Engineers and Surgeons Collaborate to Test Strength of Humeral and Ulnar Intramedullary Screw Fixation

November 23, 2021

Orthopaedic surgeon Robert A. Kaufmann, MD, and research coordinator Sameer Shetty of the University of Pittsburgh Department of Orthopaedic Surgery collaborated with both local and international engineering colleagues and orthopedists to test the pullout strength of intramedullary (IM) screws from within the humerus to establish their ability to seat an uncemented elbow arthroplasty.

In conducting the study, six humerus and 6 ulna Sawbones specimens were drilled with a drill bit diameter of 5/16 inches, and the inner cortex was hand tapped for a ⅜-16 thread. A ⅜-16 custom-made titanium screw with an outer bolt diameter of 3/8 inches and 16 threads per inch was inserted by hand into the tapped holes. The specimens were then axially tensile loaded at a rate of 5 mm per minute until either the screw began to pull out from the bone or a fracture was noted.

Intramedullary screw fixation in the humerus achieved an average pullout strength of 1,439 pound-force (6,401 N), and IM screw fixation in the ulna achieved an average pullout strength of 882 pound-force (3,923 N). A fracture was noted in 3 humeral specimens, with 3 screws pulling out. In the ulna, the IM axial load caused a fracture in 5 specimens. In 1 specimen, the screw pulled out.

The team’s findings demonstrate that IM screw fixation can create a tensile force within the screw that is greater than that required to generate the calculated level of compression between the implant and bone. This may be beneficial in ensuring fixation between arthroplasty components and bone.

View the full study.

The Research Team

Robert A. Kaufmann
Associate Professor,
University of Pittsburgh Department of Orthopaedic Surgery

Sameer Shetty
Research Coordinator,
University of Pittsburgh Department of Orthopaedic Surgery

Johannes Schneppendahl, MD
Department of Orthopaedics and Trauma Surgery,
University of Duesseldorf, Düsseldorf, Germany

Brody Nelson
Engineering Supervisor,
Element Materials Technology, Fairfield, OH

Brian Knopp
Engineering Supervisor,
Quality Tooling & Repair, Irwin, PA