This system allows intra-articular manipulation of the biceps tendon, ensures placement of the tendon into the base of the bone socket, allows insertion of the screw while maintaining the position and tension in the tendon, and ensures an adequate screw-tendon-bone interface.
They concluded that these implant failures were related to intraoperative technical errors including the use of plates that were too short and those that did not have adequate empty screw holes over the fracture site.
Adequate pedicle screw fixation in the presence of compromised bone quality presents a challenging problem for spine surgeons.
The analysis in terms of ductility and strength shows that bolted connections are less adequate than screwed connections (reported in Part 1 of this paper) for the seismic design of X-braced shear walls in lightweight structures.
If unable to achieve an adequate press-fit fixation, screws should be inserted cautiously with regard to their number and placement.
Furthermore, they also determined that there is no improvement in pullout strength observed when using a double coupler system as opposed to a single coupler of adequate stiffness between pedicle screws.
Obtaining adequate purchase with standard pedicle screw techniques remains a challenge in poor quality bone.
Obtaining adequate fixation of a pedicle screw in fragile bone, as that of an osteoporotic patient, has been proven to be an ongoing challenge.
For some light weight applications (electrical boxes, conduit straps), plastic anchors (with regular screws) or "Tapcon" concrete screws (without anchors) are adequate.
The plate was placed directly on the radius after the reduction of the fracture, and the adequate positioning of plate and screws were confirmed by intraoperative fluoroscopy.
