Bark City Veterinary Specialists, Park City, Utah, USA.
Blue Pearl Pet Hospital, Sandy Springs, Georgia, USA.
Vet Surg. 2023 Nov;52(8):1112-1120. doi: 10.1111/vsu.14009. Epub 2023 Aug 18.
To assess the incidence of transcortical fracture (TCF) development based on screw insertion angle and screw insertion speed.
Cadaveric experimental study.
Sixty-six canine tibiae.
Sixty-six cadaveric tibiae were randomly assigned to one of six groups that varied based on screw insertion angle relative to the pilot hole (0, 5, or 10°) and screw insertion speed (650 or 1350 revolutions per minute [rpm]). Each tibia was mounted in a custom jig. Locking self-tapping screws (3.5 mm) were inserted at varying speeds and insertion angles, based on group assignment. Orthogonal radiographs were evaluated for TCFs. Fisher's exact tests with a Bonferroni correction were performed to evaluate differences in the frequency of TCF between groups.
In Group A (0°/650 rpm: control), a 0% TCF rate was observed (n = 0/80). Group B (5°/650 rpm) had a 3.75% TCF rate (n = 3/80). Group C (10°/650 rpm) had a 12.5% TCF rate (n = 10/80). Group D (10°/hand insertion) had a 3.75% TCF rate (n = 3/80). Group E (10°/1350 rpm) had a 17.5% TCF rate (n = 14/80). Group F (0°/1350 rpm) had a 0% TCF rate (n = 0/80). Groups C and E had the highest TCF rates with a difference in TCF rates observed between the control group and Group C (p = .001) and between the control group and Group E (p < .001).
Increased screw insertion angle and insertion speed appear to be predisposing factors for TCF development in cadaveric bone.
Ensuring screw insertion is coaxial with the pilot hole and using slower screw insertion speeds may help reduce the risk of TCF development.
根据螺钉插入角度和插入速度评估皮质穿透（TCF）的发生率。
尸体实验研究。
66 只犬胫骨。
66 个尸体胫骨随机分为 6 组，根据螺钉相对于导孔的插入角度（0°、5°或 10°）和螺钉插入速度（650 或 1350 转/分钟[rpm]）而有所不同。每个胫骨都安装在定制的夹具中。根据分组，以不同的速度和插入角度插入锁定自攻螺钉（3.5mm）。评估正交射线照片上的 TCF。使用 Fisher 精确检验（Bonferroni 校正）来评估组间 TCF 发生率的差异。
在 A 组（0°/650rpm：对照组）中，观察到 0%的 TCF 发生率（n=0/80）。B 组（5°/650rpm）的 TCF 发生率为 3.75%（n=3/80）。C 组（10°/650rpm）的 TCF 发生率为 12.5%（n=10/80）。D 组（10°/手动插入）的 TCF 发生率为 3.75%（n=3/80）。E 组（10°/1350rpm）的 TCF 发生率为 17.5%（n=14/80）。F 组（0°/1350rpm）的 TCF 发生率为 0%（n=0/80）。C 组和 E 组的 TCF 发生率最高，与对照组相比，C 组（p=0.001）和 E 组（p<0.001）的 TCF 发生率差异有统计学意义。
增加螺钉插入角度和插入速度似乎是尸体骨中 TCF 发生的诱发因素。
确保螺钉插入与导孔同轴，并使用较慢的螺钉插入速度可能有助于降低 TCF 发生的风险。
