A Tour of the Most Expensive Screw in the WORLD

[@jordanscottmacaulay]

Built my deck using these. Didn't cost me anything just a lot of digging at night.

[@-iIIiiiiiIiiiiIIIiiIi-]

*At your next Backyard BBQ* Guest: "Why does this dude's deck keep whispering to me? I'm just trying to eat this burger." Spirits: "HELP US! THIEF! HELP US KILL THE THIEF!" Guest: *puts on Bose QuietComfort Ultra Headphones* "That's better." *Seal's "Waiting For You" plays in the background and fades out*

[@ddegn]

I've got at least three in my neck. Keep a watch out for my obituary.

[@jordanscottmacaulay]

@@ddegn looking forward to it.

[@somedude4805]

Ha, gallows humor.

[@yongyea4147]

You must be the USG

[@thereddrob]

there's another expensive screw that takes most people at least 18 years to pay off

[@carlosmejia5728]

Made in USA...

[@1981czarsean]

Hahahahah😂 nice...😭😭😭

[@a9ball1]

Made me laugh 😊

[@querty292]

That’s a screw up

[@davidklug6980]

I have three of those 😢

[@Ryarios]

It’s so expensive because they attached the word "surgical" to it. It’s sterile, non porous, tested in medical trials, and has been approved by the government for long term use inside the body. (The last two probably sent them back a pretty penny.)

[@baseder514]

Nah thats just straight 🧢. Machining titanium isn't that hard when it is with small parts. It mostly takes a bit more time but thats all. It the damn mark up they throw on these things that make them this expensive.

[@Dagrizzb]

R & D isn't free.

[@pojuh645]

@@baseder514 machining titanium is not the same like being an approved producer of titanium. you still have other standards for screws that go inside your body than for engine parts or whatever you could use such screws for. They must be tested and approved for certain applications. Like no splinters, maybe a super smooth and high quality surface finish, no air inside them, or idk what could be wrong with a screw. The chances would probably at least be 90% fine if sb would produce the same screws without being approved or tested, but we just live in this world where we have such standards and make up hefty prices for it. Do you know the collection of all Food items per definition? It is the same. A glass of peanut butter is like $3k or sth, because it is a reference object for all other peanut butter and used for aroma or stuff like that and has it's ingredients certified and atoms analyzed in a spectrometer. It is the same like peanut butter you do at home, but it has other conditions making it expensive. Maybe they also use a certified supplier for their titanium that also has a 100% pure grade to their purity and need to be able to trust them not buying from any china market and having impurities. Because if you think you have titanium inside your body but it has magnetic parts this would rip the inside fo your body outside where the screw is in an mrt for example. That's also a reason why they must produce on a super high level of ingerity. Also you don't want screws to rust inside your body because of impurities and bad quality. If you buy them in china for $5 each, you probably get any other metal with some paint on it. Of course a national production would not be the same as made in china maybe. But I think you see my point. You still need the most trustworthy and tested facilities and producers for these kind of products and it comes with a price. Also rather let them have their price instead of being shady and giving a bad product. Expensive and trustworthy is more worth than cheap and "probably good enough". Would you want to have $20 screws each in your leg that would probably be "good enough", or those $400 screws, you know were tested for medical conditions? I'd pay those $400 screws myself if I had to, to have the better choice. Maybe they could sell them at $100 for a profit, but I don't care.

[@QuattroSG]

R&D on a screw driving the price up that high? Come on bro.

[@vadimuha]

Most of that cost is a warranty pretty much

[@EricLS]

The reason it cost $423 is the same reason my surgeon buddy got a complaint from a patient that the hernia mesh he selected during her surgery was causing issues with her insurance because it’s cost $10,000. He was like “oh, no that’s a mistake”. It wasn’t. When he pressed the manufacturer he was told it was the “industry standard markup”. What was that industry standard markup, you may ask? 400%. That’s right, a whopping 80% of the cost was markup. Her insurance was forced to pay. I’m so over this nonsense.

[@smashyrashy]

Same with the aviation indusrtry, if it goes in a plane it automatically costs an unbelievable amount more

[@alan3082]

Thank money grubbing attorneys and ridiculous jury awards for the cost.

[@tookitogo]

@@alan3082Those explanations, as logical as they seem, have been debunked. It’s actually just plain corporate greed that is responsible for it.

[@skullthrower8904]

​@@alan3082you got the money grubbing part right

[@InevitableTruth247]

@@alan3082 no, high cost for medical goods and care solely in the United Sates is what happens when everyone needs to make a profit off each other.

[@samiklaa3445]

I want to thank the KZbin algorithm for recommending this

[@silviuvirgil12]

same here

[@kylejuve5494]

Hardware dork. Right there with you man.

[@dhgmllcshea5038]

AND thank non AI content review. He uses "bone" "screw" and $430 a lot. This should set off AI alarms!

[@JohnSmith-dp2jd]

I make screws very similar to that at work. So, the cost for titanium is partly the machining, but a large part is also the traceability requirements. There has to be chain of custody paperwork every step of the way from where it was smelted to the finished screw's serial number, along with documentation of inspections done at each step, like ultrasonic and XRF testing, dimensional inspections of the screw, cleaning, passivation, and sterilization after it's packaged. My standards might be a little skewed, but 6-4 titanium isn't actually that bad to machine, definitely less of a hassle than 300-series Stainless or cobalt-chrome. You absolutely need to run it with flood coolant and have some kind of fire suppression ready, but if you've got that and have the right inserts it behaves itself pretty well. As for the threads, most of those are custom threadforms, not any kind of off-the-shelf thing. Some of them need to be cut with a thread whirler, others can be done with custom inserts in single-point threading tools, and many of them are multiple-start threads. Some of the larger types that get used in spinal surgery will have a 2-start thread for the first inch or so and then switch to a 4-start near the end.

[@Damoinion]

Interesting. Thank you from an old school fitter/turner with a background in steam and cryo.

[@BlueberryFarm900]

Your knowledge of both the lineage and the machining components of the part cost makes for a riveting (pun?) and thorough explanation. Thanks!

[@frankmurphy5]

Cool

[@Eluderatnight]

This screw was made on swiss style lathe with a subspindle and whirler. Takes about 5min cycle time.

[@Shorty_Keeper]

I used to program and setup bone screws on citizen, tornos and star turning centers. Lots of multi axis constant contour bone plates on dmg dmu’s too. Was fun but I cant say I miss the days of medical instruments and implants.

[@Eluderatnight]

@@Shorty_Keeper same, went to aerospace defence. Medical manufacturing is a PITA.

[@Shorty_Keeper]

@@Eluderatnight yes sir it is. Pushed me back into being a field repair technician. Kinda funny i did military, aerospace years ago. I dont even miss that lol

[@dakotarichline7398]

@@Shorty_Keeper Same, Stars and Mori NLX when I worked at Exactech

[@ras0k]

i understand some of these words

[@zacablaster]

Holy crap man. This is somehow all at the same time legitimately good comedy, wildly informative (that bit about threading, shear, and clamp was outstanding), and a bit of social commentary. You are very good at this and I wish you success.

[@Fallout-xk8vk]

Everything i was thinking! Thanks

[@rosskingii]

Like $10 for the material and machining, and $413 for liability

[@RunsWithKniefs]

Thats the main part people dont know. "It's no different than a home depot screw!" But the expensive screw has a papertrail, ceritifications, and testing behind it. But a lot of people would happily take the home depot screw when they see the pricetags 😅

[@abrahamalviarez5870]

@@RunsWithKniefs even if u do the certifications and testing it doesnt justify the price, it's just corporate greed.

[@RunsWithKniefs]

Definitely the quest for profit drives a lot of this. No amount of certs will justify a 20$ tylenol.

[@hibahprice6887]

@@RunsWithKniefs No. Dental implants (not made in the USA) cost 100 bucks. There is the same screw that is screwed into the jaw, this is very responsible since repairing the jaw bones is much more difficult and dangerous for the patient. If it doesn’t take root and breaks (why would titanium suddenly break), then you can get pus, pus in the jaw is very bad. The brain is nearby...

[@RunsWithKniefs]

@@hibahprice6887 I have no idea what youre trying to argue because you literally just explained why tracability is a thing. Liability.

[@DeereX748]

It's cannulated (can-you-LATE-ed), nothing new under the Sun for orthopedic surgery. In my tenure as a Surgical Nurse specializing in neuro and orthopedic procedures, we've been inserting rods and screws over a guide wire or pin for 40+ years. You'd really appreciate the dual-pitch screws we use, the threads are on either end of a screw and when screwed across a fracture line, pull the two pieces of bone tightly together. Used in places where a screw head would interfere with joint motion, like the wrist.

[@espritdealaska]

I've seen dual pitch screws before to do as you described. One example would be to pull sub-floor tightly together with floor joists to prevent the classic floor creak sound that many are familiar with.

[@PacoOtis]

Thanks for the info!

[@im.empimp]

@DeereX748 - I understand that the guide-wire is supposed to avoid the screw itself from slipping while being inserted, but _how do you insert the guide-wire itself in the first place?_ (It seems that there would have to be a hole to insert it, which implies that the surgeon is back to having to drill a hole during which the drill itself could still slip.)

[@DeereX748]

@@im.empimp The guide wire is somewhat flexible and has a trocar type point. It's inserted with a chuck in a drill under fluoroscopy guidance. It can be pulled out and repositioned as necessary, leaves a very small hole if it isn't in the right place to begin with so doesn't affect the final result. Once the guide wire is positioned as desired, the cannulated screw is driven in over the guide wire and then the guide wire gets removed.

[@im.empimp]

@@DeereX748 Thank you for the detail! 👌Explanation

[@onestopfabshop3224]

I was working on a roll up door on the back of a semi trailer onsite, the ladder kicked out, and about 10 feet later, straight down and I'm left with a lot of titanium now. That was my Valentine's Day present in 2019, not quite what i had in mind that day I'll tell ya that much. Lol

[@Sceptile29]

Speak for yourself I've been trying to get screwed on Valentine's Day for years

[@FuukPronouns]

At least your a walking bank!

[@unexpectedTrajectory]

As soon as you said "bone" I was like, "Oh, rats why it's so expensive." Your not paying for titanium, or machining, or canulation... your paying for certainty that it's perfect. Great video! The History Guy has a great video on the history of why Canada typically uses Robertsons and the US typically using Phillips (patents and world wars is all I remember now.)

[@thechumpsbeendumped.7797]

It’s nice of AvE to let you use his “studio” for filming.

[@RichCadwalader]

LMAO!!! Well, somebody cleaned it up.

[@lintelle2382]

and his look and feel...

[@SquirrellyDan88]

Skukum as frig

[@d.k.1394]

Lol

[@lokoverkkaritalli]

Umm I'm not sure about this old tony

[@davedemo8229]

Pretty cool how it drills with the guide wire. Hope I never see one of my own.

[@thedoubtfultechnician8067]

Well, the good news is you’ll be unconscious for it so you won’t see anything!

[@threepot900]

The screws come in two different threads depending if they are going into cancelous or cortical bone. Cortical screws have a deep, coarse thread like a chipboard screw, cancellous screws are more like machine screws, and a tap is often slid over the kwire first to cut threads in the bone, before the screw is inserted. If you ask about the cost of the splined screws they use on femoral heads, make sure you’re sitting down. It will have a figure in front of the 4 of yours. - the screw portion goes into the ball end of the femur that is in your pelvis, with the splined shaft in an oversized hole through the neck of the femur. An L shaped plate slides over the shaft and is secured to the screw with a compression screw up the middle. (Like a belt pulley on the end of a crankshaft.) the plate is positioned so it points down the leg and is secured with two or three screws like the one you have here to hold everything in place. The shape of the underside of the screw head fits into an oval machined groove on the plate. The surgeon uses a drill guide to put the screw in the middle of the slot, or to offset it to one end or the other. Placed centrally it provides a clamping force, holding the plate to the bone. When the offset guide is used, due to the shape of the slot and the screw head it can be used to pull/push the plate a millimetre or two to close or open the fracture.

[@DeereX748]

That's backwards. Cancellous screws have the coarse, deep threads. Cancellous bone is light and porous, and needs deep widely spaced (relative) threads to gain purchase. Cortical bone is dense and hard, more like wood and the threads for cortical screws are more finely pitched and smaller. Generally, cortical screw holes are drilled and then pre-threaded (tapped) before inserting a screw, otherwise the screw has a chance of splitting the bone around the hole. Cancellous screws don't need the hole threaded prior to inserting the screw, as the cancellous bone will compress slightly as the screw moves forward. The hip plate you mention in some fashion or another has ben in use for over 40 years, we were using them when I first went to the O.R in 1984. What you mention regarding the slotted holes in the plate is called compression. Putting the screw in a position where the head pushes against the edge of the slot as the screw is tightened causes the fractured bone ends to be forced together. This improves the stability of the fracture and makes healing faster. Think of gluing two rough pieces of wood together (end to end). If you just mate the ends, it's all glue holding the joint together; if you press them together, much of the glue (or the callus, in bone healing) is pushed to the outside edge and the two pieces of wood will be in contact with the remaining glue forced into the fibers. Not a truly accurate comparison, but close. The long screw that fits the angled portion of the plate and enters the femoral neck and into the femoral head (ball) has a large thread at the end made to get a good "bite" in the cancellous bone within the head, This lag screw also has a threaded hole at its other end where a fixation screw goes to hold the lag screw tightly inside its angled hole in the plate, and also provides compression. There are other ways to reduce a hip fracture and pin the head/neck to the shaft, depending on the actual location of the fracture, too many to describe here.

[@threepot900]

@@DeereX748 And that is precisely why I spent my 35 years in theatre on the clean side of the blood brain barrier! 😁 It's been a while since I had to scrub for a case as the hospital I worked at for the last 25 years was pretty much you do anaesthetics and nothing but, (or scrub or scout, and recovery was a separate department altogether.) There wasn't a great deal of overlap , unlike previous places I worked at where it wasn't unusual to do anaesthetics in the morning and perhaps scrub for a Moores in the afternoon. Before the DHS (dynamic Hip Screw) you mention they used Intertrochanteric nails that looked like long wire nails, and neither I nor my wife can remember the trade name! We never put them in as they had gone out of fashion, but we certainly removed a few! About the early 90's the GK nails came into service providing a better solution.

[@PaulSchaffert]

Medical and Aviation both have parts that are significantly more expensive than their material or machining cost. It adds up in the documentation, testing, certifications, provenance, amortized development costs, low production volume and liability insurance.

[@zul448]

I used to work in a machine shop that made bone screws exactly like this plus a bunch of other kinds. The term cannulated (can-you-lay-ted) comes from the work cannula and is just a fancy word that means it's a tube. The heads aren't actually Torx but a special medical-grade kind of torx called "Hexalobe". If you want to see some really cool screws, look up the headless compression screws that use a coarser thread at the tip which gets finer at the end to squeeze two pieces of bone together (usually on very small bones or ones with little muscle tissue over it like on the foot) without leaving an exposed head or needing to countersink the head.

[@searchBLOC941]

Getting married was my most expensive screw

[@triedzidono]

the mistress will cost more

[@daftgreene9474]

Boomer mentality

[@hateferlife]

Coming or going?

[@TomAnderson.]

Choosing the wrong person I see

[@searchBLOC941]

@TomAnderson. not even. I just spoil the crap outa her.

[@TJ-qj2km]

This was an awesome, funny, and entertaining video! Something to keep in mind about these orthopedic/surgical/ bone screws Is that there is no mass production of them in the same way that regular screws are mass produced. Each screw is individually machined. Each screw must be perfect and completely free of burrs (You don't want a burr breaking off into your body). There is no margin for error.

[@bosanaz2010]

actually the main reason why they are not cold stamped is a they a from Titainum,which is not really stamp able. Secound thing.IN medical stuff machining, forming parts ist forbiden mostly. For exampe :threats have to be cut,not formed. Cause somehow a formed thread has more risk of having bacteria grow on the surface. Precision wise,you could make those screws like normal ones. Its just the titanium(which could be worked out somehow with a big press and special multistage tooling) and the Medicinal fact with the Sterilnes of the Surface. next thing is. In germany you would pay like sub 1€ for 1000pcs of those screws from steel with a Torx. The thing is.Most companys have a mininmal order amount of like 50K or even 1 Million.Deppending on the screw. Thats the reason they get Turned. But the cost to make them wouldnt be that high. You could take 50 bucks for one and still make a shit ton of money,if there is enough market. Most of the price is just scamming the Healtinsurence.Its the same in germany,just not that stupid like in the staates( insulin couple hundred bucks and so on) Greeting from a tool shop guy in a screw Factory

[@robertpearson8798]

Robertson screws are alive and well and living in Canada.

[@jasonsmith4902]

They plentiful in the USA also, we just call them square drive instead.

[@Colorado_Native]

I just checked. The titanium bolts (1,400 of them) used on a Pagani sports car cost $95 apiece, that $133,000 total, not counting the rest of the car.

[@wendull811]

That's why the car cost 2.5 million dollars.

[@JaSon-wc4pn]

The thermostat modules come from a Rover Pagani is cutting corners

[@qwerty112311]

lmao brother, that’s not how it works. They aren’t paying single bolt retail for the 1000+ bolts. Get a clue man.

[@Colorado_Native]

@@qwerty112311 They don't buy them retail. Did you think Lowe's or Home Depot sells them? You are crazy. They are custom made. Don't laugh too hard. You'll choke on your Bud Light.

[@Colorado_Native]

@@qwerty112311 Go look for yourself. I tried posting the website for you but it keeps getting deleted.

[@jamesklatt8245]

Stormy Daniels would like to have a word.

[@HauntedXXXPancake]

Ha, You beat me to it ! 😄🤝

[@VoIcanoman]

I've actually witnessed surgeries where screws like this were used. I trained as an x-ray technologist, and they do require such professionals in the OR when they are repairing bone injuries, to take x-rays of the area, giving surgeons the ability to have real-time confirmation that their holes are being drilled in the right place, the guide wires are correctly-placed, and the hardware is properly securing bone fragments. Everyone in the OR wears lead aprons (or is hiding behind a lead shield, as the anesthesiologist often does) when x-ray is required for that surgery (it leads to a LOT of sweating, which is why it's so nice that operating theaters are kept pretty chilly). I've seen ankles (distal tibia/fibula), heels (calcanei), proximal tibia/fibula (tibial plateau), ulnae and radii, and even femurs repaired in this manner, as well as spines (cervical and thoracic mainly) fused with metal hardware. It's super-cool. And that was all during TRAINING. Like, literally - I took a few pre-requisites (3 courses - Anatomy and Physiology 1 and 2, and Medical Terminology*), attended classes (mainly online - only our labs, actually manipulating x-ray equipment, learning positioning and projections, were in person) for 8 months (from October to May - this was at the start of Covid, so it would normally be September to April), and the following September, I was allowed into an OPERATING ROOM to actively help surgeons (even med students don't get to see the OR until their 3rd year of training, and 7th year of post-secondary education) save people's limbs. It was a bit bonkers. Incidentally, I now work in a clinic, and we don't have operating rooms. But I do want to get a hospital job sometime, mostly because I loved being in the operating room, and miss it. It's a unique experience...and some of the surgeons have killer taste in music (which they play during their surgeries). *There were a few other prerequisites that were necessary, but I had them...all in all, it would take a high-school graduate around 8 months to qualify for a Medical Radiologic Technology program. So technically, it's ~2 years of post-secondary education to gain entry to the sterile, life-and-death OR.

[@Aluttuh]

This might be kinda dark but one of the only things i was looking forward to in the process of cremating a loved one was being able to see/recover the titanium knee and hardware he had put in that cost him like 50 grand... long story short, the cremation business recycled (stole) all of the metals, including gold fillings and a silver coin i left in his pocket.

[@dontknow3886]

danm how is that even legal

[@Aluttuh]

@@dontknow3886 I have no idea… i guess the grave robbers found a more legitimate career

[@immaculatelation]

As I heard on Scrubs, "people are bastard-coated bastards with bastard filling." Slipknot is a little more succinct when they say "people=shit."

[@Redchrome1]

There was a consumer reports-type podcast I listened to some years ago which studied pet cremation services. They proved that the ashes they got back from the cremation service, did not come from the pets they sent in. How? They made cat cadavers without bones... but the ashes they got back all had bone fragments in them. Kind of scary what might be happening when you aren't watching.

[@theronwolf3296]

Minor point. A metal detector senses inducted field, so it will sense titanium (like it does copper)

[@jasonsmith4902]

Yea, its surprising how widely held this misconception is. The metal doesn't have to be ferrous to be picked up.

[@cianmoriarty7345]

How do people think metal detectors find gold if they think that?

[@gaburieruR]

Banks metal detectors hate my spinal fusion pins. And fun fact, the majority of them are powered off.

[@davidgrim5990]

Clearly the poster of this doesn't work for a defense contractor.

[@hoperp1951]

Well said (40 years in Aerospace Titanium, with some Chemical, bio-medical and other assorted military applications, plus Zirconium, Hafnium and Niobium products thrown in for good measure).

[@xxlocobassistxx]

Yep, i immediately thought it was going to be some sort of military aircraft screw. I think the high cost of this is more justified though, you can't open up your ankle every year for an inspection, so I would want to know no expense was spared in the design and QC of my surgical hardware.

[@carsonhc305]

She was the most expensive screw in the world, but worth every penny.

[@PacoOtis]

Great comment! LOL

[@BrilliantDesignOnline]

Thank you Dr. DT for all the helpful medical hints. I am going to try this at home, since there was no disclaimer.

[@amandahugankiss4110]

pipe bomb jokes are always appropriate.

[@mr2_mike]

I felt the joke bombed. :|

[@jpsother1183]

For even more fun. Some folks react to Titanium, so they need special screws made from Platinum. I knew a (then) kid who was helping a specialist machinist as an after school job. One day he showed up to the shop and a Loomis/Brinks truck was parked out front, and two gentlemen with sidearms were watching the machinist on his small lathe make a few screws. below the chuck resided a towel, collecting chips. When finished, they weighed the bar stock, towel and screws, decided it was within having collected all the platinum chips and put it all in a locking case and departed.

[@jpak1130]

i work for an orthopedic manufacturing company. we make very similar screws among other things. after these screws come off the machine, they are meticulously tested and measured, then manually deburred by hand under microscope to ensure that there are no burrs or chips or rolled edges along the threads, the hexalobe is glass bead blasted one at a time by hand in a microblaster, then they go through several cycles of ultrasonic cleaning and passivation and then some get anodized a specific color depending on the client wants. so yeah expensive screws.

[@bosanaz2010]

Is the production cost so high in the us? I mean i get all the steps and extra steps,you wouldnt find on a normal screw thats turned. But still 400Bucks....

[@infxmhc]

"$400 is your most expensive screw?" (Laughing in US Government)

[@michaelrogers9809]

Very cool video! I've got at least 12 in my shoulder. I didn't realize that they are hollow.

[@Tomeroche]

Of it's intended for medical use I think the reason for it's high price is the same reason everything in the medical industry is expensive, to milk more money out of insurance policies. Hospitals, and the rest of the medical industry, will inflate the price of everything and charge you for anything to get that extra money out of insurance. There's things that of course are expensive by nature, but a lot of times it's intentionally overcharged since hospitals know that they insurance will negotiate the price down in the majority of cases so use these strategies to compensate.

[@arthurmoore9488]

Having done anything involving government regulations, at least half the price is in paperwork. The thing I'm surprised about is there isn't a serial number laser engraved on it. If it's like Aerospace, that screw was X-rayed and probably has a certificate for it.

[@DewPrototype]

So-so. 50/50. A lot of that cost is for rnd, exams, tests, qualifications, and guarantees that thus screws will not create any additional damage, issues, and risks for the body on its own. There is not so much of this screws produced at all, but costs what was spent on creating it, even on paper, is huge. Sometimes they even custom made, for realy interesting and hard cases. But, if you will need that screw - it cost is will be the smallest line in the bill, coz installing it(like anything in live human body) is not so trivial task.

[@ikvangalen6101]

Lol, actual cost to fabricate one screw could be 5 euro

[@Tomeroche]

@@ikvangalen6101 Pretty much, everyone points to RnD and testing but always treat it like every instance is rediscovering the wheel, and doesn't explain why the price remains high years or even decades later or that much of the cost is covered in government grants or tax breaks. A screw is the most simple thing you could develop, the infrastructure exists to make them already, it's a standardized part already since it needs to work with other implants, and basically all that needs to be tested is potential chemical reactions because every other physical interaction it could have would have already been before with other screws.

[@Daniel15au]

This is US-specific and isn't how medical billing is handled in other countries.

[@CarbonKevin]

Titanium is also bio-compatible! Also, medical implants are all going to be serialized and traceable.

[@Jacob-ABCXYZ]

Yeah I'm not a fan of that on paper

[@ieuanhunt552]

​@Jacob-ABCXYZ You definitely want medical implants to be tagged. One obvious reason is if there is a defect in the batch they need to be able to track you down and rectify it. There are probably a few other good reasons too.

[@typograf62]

The company I work for makes it possible to pull data from the warehouse it-system to the patient care system. If something is wrong with a certain implant or a certain batch then all relevant data can be found readily in the journal - automatically by pulling a list. This was made after failures on some hip implants caused secretaries or doctors to read through patient journals to find the rest. And the info was not alway there.

[@CalamityJay-ez2mq]

​@@Jacob-ABCXYZ I understand the knee jerk reaction, but it's not like they'd be able to track you by the serialized screw in your leg, if they're reading the serial number you have bigger problems

[@ColonelSandersLite]

@@CalamityJay-ez2mq That points to one of my issues with the idea - If they're reading the number, you have bigger problems. Sure. So in the event that 'I'm not needing mine anymore', the serialization is very unlikely to actually benefit me. But I *will* have to pay for the very expensive machining that it's going to take to put it on there in the first place. Because, what? They want to be able to figure out who's leg this is in the unlikely event I happen to be in a plane crash? I don't think I'm really going to care at that point.

[@mmmhorsesteaks]

If i count the child support, i've had way more expensive than that.

[@vanguard6937]

Fun fact, if you go to enough machine tool trade shows and go to the swiss type lathe manufacturers, you can usuallt grab a free bone screw. I have a titanium bone screw, and a brass bone nail. The brass one being a show piece, not a functional piece.

[@xdfanatic]

I have a bag of 18 $700 screws at my desk at work. They are custom machined. Custom screws cost a lot because they aren’t mass produced, and they also usually have processing controls that significantly drive up costs. Plus I don’t think any of us would want our fractured bones being held together with a 5 cent drywall screw.

[@Snowsea-gs4wu]

Economics: cost ≠ price. Thanks for the video.

[@binaryguru]

Those type of screws are usually made on a swiss style CNC machine. Every screw is machined one by one. That's why it's so expensive. Same reason for aerospace parts being expensive. It's the machining process.

[@Redchrome1]

An old machinist I knew long ago had a screw like this put in his heel and later removed. He could spent 15 minutes describing that screw in exacting detail, pretty much giving the same rundown you just did. It brought a tear to his eye as he described the screw as "a thing of beauty".

[@cgrado]

DoD: Am I a joke to you? *$10000 screws for old planes*

[@watcherwatchmen7785]

I know an engineer that was given a "junk" $10,000.00 bolt because it failed QA/QC at the hangar where he worked. Three 10,000.00 bolts are all that were used to fasten a jet engine to the wing, so I guess it was a pretty important part. As you mentioned in your video, titanium is very difficult to machine, and anything in the aerospace or medical field has to have traceability back to the manufacturer, etc. for liability reasons so they know who to blame when something goes wrong. Titanium is one of the few metals that your bones will readily grow onto and integrate into your body. Your bones are actually an organic "alloy" of Calcium, Magnesium and Phosphorus.

[@InfectiousDust]

"My leg will not explode like a dirty pipe bomb the next time I go through an MRI" 😂😂😂

[@Ronsonic]

As the recent recipient of a total ankle replacement your choice of mayhem leading to a broken talus earns my respect.

[@BobbyDukeArts]

Super interesting, I thoroughly enjoyed this video!

[@chrisboston5629]

When you said they had no resale value my new lathe vanished. I have 8 of these in my top box with the oddball fasteners I've saved over the years, along with some very twisted plates. Fun fact, kickstarting a poorly timed Panhead can shear these little beauties right off, and we all know what a pita broken fasteners can be. Turns out surgeons don't know what an easy out is. Interesting video.

[@Dasycottus]

Honestly, these are pretty much worth it. Its amazing how many tiny details have been thought through and beautifully executed. Imagine what the history of trial and error in surgical screws looks like? Also... Screwvounier? 😃

[@fontcaicoya5686]

I've got 6 of these screws, along with scaffolding, for L5-S1 and L4-L5. Been holding me up since May 15th 2008. Cheers, it's nice to get some perspective and a reminder of what good fortune modern medicine can bring despite our stupidity.

[@andrewtackett8836]

I work at Medtronic and I see lots of different bone screws all the time. Some much larger and expensive that this one. I’ve unpacked a pallet of spine screws worth over $1.5 million. This video is not surprising.

[@drstefankrank]

I have 3 of them, around 70mm in length, came out of my broken leg and the doctors were kind enough to give them to me as a reminder.

[@alanrogs3990]

My uncle (now passed) worked for an orthopedic manufacturer. My father (also passed) was getting a hip replacement using a manufactured hip by the company my uncle worked for. My uncle had been working there since the beginning of the company in the US. He gave my dad a hip that had a slight flaw in it that the company made to show him what they were going to put in him. I still have it. I'm guessing, if it didn't have that flaw, (I can't find one) it would be a costly item. It's really well made.

[@francisphillipeck4272]

They sell it for that much, that doesnt make it cost that much or worth that much. its the medical industry so everything costs 100x more then its worth.

[@brkbtjunkie]

Medical equipment is insanely expensive. I have a client who’s retired but patented several surgical tools, and made bank from royalties

[@supertyp9148]

I had a holiday job in a screw factory. They were specialized in making screws from any alloy requested by the client. Minimum order quantity was 1 piece. Sometimes orders came in on which clients actually ordered 1 screw made out of specific material. Such a screw was a bit more expensive. It must be, because at this low quantity, the screw was literally hand made from scratch.

[@Wuqz]

I'm not a very handy guy but still get a ton of entertainment from your videos lol

[@Nefville]

There are super expensive screws in watchmaking. They are known as the 100 Swiss Franc screws but some cost and due to the labor involved, are worth far more than that. They're entirely hand made, beveled, black polished and often heat treated to blue or violet. To avoid scratching the recesses, watchmakers sharpen their screwdrivers so only the outer-most part of the blade touches the head of the screw. The types I am taking about are made in house by brands which also make their own watch movements and so they are unique to their specifications. I highly doubt they would ever sell one but if you could get one, it would be immediately apparent why they cost so much.

[@ThomasFlorimonte]

For someone that's had "Several" screws holding body parts on, every example of using house hold screws "Going Wrong" made me cringe. LOVE IT!!! Funny stuff. Keep it up :)

[@zephiriz]

Just a note a metal detector, well detects all metal. Not just if a metal is ferromagnetic. Metal detectors create a magnetic field and when metal passes through that field its changes the field somewhat and they detect that change. All metals will change the field now of course to varying degree. But even gold and titanium can set off a metal detector. Its more about size/quantity and proximity.

[@hateferlife]

Welcome to the Titanium Screw Club! We meat every 5th Whendesnay in months ending in 'i' at the Tabernacle next to the pool hall. Punch and cookies are provided for a nominal fee. For that or tee shirts see Billy Gregor. Proud member since 1997. Two pins in my upper jaw. That asphalt never even saw my face coming!!

[@jasonconstant455]

The screw is also sterilized to be safe to not cause your bones to get infected, that step adds to the cost significantly.

[@SanchoPanza-wg5xf]

I don't know about that. You can sterilize a needle with a candle flame.

[@jasonconstant455]

Tell your surgeon that next time they get surgery!!!! That’s ridiculous. Any bacteria on that could start a bone infection. Give it a google “why are surgical instruments individually packaged.” There may be some new innovations to replace the already sterilized individual bagged components like screws, but the sterilization of the components is a significant reason for their high cost. Think about the coolant and lubricants used when manufacturing screws. That all needs to be removed and then the screw can get sterilized.

[@SanchoPanza-wg5xf]

@@jasonconstant455 You're probably right, but I'll continue to play the smartass for the sheer fun of it. Removing the surface contaminants is called cleaning and removing the microbes is called sterilizing. Burning accomplishes both in one step. Just blow off the ash and drop it in a baggie!

[@briandeschene8424]

Thumbs up for positive comment about Robertson head screws! Only reason they didn’t become internationally used is that they were invented in 🇨🇦.

[@Sean-fj9pn]

"Can't find a Snap-On logo anywhere on it." Haha, that have me a good laugh this morning.

[@jwavr2854]

Yet another underrated channel that deserves more.. subbed thanks for the laughs haha

[@chadpilling4073]

Long live the Robinson!! That’s what we use in Canada mostly

[@sinfulhappiness]

This is channeling AvE and This Old Tony vibes and I am in.

[@monbulla4026]

Fun fact: depending on the manufacturer the torx has a special shape that keeps it from dropping of the bit. Fun fact n2: the walls of my garage toilet are held together by some of these screws

[@CaineOs]

Cheers man, never knew there was a proper name for #2 square screws lol. I like how the stay on the drill bit. Also still have two thart I had in my ankle, dont think my ones were hollow though but they were temporary. Ill tell you, the bone will give before the screw LOL.

[@gambit3le]

I had 2 of these in my right knee for 8 months back in the year 2000. After the bone healed, they were removed in a second surgery.

[@robertheim352]

The most unsettling comment I've heard from a surgical nurse was her comment: "Boy, your drill bits are much sharper than ours." (They were low grade twist drills.) I just pray that surgical drills are designed for control, not the speed of the cut.

[@TheEudaemonicPlague]

I had some in my ankle, then I did something stupid and tore it up--they replaced the screws and plates with cadaver bone...but I have one of the long pins that was run through the top of my ankle into my foot for several months, it's like nine or ten inches long. More recently, they did surgery on my spine to remove an infection, and now I'm held together by pins and screws...probably very much like that. I have a couple staples and a staple puller from my back surgery. My wife has similar stuff in her neck. Fun, fun, fun.....

[@kosta_k_86]

3:40 You could also just take the first screw with thread relief and the second one without.....and then swap the first one with thread relief for one without....so you can screw the beams together perfectly without forcing

[@invisi-bullexploration2374]

*Butterscotch Horseman Intensifies* IYKYK

[@adrianTNT]

2:22 imagine you are on the table and the surgeon opens up this exact toolbox 😮😅

[@lapaleves]

i know the feeling. our 3-months young cat Cherrykern got her thighbone broken some mysterious way, right at the end. as we didn't intend watching her being crippled from the beginning of her life, we needed to have it fixed. the vet did it not with such a fancy screw, but a nice piece of hand formed titanium until recovered. unlike us, financially... also never show your keys on the internet.

[@NullAndVoided]

A HUGE part of the cost is the refinement of titanium is a long and tedious process. It’s not a metal that can be smelted and then cast, like steel. Crushed ore must be treated with chlorine to create a slurry which gets baked into essentially a titanium sponge which then must be heated and compressed in an oxygen free environment (Ti at high temperatures is extremely reactive with hydrogen, nitrogen and oxygen) until it’s a solid block.

[@Manuelslayor]

Its expensive because so few are sold. Its the same with army equipment. You can sell milions of normal screws but only a few thousand of those yet they still gota cover the bill.

[@Weisz]

Really cool video. Gonna keep watching for new videos :) keep up the good work

[@thearcticdivini]

3:37 Canada still uses them, and yes they definitely are better than Phillips, they don’t strip nearly as easily. The head often times snaps before it strips

[@ninizeldav7174]

I love your sense of humour!

[@JimP419]

Robertson screws are still used regularly in the RV industry. With that fridge pulled out of ur camper you must have seen a few of them.

[@tehpanda64]

if we had nationalized healthcare, a box of 20 of these bad boys would cost 10 bucks

[@silviuvirgil12]

The algorithm really nailed this one, cool stuff!

[@philhey8847]

I had my tibia and fibula screwed together as young lad and subsequently had said screws removed because they were causing me pain whilst in a ski boot. I don’t like full anesthesia so I got to watch the surgeon pull them out with a cordless Makita drill driver. After the surgery he gave me the screws in a little Ziploc bag; I'm sure they were stainless steel. Years later I sustained another injury at the top of the knee. A tibial plateau fracture that required bone grafts, a plate, and another 12 screws. I wonder if those are titanium?

[@corneliusblackwood9014]

😂 - Riverdance, everyone always makes a joke out of it but I’ll be honest, I saw the production when I was a kid and it was actually pretty cool.

[@christopherleubner6633]

I remember laser engraving the serial numbers on similar screws. Typically the surgeon will drill a small hole to guide it even though its self tapping. At one point got several sets including the drill and bits. What is very surprising is the drill was made of stainless steel and looked a lot like something astronauts would use, but used standard Dewalt battery packs. 😂

[@Matt-my7pz]

Robertson screws are still everywhere in Canukistan. Torques is very popular now too.

[@EarthAmbassador]

I have some DePuy titanium in my femur. Didn't explode during a recent MRI, but it did hurt during one of the sequences.

[@davidkohler7454]

I've got two rows of 3 inch long screws and rods in my back. I had to have two of them removed and I got to keep them. They are very thick .And are pedestal screws with no head. The Dr actually used a hammer and vise grips to get them out. Needless to say I've been in endless pain since 2007 and no doctor will even touch me now.

[@notpoliticallycorrect1303]

I have a 2 inch long tapered grub screw holding my shattered left wrist/schaphoid together, its around 10 mm at the wide end tapering to 4 mm with a coarse(0.75 approx) thread, 6 small screws holding the 3rd metacarpal together in my right hand and a couple of plates and 8 more screws holding my collar together.Amazingly apart from only having about 90% articulation of my left wrist ( I am left handed)I am still fully mobile and active, participating in climbing,pot holing/caving,cycling and motorsports and wouldn't even know they were there if I didn't see the x rays. I must be worth a fortune in scrap😂

[@benjamin1503]

This video makes me think of that recent stunt some senator pulled where he questioned a military official about fastener prices

[@alandowney6961]

Great video! I thought, from the title, it was another dig on the US military getting gouged for their hardware. Pleasantly surprised. Thanks!

[@robertreynolds1044]

I was skeptical at first, but you won me over with the good smart alec banter. My name is Bicycle Bob and I approved this message.

[@LeCafeRacer]

You inspired me. I have 4 in my femur. I just went on eBay and just bought one for 12 bucks that was "open box". Gonna be a sweet keychain.

[@Danny-cl2zd]

They put a "bio-screw" in my shoulder to hold stitches in my rotater cuff. It was $750 . That was 2011 price. It was a 5mm plastic screw. Blue.

[@Curtis1984]

I have two dental implants.. it's a 6 month procedure. Had it done over 10yrs ago. Cost 3k each. They are more now, but it was the whole procedure, crowns and multi-visits. I was awake and numbed up as he was drilling in my top bone (front of my mouth).. I thought to myself, "what did I agree to, this is crazy?" After they drill and screw in the titanium implant piece (the fixture) they wait months for the bone to grow around it, then after it's confirmed they install a titanium abutment with a crown glued to it. So 3 pieces total, 2 of them titanium. Overall it was interesting and no major issues, unsure how expensive the parts were, but most of the cost is labour, about 2/3. The crowns were likely more expensive than the metal parts too. I have a small x-ray as a keepsake, and my original teeth roots that had failed root canals (only due to trauma). My injury is another story.. but I'm thankful its repaired.

[@soaringvulture]

The part that I liked about getting implants was that the dentist screwed the crowns in with a torque wrench. It was really strange being torqued.

[@GeahkBurchill]

I have about 15 of those in my ankle. One of them is 6.5” long and goes up the middle of my Fibula!

[@the_hiroman]

I can guess that the actual production cost of one of these screws is about 10-20 USD tops, but the healthcare/medical industry balloons its price to more than 400 USD out of pure greed.

[@kikook222]

It's expensive because it's used for medical procedures, not because it's inherently expensive or hard to make. Got it.

[@davidterry2038]

WOW - I had nine in my ankle and fibula - that's a lot of value. Fascinating.