Faculty Collaboration Database

Biomechanical Evaluation of Transverse Patella Fracture Fixation Using Headless Screws: A Comparison of Suture Versus Cable as a Tension Band. J Orthop Trauma 2023 Jun 01;37(6):e253-e257

Date

02/03/2023

Pubmed ID

36729011

DOI

10.1097/BOT.0000000000002556

Scopus ID

2-s2.0-85159765507 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

OBJECTIVES: To explore the performance of headless screws with FiberWire Suture as a tension band and headless screws with a mini-cable tension band in patella fixation.

METHODS: A transverse osteotomy was created in 6 matched pairs of fresh-frozen cadaver knee joints. One knee was randomly assigned to receive fixation with headless screws plus a cable tension band while the other was fixed with headless screws plus a suture tension band. Using a servo-hydraulic material testing system, the specimens were first tested nondestructively under 20% of the reported mean failure load with a standard technique of cannulated screws with tension band wiring. The specimen was then loaded to 1000 N to test the construct's failure strength. All tests were run under displacement-control with loading threshold. A motion analysis system was used to track the interfragmentary motion to assess fixation stability.

RESULTS: In the nondestructive loading test, gap displacement under 150 N was 0.10 mm or less for 11 of 12 specimens, and the difference between the 2 groups was not statistically significant. In the destructive test, 3 of 12 specimens maintained reduction (gap <2 mm) at the maximum load of 1000 N. Of the failed specimens, the mean strength was 648 ± 185 N for suture and 784 ± 228 N for cable.

CONCLUSIONS: There was no significant difference in fixation strength or subfailure fragment displacement between the suture and cable tension band techniques when using headless screws.

Author List

Bric JD, Martin JM, McGrady LM, Wang M, Schmeling GJ

Authors

Gregory J. Schmeling MD Vice Chair, Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
Mei Wang PhD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Biomechanical Phenomena
Bone Screws
Bone Wires
Cadaver
Fracture Fixation, Internal
Fractures, Bone
Humans
Knee Injuries
Patella
Sutures