Interfragmentary compression forces of scaphoid screws in a sawbone cylinder model.

Various screws have been developed to stabilise fractures of the scaphoid. Commonly used are the Herbert, the HBS, the 3-mm AO and the Acutrak screws. Not long ago a new screw, the Twin Fix, was introduced. This is cannulated and similar in shape and appearance to the classical Herbert screw. In our test series we compared the maximum achievable compression forces of the Twin Fix screw with that of three other screws (AO, HBS and Acutrak screws). To avoid the variations of density, stiffness and rigidity in natural bone, a polyurethane sawbone-based test setup was used. The test series included 10 screws of each type. The compression force was measured using a special strain gauge. The mean compression force was significantly higher for the Twin Fix screw (8+/-1N) and the Acutrak screw (7.6+/-0.4/0.6N) in relation to the AO screw (6.8+/-1.0/1.4N) and HBS screw (2+/-1N). We found the Twin Fix and Acutrak screws to be promising in the treatment of scaphoid fractures.