Windham B Pearson, Jordan J Randall, Parsell Doug E
Department of Otolaryngology, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA.
Laryngoscope. 2007 Nov;117(11):1964-8. doi: 10.1097/MLG.0b013e31813437c6.
To compare the pullout strength of titanium screws and resorbable screws from human fresh-frozen cadaveric laryngeal cartilage. The importance of drill hole diameter, screw diameter, and whether the drill hole was tapped (resorbable screws only) was also determined.
Prospective.
Sixteen cartilage specimens were tested after debridement of connective tissue and perichondrium. Linear pullout strength of screws was measured using a load cell. Titanium and resorbable screw sizes of 1.5 and 2.0 mm were tested using drill hole diameters of 1.1 and 1.5 mm. For the resorbable-tapped group, screw diameters of 1.5 and 2.0 mm were tapped with 1.5 and 2.0 mm taps, respectively. All tested screws were 6 mm in length.
We found a uniformly constant difference between the three screw types (P < .001). Post hoc analysis indicated a significant difference between the resorbable-untapped screw and both the resorbable-tapped screw and the titanium screw. We failed to find a significant difference, however, between the resorbable-tapped screw and the titanium screw. We also found a significant effect in regard to screw size (P = .0133), with post hoc analysis demonstrating the 1.1/1.5 mm combination to be inferior to the 1.1/2.0 and 1.5/2.0 mm combinations. There was no significant difference between the 1.1/2.0- and 1.5/2.0-mm combinations.
Resorbable screws with untapped drill holes result in higher resistance to linear loads than both titanium screws and resorbable screws with tapped drill holes. The 1.1/2.0- and 1.5/2.0-mm drill/screw combinations are superior to the 1.1/1.5-mm combination when considering untapped resorbable screws.
比较钛螺钉和可吸收螺钉从人新鲜冷冻尸体喉软骨中的拔出强度。还确定了钻孔直径、螺钉直径以及钻孔是否攻丝（仅适用于可吸收螺钉）的重要性。
前瞻性研究。
对16个软骨标本进行结缔组织和软骨膜清创后进行测试。使用测力传感器测量螺钉的线性拔出强度。使用1.1毫米和1.5毫米的钻孔直径测试1.5毫米和2.0毫米的钛螺钉和可吸收螺钉尺寸。对于可吸收攻丝组，1.5毫米和2.0毫米的螺钉直径分别用1.5毫米和2.0毫米的丝锥攻丝。所有测试螺钉长度均为6毫米。
我们发现三种螺钉类型之间存在一致的恒定差异（P <.001）。事后分析表明，未攻丝的可吸收螺钉与攻丝的可吸收螺钉和钛螺钉之间存在显著差异。然而，我们未发现攻丝的可吸收螺钉与钛螺钉之间存在显著差异。我们还发现螺钉尺寸有显著影响（P = 0.0133），事后分析表明1.1/1.5毫米组合不如1.1/2.0毫米和1.5/2.0毫米组合。1.1/2.0毫米和1.5/2.0毫米组合之间没有显著差异。
未攻丝钻孔的可吸收螺钉比钛螺钉和攻丝钻孔的可吸收螺钉对线性载荷的抵抗力更高。在考虑未攻丝的可吸收螺钉时，1.1/2.0毫米和1.5/2.0毫米的钻孔/螺钉组合优于1.1/1.5毫米组合。
