Research Article| Volume 33, ISSUE 8, P685-689, October 2002

A new method of fixation in osteoporotic bone

A preliminary report


      Over-tightening of cortical bone screws in osteoporotic bone results in weak fixation. Once a screw is over-tightened and the bone thread form is stripped, there are limited means at the surgeon’s disposal to rescue the situation, none of them entirely satisfactory. We describe a simple device that is specifically designed to resolve this problem. It consists of a nylon cavity plug and applicator. The plug is inserted into the stripped hole and the screw re-applied and tightened in the normal manner. The plug expands and forms a load-bearing region on the inner face of the bone. Tests on osteoporotic cadavaric bone have shown that the plug effectively re-establishes screw fixation. When compared to an over-tightened screw, the plug is at least twice as resistant to loads acting to pull the screw out of the surrounding bone.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Partridge A.
        Nylon plates and straps for internal fixation of osteoporotic bone [letter].
        Lancet. 1977; 8015: 808
        • Tadross T.S.
        • Nanu A.M.
        • Buchanan M.J.
        • Checketts R.G.
        Dall-Miles plating for periprosthetic B1 fractures of the femur.
        J. Arthroplasty. 2000/2001; 15: 47-51
        • Banim R.H.
        • Fletcher M.
        • Warren P.
        Use of a Dall-Miles plate and cables for the fixation of a periprosthetic tibial fracture.
        J. Arthroplasty. 2000/2001; 15: 131-133
        • Benum P.
        The use of bone cement as an adjunct to internal fixation of supracondylar fractures of osteoporotic femurs.
        Acta Orthop. Scand. 1977; 48: 52-56
        • Harrington K.D.
        The use of methylmethacrylate as an adjunct in the internal fixation of unstable comminuted intertrochanteric fractures in osteoporotic patients.
        Am. J. Bone Joint Surg. 1975; 57: 744-750
        • Schatzker J.
        • Haeri G.B.
        • Chapman M.
        Methylmethacrylate as an adjunct in the internal fixation of intertrochanteric fractures of the femur.
        J. Trauma. 1978; 18: 732-735
        • Cameron H.U.
        • Jacob R.
        • Macnab I.
        • Pilliar R.M.
        Use of polymethylmethacrylate to enhance screw fixation in bone.
        Am. J. Bone Joint Surg. 1975; 57: 655-656
        • Struhl S.
        • Szporn M.N.
        • Cobelli N.J.
        • Sadler A.H.
        Cemented internal fixation for supracondylar femur fractures in osteoporotic patients.
        J. Orthop. Trauma. 1990; 4: 151-157
        • King S.J.
        • Cebon D.
        An alternative to screws for plating osteoporotic bone.
        J. Biomed. Eng. 1993; 15: 79-82