to compare variable pitch locking screws (3.5-mm KreuLock Ti locking compression screws, Arthrex Inc., Naples, FL) with standard locking screws (from the same manufacturer) in bicortical fixation scenarios in cadaver bone by assessing (1) interfragmentary compression and plate-bone compression and (2) construct biomechanical stability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Nine matched pairs of fresh-frozen cadaveric specimens with an average age of 67.2 years (range, 37\u201383) were used. Interfragmentary compression and plate-bone compression associated with insertion of single bicortical screws were compared between the variable pitch and standard locking screws at increasing levels of torque. The specimens tested were distal tibiae having a simulated longitudinal fracture. Additionally, fibulae were osteotomized to create a stable longitudinal fracture pattern and were fixed with a 5-screw plate construct with either all variable pitch or all standard locking screws. One of the 5 screws was placed across the osteotomy without lagging. Fibulae were tested cyclically with axial with torsional loading to compare displacements, rotation, and loads at failure or tested in 4-point bending to compare construct stiffness and maximum force to failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Interfragmentary and plate-bone compression forces in the distal tibia model varied across specimens but were significantly higher with variable pitch locking screws compared with standard locking screws [512 N (SD = 324 N) vs. 79 N (SD = 64 N),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002, and 242 N (SD = 119 N) vs. 104 N (SD = 123 N),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.028, respectively]. In cyclic loading of fibula constructs, no significant differences were detected in construct axial displacement or angular displacement (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). In 4-point bending, no differences were detected in maximum force or bending stiffness (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Variable pitch locking screws produced interfragmentary compression between cortices and plate-bone compression that was greater than that produced by standard locking screws. In a stable bicortical fibula fixation scenario under external loading, the stability of variable pitch locking screw constructs was similar to constructs with standard locking screws.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/bot.0000000000002869","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T09:02:46Z","timestamp":1720429366000},"page":"e339-e346","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Bicortical Compression and Construct Stability With Variable Pitch Locking Screws in Cadaveric Specimens"],"prefix":"10.1097","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7645-8179","authenticated-orcid":false,"given":"Zachary A.","family":"Koroneos","sequence":"first","affiliation":[{"name":"Department for Orthopaedics and Rehabilitation, Penn State College of Medicine, Hershey, PA;"},{"name":"Department of Mechanical Engineering, The Pennsylvania State University, University Park, PA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8234-1506","authenticated-orcid":false,"given":"Shelby","family":"Alwine","sequence":"additional","affiliation":[{"name":"Department for Orthopaedics and Rehabilitation, Penn State College of Medicine, Hershey, PA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7626-9446","authenticated-orcid":false,"given":"Peter","family":"Tortora","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine, Hershey, PA; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michaela","family":"Pitcher","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine, Hershey, PA; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Benedict","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine, Hershey, PA; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hwabok","family":"Wee","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, The Pennsylvania State University, University Park, PA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8485-2953","authenticated-orcid":false,"given":"Allen","family":"Kunselman","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, The Pennsylvania State University, Hershey, PA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7648-3868","authenticated-orcid":false,"given":"Michael","family":"Aynardi","sequence":"additional","affiliation":[{"name":"Department for Orthopaedics and Rehabilitation, Penn State College of Medicine, Hershey, PA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3673-0182","authenticated-orcid":false,"given":"Gregory S.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department for Orthopaedics and Rehabilitation, Penn State College of Medicine, Hershey, PA;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"e216","DOI":"10.1097\/OI9.0000000000000216","article-title":"Indications for retrograde intramedullary screw fixation of the distal fibula: a retrospective cohort series","volume":"5","author":"Albana","year":"2022","journal-title":"OTA Int"},{"key":"R2-20250614","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s12178-018-9508-x","article-title":"Special considerations in the management of diabetic ankle fractures","volume":"11","author":"Manway","year":"2018","journal-title":"Curr Rev Musculoskelet Med."},{"key":"R4-20250614","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1016\/j.injury.2010.03.001","article-title":"Screw fixation of radial head fractures: compression screw versus lag screw\u2014a biomechanical comparison","volume":"41","author":"Burkhart","year":"2010","journal-title":"Injury"},{"key":"R5-20250614","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1016\/j.injury.2009.01.003","article-title":"Indications and limitations of locked plating","volume":"40","author":"Tan","year":"2009","journal-title":"Injury"},{"key":"R6-20250614","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1016\/j.clinbiomech.2015.06.008","article-title":"Interfragmentary lag screw fixation in locking plate constructs increases stiffness in simple fracture patterns","volume":"30","author":"M\u00e4rdian","year":"2015","journal-title":"Clin Biomech."},{"key":"R7-20250614","doi-asserted-by":"crossref","first-page":"105002","DOI":"10.1016\/j.jmbbm.2021.105002","article-title":"Non-linear explicit micro-FE models accurately predict axial pull-out force of cortical screws in human tibial cortical bone","volume":"126","author":"Ovesy","year":"2022","journal-title":"J Mech Behav Biomed Mater."},{"key":"R8-20250614","doi-asserted-by":"crossref","first-page":"e315","DOI":"10.1097\/BOT.0000000000000920","article-title":"Rate of and risk factors for intermediate-term reoperation after ankle fracture fixation: a population-based cohort study","volume":"31","author":"Pincus","year":"2017","journal-title":"J Orthop Trauma"},{"key":"R9-20250614","doi-asserted-by":"crossref","first-page":"109","DOI":"10.5435\/00124635-200303000-00005","article-title":"Internal fracture fixation in patients with osteoporosis","volume":"11","author":"Cornell","year":"2003","journal-title":"J Am Acad Orthop Surg."},{"key":"R10-20250614","doi-asserted-by":"crossref","first-page":"647","DOI":"10.5435\/00124635-200910000-00007","article-title":"Failure of fracture plate fixation","volume":"17","author":"Gardner","year":"2009","journal-title":"J Am Acad Orthop Surg."},{"key":"R11-20250614","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1177\/107110070302401106","article-title":"A protocol for treatment of unstable ankle fractures using transarticular fixation in patients with diabetes mellitus and loss of protective sensibility","volume":"24","author":"Jani","year":"2003","journal-title":"Foot Ankle Int."},{"key":"R12-20250614","doi-asserted-by":"crossref","first-page":"S255","DOI":"10.1016\/j.otsr.2014.03.005","article-title":"Internal fixation of the fibula in ankle fractures. 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