Slippage between screwdriver and bone screw.

Cortical 3.5-mm stainless steel screws with hexagonal heads and corresponding screwdrivers from two manufacturers were investigated. Measurement of dimensions and torsional testing were done to study slippage between the screw and the driver bit. There were only small differences in dimensions between the manufacturers. Ultimate torque values obtained were at the level of 2.7 N-m where reaming of the screw socket took place. Additional rotation resulted in approximately (1/2) of the maximum torque. Subsequent torque testing in the opposite direction, corresponding to removal of the screw, revealed that the torque values were equally low in that direction. Additional insertion and removal of bone screws with hexagonal sockets are hampered after only one episode of slippage. It is justified to consider new shapes of drive bits and corresponding screw head sockets, such as a fluted multiedge configuration.