{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T20:47:39Z","timestamp":1727124459833},"reference-count":17,"publisher":"SLACK, Inc.","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopedics"],"published-print":{"date-parts":[[2024,9]]},"abstract":"\n Background:<\/jats:title>\n Displaced diaphyseal fractures can be reduced using the push-pull technique, wherein a plate is affixed to the distal fragment of the fracture, a post screw is placed proximal to the plate, and a lamina spreader creates distraction. This study evaluated the load to failure and mechanism of failure of bicortical and unicortical post screws during reduction.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n Four matched pairs of cadaver legs were subjected to a 2-cm oblique osteotomy simulating a displaced, oblique diaphyseal fracture. A 6-hole compression plate was affixed to the distal fragment with 2 unicortical locking screws, and a 12-mm unicortical or 20-mm bicortical screw was inserted as a post screw proximal to the plate. A lamina bone spreader was used to exert a distraction force between the plate and the post screw. A mechanical actuator simulated the distraction procedure until failure. Maximum applied load, displacement, and absorbed energy were recorded and compared across unicortical and bicortical groups by paired\n t<\/jats:italic>\n tests.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n At maximum load, we found statistically significant differences in displacement (\n P<\/jats:italic>\n =.003) and energy absorbed (\n P<\/jats:italic>\n =.022) between the two groups. All unicortical screws failed through screw toggle and bone cut-out. Bicortical screws failed through bending, with no visible damage to the bone at the screw site.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n When diaphyseal fractures are significantly shortened and require a greater distraction force to achieve reduction, bicortical screws demonstrate a higher mechanical load to failure and increased bone loss from the screw-removal site. A unicortical post screw may be used if minimal distraction is needed. [\n Orthopedics<\/jats:italic>\n . 2024;47(5):308\u2013312.]\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3928\/01477447-20240702-02","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T20:25:17Z","timestamp":1720470317000},"page":"308-312","source":"Crossref","is-referenced-by-count":0,"title":["Preventing Iatrogenic Fibula Fractures Using the Push-Pull Technique: A Biomechanical Comparison of Unicortical Versus Bicortical Post Screws"],"prefix":"10.3928","volume":"47","author":[{"given":"Sheldon A.","family":"McCown","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J.","family":"Weatherby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randal P.","family":"Morris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinod K.","family":"Panchbhavi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"II","given":"John C.","family":"Hagedorn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William M.","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2308","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000006926"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2016.04.001"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198466090-00027"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198466080-00012"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0001925900001608"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-010-1093-4"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197052030-00008"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100080610"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2014.164"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms15034714"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/BCO.0000000000000570"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.31616\/asj.2020.0353"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0268-0033(96)00062-9"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2014.06.141"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/10711007211021017"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2019.00268"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1159\/000469704"}],"container-title":["Orthopedics"],"original-title":[],"language":"en","deposited":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T19:37:43Z","timestamp":1726515463000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.healio.com\/doi\/10.3928\/01477447-20240702-02"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.3928\/01477447-20240702-02"],"URL":"https:\/\/doi.org\/10.3928\/01477447-20240702-02","relation":{},"ISSN":["0147-7447","1938-2367"],"issn-type":[{"type":"print","value":"0147-7447"},{"type":"electronic","value":"1938-2367"}],"subject":[],"published":{"date-parts":[[2024,9]]}}}