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  • Title: Syndesmosis fixation: analysis of shear stress via axial load on 3.5-mm and 4.5-mm quadricortical syndesmotic screws.
    Author: Hansen M, Le L, Wertheimer S, Meyer E, Haut R.
    Journal: J Foot Ankle Surg; 2006; 45(2):65-9. PubMed ID: 16513499.
    Abstract:
    The effect of shear stress on a fixated distal syndesmosis of the ankle was evaluated with a servohydraulic materials-testing machine. Eighteen syndesmoses were fixated in a quadricortical technique using 3.5-mm cortical and 4.5-mm cortical stainless steel screws. A shear stress was applied via an axial load in an attempt to simulate weightbearing. The 4.5-mm quadricortical screws produced a higher yield load and peak load (484.3 +/- 93.8 N and 597.7 +/- 81.4 N) when compared with the 3.5-mm quadricortical syndesmotic screws (412.8 +/- 55 N, P = .033 and 511.2 +/- 64.4 N). These findings suggest that a larger diameter screw provides greater resistance to an applied shear stress at the distal syndesmosis.
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