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Cortical fragment definition11/23/2023 ![]() As the screw is tightened the head of the screw engages the near cortex and the fracture fragments are compressed together. When the screw is inserted, it glides through this hole and the threads only engage the far cortex. The application of cortical screws involves overdrilling the near cortex to the external diameter of the screw. Avulsion fractures are most common around the hip or pelvis but can also occur in the ankle, foot. In children, they are most common in sports like soccer, football, gymnastics, and other sports that involve sudden changes in direction, leaping, and kicking. Because of the weakness of the cortical bone in this area washers are used to prevent sinking of the screw head into the bone. Avulsion fractures happen when a bone fragment separates from the rest of the bone. Therefore, when inserted across a fracture, the threads of the tip of the screw engages in the cancellous bone of the metaphyseal area, causing compression of the fracture fragments upon tightening. Nevertheless, there are some indications for cortical lag screws.Ĭancellous bone screws have threads only on the terminal end of the screw. Treatment for displaced fracture usually includes immobilization using splints, casts or traction and reduction is mostly performed to re-align the bone fragments. They are the second commonest carpal bone fracture, after the scaphoid. The triquetral may be fractured by means of impingement from the ulnar styloid, shear forces, or avulsion from strong ligamentous attachments. In the appendicular skeleton, the larger amount of cortical bone contributes cortical fragments that are seen as trabecular bone by the thresholding method. In the proximal tibia most often cancellous bone screws are used due to the absence of real cortical bone. Fracture of a bone, in which the parts of the bone break and move from their original position is called a displaced fracture. Triquetral fractures are carpal bone fractures generally occurring on the dorsal surface of the triquetrum. The cancellous bone screw and the cortical screw through a gliding hole. Comminution zones have been investigated in pilon fractures. However, in osteoporotic proximal humerus fractures, there is commonly a loss of definition of the edge of the cortical bone fragments on cross-sectional imaging. There are two screw types by which to achieve this. Most studies defined a single fracture line transcribed from the position between two fragments. Lag screws / the lag technique compresses the fracture fragments together.
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