Olecranon fractures repaired with FiberWire or metal wire tension banding: a biomechanical comparison.
OBJECTIVE
Tension band constructs are commonly used for olecranon fracture fixation. The purpose of this study was to determine if a tension band constructed of FiberWire (Arthrex, Naples, FL), a high-strength polyester and polyethylene suture, will provide fixation that is equivalent to an 18-gauge metal wire tension band.


METHODS
The following 4 fixation methods were biomechanically tested in cadaveric elbows with a simulated transverse olecranon fracture: (1) Kirschner wires (K-wires) with an 18-gauge metal wire tension band, (2) K-wires with a FiberWire tension band, (3) intramedullary screw with an 18-gauge metal wire tension band, and (4) intramedullary screw with a FiberWire tension band. Each elbow underwent all 4 repair methods. The K-wire repairs were performed first followed by the intramedullary screw repairs. The order of the tension band (FiberWire or metal wire) was randomly assigned. Specimens were tested under cyclic loading conditions that simulated stresses generated by (1) active range of motion and (2) pushing up from a chair. Fracture displacement was recorded by using transducers placed at the articular surface of the fracture and on the posterior surface of the olecranon.


RESULTS
There were no significant differences in fracture displacement associated with the use of a high-strength suture or metal wire tension band under conditions simulating active range of motion or a more vigorous physiologic stress. Also, there were no significant differences associated with the use of an intramedullary screw versus K-wire fixation under either condition.


CONCLUSIONS
The biomechanical characteristics of high-strength suture tension bands are equivalent to 18-gauge metal wire tension bands when used with either an intramedullary screw or K-wires. The fatigue patterns of high-strength suture tension bands and metal wire tension bands are similar. There is not a significant difference between the biomechanical strength of intramedullary screw fixation constructs and K-wire constructs.


CONCLUSIONS
FiberWire tension bands may be used in place of metal wire tension bands without sacrificing fixation strength.
Carofino
Bradley C
BC
Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, USA. bradcarofino@yahoo.com
Santangelo
Stephen A
SA
Kabadi
Mitesh
M
Mazzocca
Augustus D
AD
Browner
Bruce D
BD
D000368:Aged; D001672:Biocompatible Materials; D001696:Biomechanical Phenomena; D001864:Bone Wires; D002102:Cadaver; D004551:Elbow Joint / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D050723:Fractures, Bone / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D011108:Polymers; D013537:Sutures; D000092464:Elbow Injuries
D001672:Biocompatible Materials; D011108:Polymers