title: FiberWire is superior in strength to stainless steel wire for tension band fixation of transverse patellar fractures.
abstract: BACKGROUND
  The metal implants used to achieve fixation of displaced transverse patellar fractures are associated with implant failure, postoperative pain and a significant re-operation rate. Recent studies have examined braided suture as a possible alternative to stainless steel wire to increase patient satisfaction and decrease re-operation rates, but suture has not demonstrated clearly superior fixation strength. FiberWire is a reinforced braided polyblend suture that has demonstrated superior characteristics to the previous sutures studied and has not to our knowledge been examined as a material for tension band fixation of transverse patellar fractures.
  
  
  METHODS
  Materials testing was performed on repeated samples of No. 5 FiberWire suture and 18-gauge stainless steel wire. The strength and stiffness of each material was measured. The two materials were then used for tension band fixation on a novel transverse patellar fracture model and tested to failure by three-point bending. The constructs included a single stainless steel wire, a single-strand FiberWire tied with a sliding knot, double-strand FiberWire tied with sliding knots and double-strand FiberWire tied with a Wagoner's Hitch. The fixation strength and stiffness of the constructs were measured.
  
  
  RESULTS
  Unlike stainless steel, FiberWire maintained its initial stiffness until failure. Furthermore, during three-point-bend testing, double-strand FiberWire was found to have a significantly higher failure load than stainless steel wire when the suture was tied and locked under the tension produced by a modified Wagoner's Hitch.
  
  
  CONCLUSIONS
  FiberWire is a potentially superior alternative to stainless steel wire in tension band fixation of transverse patellar fractures.
authors.affiliation: Bone and Joint Research Center, Department of Orthopaedic Surgery, University of North Texas Health Science Center, Fort Worth, TX 76107, USA. Patrick.B.Wright@gmail.com
authors.forename: P B
authors.initials: PB
authors.lastname: Wright
authors.forename: V
authors.initials: V
authors.lastname: Kosmopoulos
authors.forename: R E
authors.initials: RE
authors.lastname: Coté
authors.forename: T J
authors.initials: TJ
authors.lastname: Tayag
authors.forename: A D
authors.initials: AD
authors.lastname: Nana
mesh_terms: D000368:Aged; D001864:Bone Wires / Q000592:standards*; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008422:Materials Testing / Q000379:methods*; D010329:Patella / Q000293:injuries*; D012086:Reoperation / Q000706:statistics & numerical data; D013193:Stainless Steel; D013536:Suture Techniques; D013537:Sutures; D013718:Tensile Strength; D016896:Treatment Outcome
chemical_list: D013193:Stainless Steel