title: Biomechanical analysis of the FlatWire Figure 8 sternal fixation device.
abstract: OBJECTIVE
  To determine whether the FlatWire Figure 8 sternal fixation device (Penn United, USA) is mechanically superior to the current standard in sternotomy closure.
  
  
  METHODS
  Unstable sternal closure using traditional steel-wire cerclage can increase postoperative pain, bony cut-through and wound dehiscence. The authors present the Figure 8 sternal fixation device to minimize these complications. Biomechanical properties of the device were compared with conventional steel wire sternal repair.
  
  
  RESULTS
  Using two constructs of both FlatWire and steel wire, pull-to-failure, Hertzian contact and cut-through were compared. Samples were tested to 500,000 cycles or failure. Cyclic comparisons were performed using log-rank t tests and Student's t tests for cut-through analysis. FlatWires were found to have superior biomechanical properties in all categories tested.
  
  
  CONCLUSIONS
  The FlatWire provides superior biomechanical properties compared with conventional steel wire, which may lead to reduced sternal wound complications.
authors.affiliation: University of Kentucky College of Medicine, Department of Plastic Surgery, Lexington, Kentucky;
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Wilson
authors.affiliation: Emory University School of Medicine Department of Surgery, Division of Plastic Surgery, Atlanta, Georgia;
authors.forename: Paul A
authors.initials: PA
authors.lastname: Ghareeb
authors.affiliation: West Virginia University School of Medicine, Department of Surgery, Division of Plastic Surgery, Morgantown, West Virginia;
authors.forename: W Thomas
authors.initials: WT
authors.lastname: McClellan
authors.affiliation: University of Kentucky College of Medicine, Department of Plastic Surgery, Lexington, Kentucky, USA.
authors.forename: Ashley N
authors.initials: AN
authors.lastname: Boustany
keywords: Figure 8; FlatWire; Sternal fixation; Sternal wound; Sternotomy