Basmajian Hrayr G, Liu Joseph N, Scudday Travis, Campbell Seth T, Amin Nirav H
Premier Orthopaedic and Trauma Specialists 160 E. Artesia Street, Suite 310, Pomona, CA 91767, USA.
Loma Linda University, Department of Orthopedics, 24851 Circle Dr, Loma Linda, CA 92354, USA.
J Clin Orthop Trauma. 2020 Feb;11(Suppl 1):S100-S104. doi: 10.1016/j.jcot.2019.08.015. Epub 2019 Aug 22.
To compare the pullout strength and maximal insertional torque of pilot holes prepared with the traditional twist drill bit versus a smooth Kirschner wire.
Pilot holes were prepared using a drill press with either a 2.5 mm twist drill bit or a 2.5 mm smooth Kirschner wire into 2 distinct polyurethane foam densities representing severe and mild osteoporotic bone. 3.5 mm cortical and 4.0 mm cancellous screws were then inserted freehand into the prepared holes. All permutations of pilot hole type, screw size and foam density were tested for maximum pullout strength and maximum insertional torque.
Kirschner wire prepared pilot holes resulted in significantly higher pullout load than drill bit holes in low density blocks (P < 0.001), but not in high density blocks (P = 0.232). There was no statistical difference (P > 0.05) for maximum insertional torque in the pilot hole preparation type.
In severely osteoporotic bone, Kirschner wire pilot hole preparation may improve screw pullout strength.
比较使用传统麻花钻头与光滑克氏针制备的导向孔的拔出强度和最大插入扭矩。
使用钻床，分别用2.5毫米麻花钻头或2.5毫米光滑克氏针在代表严重骨质疏松和轻度骨质疏松骨的两种不同密度的聚氨酯泡沫中制备导向孔。然后徒手将3.5毫米皮质骨螺钉和4.0毫米松质骨螺钉插入制备好的孔中。对导向孔类型、螺钉尺寸和泡沫密度的所有组合进行最大拔出强度和最大插入扭矩测试。
在低密度块中，用克氏针制备的导向孔产生的拔出载荷明显高于钻头孔（P<0.001），但在高密度块中则不然（P = 0.232）。导向孔制备类型的最大插入扭矩无统计学差异（P>0.05）。
在严重骨质疏松的骨中，用克氏针制备导向孔可能会提高螺钉的拔出强度。
