Bending strength and holding power of a prototype tibial locking screw.

To improve mechanical performance, a prototype tibial locking screw with two components was developed for the current study: a both-ends-threaded screw with a smooth shank and a small set screw inserted obliquely through the cap of the both-ends-threaded screw. The bending strength and holding power of this prototype screw were compared with that of five commercially available tibial locking screws: Synthes, Howmedica, Richards, Osteo AG, and Zimmer. To test bending strength, the screws were inserted into a polyethylene tube and loaded at their midpoint to simulate a three-point bending test. Single-loading yielding strength and cyclic-loading fatigue life then were measured. To test holding power, the screws were inserted into polyurethane foam tubes, and stripping torque and pushout strength were measured. The results showed that the yielding strength and the fatigue life were related closely to the inner diameter of the fully threaded screws. The stripping torque reflected the pushout strength, which also was estimated by the formula D[0.5 + 0.57735 (D - d)/2p] (D, outer diameter; d, inner diameter; p, pitch). Even though, among all of the tested screws, the prototype had the smallest outer diameter at its middle, it had the highest fatigue strength, and simultaneously preserved its high bone-holding power. A clinical trial using this prototype screw is warranted, one in which the difficult surgical technique of inserting the set screws should be investigated.