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The Journal of Bone and Joint Surgery (American). 2004;86:17-25
© 2004 The Journal of Bone and Joint Surgery, Inc.

The Logic and Clinical Applications of Blocking Screws

Hans-Werner Stedtfeld, MD, PHD, Thomas Mittlmeier, MD, Peter Landgraf, MD and Andreas Ewert, MD

Corresponding author:
Hans-Werner Stedtfeld, MD, PhD
Department of Trauma, Klinikum Nürnberg Klinikum Süd, Breslauer
Strasse 201, Nürnberg 90471, Germany. E-mail address:
stedtfeld@klinikum-nuernberg.de

The first 150 words of the full text of this article appear below.


   The Blocking Screw Model
 
In 1999, Krettek et al. introduced the concept of placing screws around an intramedullary nail (so-called Poller screws)1,2. These screws were used in association with interlocking nailing of tibial fractures with either proximal or distal fragments to facilitate alignment and to prevent late loss of alignment. Krettek et al. recommended placing one screw proximally and one distally on the concave side of the displacement. These screws were thought to work by narrowing the medullary canal in the metaphysis to provide a tight mechanical fit for the intramedullary nail. Similarly, Biewener et al. employed the sequential placement of Kirschner wires to guide an intramedullary nail with a good central position into a distal short fragment3. This procedure was called the "pallisade method."

To clarify the mechanical effect of such screws and to provide a better understanding of their placement, a mechanical model was designed.

Description of the Model
The model has long and . . . [Full Text of this Article]


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