Biomechanical stability of different suture fixation techniques for tibial eminence fractures.
OBJECTIVE
Displaced tibial eminence fractures require surgical fixation in order to obtain a stable knee joint. Suture fixation with FiberWire(®) seems to be the most favorable therapeutic option. Biomechanical studies show failure of this technique most commonly due to a suture cutout with subsequent fracture of the tibial eminence fragment. The goal of this study is to compare the biomechanical properties of three different techniques of suture fixation using FiberWire(®).


METHODS
Bone mineral density was evaluated in 18 human knee specimens by pqCT, and three similar groups were formed. A standardized anterior tibial eminence fracture was created, and suture fixation was performed using one of three different techniques in 6 specimens each. Cyclic and destructive testing was conducted.


RESULTS
Significant differences between the three techniques could be shown neither in the cycles needed to achieve a steady state nor in a failure load or initial stiffness. Almost all specimens failed by suture cutout.


CONCLUSIONS
The presented modification of the existing technique for suture fixation of tibial eminence fractures did not lead to an increased initial stability nor did it lower the rate of suture cutout. All tested suture techniques showed comparable initial stiffness and failure load.
Department of Trauma and Hand Surgery, Heinrich Heine University Hospital Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
Johannes
J
Schneppendahl
Simon
S
Thelen
Sebastian
S
Gehrmann
Sören
S
Twehues
Christian
C
Eichler
Jürgen
J
Koebke
Joachim
J
Windolf
Mohssen
M
Hakimi
Michael
M
Wild
D001182:Arthroscopy / Q000295:instrumentation / Q000379:methods*; D001696:Biomechanical Phenomena; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D066298:In Vitro Techniques; D007718:Knee Injuries / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation; D013537:Sutures; D013978:Tibial Fractures / Q000601:surgery*; D016474:Weight-Bearing