Auxetic fixation devices can achieve superior pullout performances compared to standard fixation concepts

Despite bone screws being the most commonly inserted implant in orthopaedic surgery, 10% of fracture fixation failure is a result of screw migration or pullout. In this study, the effect of four auxetic structures on the pullout performance of a novel unthreaded bone fastener was investigated through experiments and numerical simulations. The auxetic fasteners included the re-entrant, rotating squares, missing rib, and tetrachiral structures. Parametric CAD models were developed for each, and polymer samples manufactured using a stereolithography process. Pullout testing using bone analogue material found the rotating squares fastener to achieve superior pullout resistance 2.5 times that of the non-auxetic control sample. With a pullout to push-in force ratio of 33.7, this fastener achieved high pullout resistance with a low insertion force improving ease of installation. The Poisson’s ratio of the structure was determined using image analysis to be −1.31, similar to the missing rib and re-entrant types. The low axial stiffness of 12.1 N mm⁻¹ for the rotating squares fastener was the reason for superior performance, allowing axial and resulting transverse strain to be initiated at relatively low load. The effect of increased diametral interference was investigated, and the re-entrant structure found to be superior with pullout resistance improved by 342%. This work provides a foundation for further development of unthreaded auxetic bone fasteners, which have the potential to replace screws for some orthopaedic applications and significantly reduce the prevalence of pullout as a failure mode.

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