{"id":"https://openalex.org/W7224901313","doi":"https://doi.org/10.1177/15589447261496536","title":"Loose Screw or No Screw? A Biomechanical Study to Answer a Common Intraoperative Dilemma","display_name":"Loose Screw or No Screw? A Biomechanical Study to Answer a Common Intraoperative Dilemma","publication_year":2026,"publication_date":"2026-10-30","ids":{"openalex":"https://openalex.org/W7224901313","doi":"https://doi.org/10.1177/15589447261496536","pmid":"https://pubmed.ncbi.nlm.nih.gov/42959000","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13724180"},"language":"en","primary_location":{"id":"doi:10.1177/15589447261496536","doi":"https://doi.org/10.1177/15589447261496536","is_oa":false,"landing_page_url":"https://doi.org/10.1177/15589447261496536","pdf_url":null,"source":{"id":"https://openalex.org/S49025288","display_name":"Hand","issn_l":"1558-9447","issn":["1558-9447","1558-9455"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"HAND","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13724180/","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5085571114","display_name":"Christopher C. Chung","orcid":"https://orcid.org/0000-0001-7497-8042","observed_orcids":["https://orcid.org/0000-0001-7497-8042"]},"institutions":[{"id":"https://openalex.org/I97018004","display_name":"Stanford University","ror":"https://ror.org/00f54p054","country_code":"US","type":"education","lineage":["https://openalex.org/I97018004"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Christopher C. Y. Chung","raw_affiliation_strings":["Stanford University, CA, USA"],"raw_orcid":"https://orcid.org/0000-0001-7497-8042","affiliations":[{"raw_affiliation_string":"Stanford University, CA, USA","institution_ids":["https://openalex.org/I97018004"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5104444469","display_name":"Adina Harri","orcid":"https://orcid.org/0000-0001-6312-3508","observed_orcids":["https://orcid.org/0000-0001-6312-3508"]},"institutions":[{"id":"https://openalex.org/I97018004","display_name":"Stanford University","ror":"https://ror.org/00f54p054","country_code":"US","type":"education","lineage":["https://openalex.org/I97018004"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Adina Harri","raw_affiliation_strings":["Stanford University, CA, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Stanford University, CA, USA","institution_ids":["https://openalex.org/I97018004"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5117248471","display_name":"Katherine Shehadeh","orcid":"https://orcid.org/0009-0008-4990-5798","observed_orcids":["https://orcid.org/0009-0008-4990-5798"]},"institutions":[{"id":"https://openalex.org/I97018004","display_name":"Stanford University","ror":"https://ror.org/00f54p054","country_code":"US","type":"education","lineage":["https://openalex.org/I97018004"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Katherine Shehadeh","raw_affiliation_strings":["Stanford University, CA, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Stanford University, CA, USA","institution_ids":["https://openalex.org/I97018004"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5058596809","display_name":"Calvin K. Chan","orcid":"https://orcid.org/0009-0002-5666-7907","observed_orcids":["https://orcid.org/0009-0002-5666-7907","https://orcid.org/0000-0003-1579-9559"]},"institutions":[{"id":"https://openalex.org/I97018004","display_name":"Stanford University","ror":"https://ror.org/00f54p054","country_code":"US","type":"education","lineage":["https://openalex.org/I97018004"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Calvin K. Chan","raw_affiliation_strings":["Stanford University, CA, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Stanford University, CA, USA","institution_ids":["https://openalex.org/I97018004"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5015006885","display_name":"Nicole S. Pham","orcid":"https://orcid.org/0000-0001-6719-3159","observed_orcids":["https://orcid.org/0000-0001-6719-3159"]},"institutions":[{"id":"https://openalex.org/I97018004","display_name":"Stanford University","ror":"https://ror.org/00f54p054","country_code":"US","type":"education","lineage":["https://openalex.org/I97018004"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Nicole S. Pham","raw_affiliation_strings":["Stanford University, CA, USA"],"raw_orcid":"https://orcid.org/0000-0001-9137-454X","affiliations":[{"raw_affiliation_string":"Stanford University, CA, USA","institution_ids":["https://openalex.org/I97018004"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5160189192","display_name":"Jeffrey Yao","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I97018004","display_name":"Stanford University","ror":"https://ror.org/00f54p054","country_code":"US","type":"education","lineage":["https://openalex.org/I97018004"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Jeffrey Yao","raw_affiliation_strings":["Stanford University, CA, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Stanford University, CA, USA","institution_ids":["https://openalex.org/I97018004"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5160189192"],"corresponding_institution_ids":["https://openalex.org/I97018004"],"apc_list":{"value":3900,"currency":"USD","value_usd":3900},"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.88318732,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":"15589447261496536","last_page":"15589447261496536"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10630","display_name":"Orthopedic Surgery and Rehabilitation","score":0.6929000020027161,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10630","display_name":"Orthopedic Surgery and Rehabilitation","score":0.6929000020027161,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10658","display_name":"Bone fractures and treatments","score":0.295199990272522,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10776","display_name":"Spinal Fractures and Fixation Techniques","score":0.004900000058114529,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/screw-removal","display_name":"screw removal","score":0.7260000109672546},{"id":"https://openalex.org/keywords/bridge-plate","display_name":"bridge plate","score":0.6359999775886536},{"id":"https://openalex.org/keywords/screw-loosening","display_name":"screw loosening","score":0.6029999852180481},{"id":"https://openalex.org/keywords/cantilever-bending","display_name":"cantilever bending","score":0.6470000147819519},{"id":"https://openalex.org/keywords/torsional-strength","display_name":"torsional strength","score":0.8939999938011169},{"id":"https://openalex.org/keywords/fracture-fixation-biomechanics","display_name":"fracture fixation biomechanics","score":0.8180000185966492},{"id":"https://openalex.org/keywords/screw-migration","display_name":"screw migration","score":0.7689999938011169},{"id":"https://openalex.org/keywords/stress-raisers","display_name":"stress concentrators","score":0.671999990940094},{"id":"https://openalex.org/keywords/comminuted-fractures","display_name":"comminuted fractures","score":0.6639999747276306}],"concepts":[{"id":"https://openalex.org/C175696284","wikidata":"https://www.wikidata.org/wiki/Q986524","display_name":"Cadaveric spasm","level":2,"score":0.7882999777793884},{"id":"https://openalex.org/C146249460","wikidata":"https://www.wikidata.org/wiki/Q2914991","display_name":"Fixation (population genetics)","level":3,"score":0.5756999850273132},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5636000037193298},{"id":"https://openalex.org/C91762617","wikidata":"https://www.wikidata.org/wiki/Q48422","display_name":"Cadaver","level":2,"score":0.5508000254631042},{"id":"https://openalex.org/C29694066","wikidata":"https://www.wikidata.org/wiki/Q118301","display_name":"Orthodontics","level":1,"score":0.5473999977111816},{"id":"https://openalex.org/C107551265","wikidata":"https://www.wikidata.org/wiki/Q1458245","display_name":"Displacement (psychology)","level":2,"score":0.5141000151634216},{"id":"https://openalex.org/C87210426","wikidata":"https://www.wikidata.org/wiki/Q1072476","display_name":"Bending","level":2,"score":0.4945000112056732},{"id":"https://openalex.org/C170700871","wikidata":"https://www.wikidata.org/wiki/Q193378","display_name":"Biomechanics","level":2,"score":0.48489999771118164},{"id":"https://openalex.org/C141354745","wikidata":"https://www.wikidata.org/wiki/Q17227","display_name":"Cantilever","level":2,"score":0.41850000619888306},{"id":"https://openalex.org/C2988617437","wikidata":"https://www.wikidata.org/wiki/Q6627318","display_name":"Materials testing","level":2,"score":0.3971000015735626},{"id":"https://openalex.org/C180478085","wikidata":"https://www.wikidata.org/wiki/Q1973366","display_name":"Universal testing machine","level":3,"score":0.36660000681877136},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3203999996185303},{"id":"https://openalex.org/C21036866","wikidata":"https://www.wikidata.org/wiki/Q181767","display_name":"Stress (linguistics)","level":2,"score":0.3061000108718872},{"id":"https://openalex.org/C155165730","wikidata":"https://www.wikidata.org/wiki/Q1319519","display_name":"von Mises yield criterion","level":3,"score":0.30550000071525574},{"id":"https://openalex.org/C159985019","wikidata":"https://www.wikidata.org/wiki/Q181790","display_name":"Composite material","level":1,"score":0.3052999973297119},{"id":"https://openalex.org/C77461463","wikidata":"https://www.wikidata.org/wiki/Q7827201","display_name":"Torsion (gastropod)","level":2,"score":0.303600013256073},{"id":"https://openalex.org/C66938386","wikidata":"https://www.wikidata.org/wiki/Q633538","display_name":"Structural engineering","level":1,"score":0.2924000024795532},{"id":"https://openalex.org/C2777304102","wikidata":"https://www.wikidata.org/wiki/Q1667915","display_name":"Osteosynthesis","level":2,"score":0.2827000021934509},{"id":"https://openalex.org/C192562407","wikidata":"https://www.wikidata.org/wiki/Q228736","display_name":"Materials science","level":0,"score":0.2808000147342682},{"id":"https://openalex.org/C2777586403","wikidata":"https://www.wikidata.org/wiki/Q4243098","display_name":"Hook","level":2,"score":0.27399998903274536},{"id":"https://openalex.org/C3019308078","wikidata":"https://www.wikidata.org/wiki/Q229367","display_name":"3d printed","level":2,"score":0.27230000495910645},{"id":"https://openalex.org/C2779372316","wikidata":"https://www.wikidata.org/wiki/Q569057","display_name":"Stiffness","level":2,"score":0.27160000801086426},{"id":"https://openalex.org/C128172907","wikidata":"https://www.wikidata.org/wiki/Q4887116","display_name":"Bending stiffness","level":3,"score":0.26759999990463257},{"id":"https://openalex.org/C152279782","wikidata":"https://www.wikidata.org/wiki/Q13583542","display_name":"Shearing (physics)","level":2,"score":0.2581999897956848},{"id":"https://openalex.org/C100776233","wikidata":"https://www.wikidata.org/wiki/Q2532492","display_name":"Bridge (graph theory)","level":2,"score":0.2572000026702881},{"id":"https://openalex.org/C144171764","wikidata":"https://www.wikidata.org/wiki/Q48103","display_name":"Torque","level":2,"score":0.25690001249313354},{"id":"https://openalex.org/C2780660378","wikidata":"https://www.wikidata.org/wiki/Q1667915","display_name":"Internal fixation","level":2,"score":0.2556000053882599},{"id":"https://openalex.org/C3018023364","wikidata":"https://www.wikidata.org/wiki/Q425265","display_name":"Significant difference","level":2,"score":0.2540000081062317},{"id":"https://openalex.org/C2778969670","wikidata":"https://www.wikidata.org/wiki/Q7880284","display_name":"Ultimate failure","level":3,"score":0.2506999969482422}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.1177/15589447261496536","doi":"https://doi.org/10.1177/15589447261496536","is_oa":false,"landing_page_url":"https://doi.org/10.1177/15589447261496536","pdf_url":null,"source":{"id":"https://openalex.org/S49025288","display_name":"Hand","issn_l":"1558-9447","issn":["1558-9447","1558-9455"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"HAND","raw_type":"journal-article"},{"id":"pmid:42959000","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42959000","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Hand (New York, N.Y.)","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13724180","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13724180/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Hand (N Y)","raw_type":"Text"}],"best_oa_location":{"id":"pmh:oai:pubmedcentral.nih.gov:13724180","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13724180/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Hand (N Y)","raw_type":"Text"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.8560000061988831}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":18,"referenced_works":["https://openalex.org/W37802878","https://openalex.org/W1970830805","https://openalex.org/W1975508000","https://openalex.org/W1999824078","https://openalex.org/W2042552864","https://openalex.org/W2065542017","https://openalex.org/W2066586764","https://openalex.org/W2082536136","https://openalex.org/W2091237134","https://openalex.org/W2118952780","https://openalex.org/W2276073286","https://openalex.org/W2415469557","https://openalex.org/W2769757024","https://openalex.org/W2890276454","https://openalex.org/W2981953423","https://openalex.org/W3162751862","https://openalex.org/W4281689890","https://openalex.org/W4404109026"],"related_works":["https://openalex.org/W2751839666","https://openalex.org/W3114364899","https://openalex.org/W2769757024","https://openalex.org/W2066586764","https://openalex.org/W3144809769","https://openalex.org/W4283388824","https://openalex.org/W4281689890","https://openalex.org/W3202655811","https://openalex.org/W3127597949","https://openalex.org/W1991436980"],"abstract_inverted_index":{"Background:":[0],"Insertion":[1],"of":[2,18,117,232],"cortical":[3],"screws":[4],"with":[5,66,157,168,221,234,240],"poor":[6],"purchase":[7],"during":[8],"metacarpal":[9,63,264],"plate":[10,59,260],"fixation":[11,40,60,261],"may":[12,38],"occur,":[13],"yet":[14],"the":[15,48,115,226,241,249],"biomechanical":[16,131,278],"tradeoff":[17],"retaining":[19],"versus":[20,161],"removing":[21],"a":[22,30,44,69,118,254,273],"loose":[23,31,71,119,158,236,242,256],"screw":[24,32,35,87,94,128,159,169,195,237,243,257,269],"remains":[25],"difficult":[26],"to":[27,92],"quantify.":[28],"Removing":[29,253],"avoids":[33,268],"risking":[34],"migration":[36,270],"but":[37],"decrease":[39],"strength":[41],"or":[42,67,100,112,214,276],"create":[43],"stress":[45,213,274],"riser":[46,275],"at":[47,146,176],"empty":[49],"hole.":[50],"Our":[51],"study":[52],"evaluated":[53,125],"bending":[54,111,144,217,224],"and":[55,90,96,114,130,193],"torsional":[56,229],"properties":[57],"in":[58,79,212,258],"for":[61,262],"comminuted":[62,263],"diaphyseal":[64,265],"fractures":[65,76,266],"without":[68,271],"single":[70,86,255],"screw.":[72,120],"Methods:":[73],"Sixty-four":[74],"cadaveric":[75],"were":[77,104,136,210],"fixed":[78],"bridge":[80,259],"mode":[81],"using":[82,138],"nonlocking":[83],"screws.":[84],"A":[85],"was":[88,150],"overtightened":[89],"stripped":[91],"simulate":[93],"loosening":[95],"then":[97],"either":[98],"retained":[99,160,184,235],"removed.":[101],"Testing":[102],"groups":[103,196],"assigned":[105],"based":[106],"on":[107],"loading":[108],"configuration":[109],"(cantilever":[110],"torsion)":[113],"presence":[116,129],"Multivariable":[121],"linear":[122],"regression":[123],"models":[124],"relationships":[126],"between":[127,183],"outcome":[132],"measures.":[133],"Failure":[134],"modes":[135],"analyzed":[137],"Fisher":[139],"exact":[140],"test.":[141],"Results:":[142],"Cantilever":[143,216],"load":[145],"2":[147],"mm":[148],"displacement":[149,179],"7.6":[151],"N":[152,163,186,191,198,203],"(SD":[153,164],"=":[154,165,173,189,201,206],"1.9":[155],"N)":[156,167],"8.0":[162],"2.6":[166],"removed":[170,194],"(":[171],"P":[172,205],".796).":[174],"Torque":[175],"10\u00b0":[177],"rotational":[178],"showed":[180],"no":[181],"difference":[182],"(0.363":[185],"m,":[187,199],"SD":[188,200],"0.054":[190],"m)":[192],"(0.370":[197],"0.139":[202],"m;":[204],".858).":[207],"No":[208],"differences":[209],"identified":[211],"stiffness.":[215],"clinical":[218,250],"failure":[219],"occurred":[220],"all":[222],"specimens":[223],"through":[225],"plate.":[227],"During":[228],"testing,":[230],"6":[231],"16":[233],"secondarily":[238],"failed,":[239],"hole":[244],"fracturing":[245],"after":[246],"rotating":[247],"past":[248],"endpoint.":[251],"Conclusion:":[252],"safely":[267],"imparting":[272],"compromising":[277],"strength.":[279]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-10-31T00:00:00"}
