title: A Biomechanical Study Comparing Cerclage Wiring Performed with a Power Tool versus the Manual Method.
abstract: BACKGROUND
  We conducted a biomechanical study comparing cerclage wiring using a power tool with the traditional manual method.
  
  
  METHODS
  Our study consisted of 4 experimental arms based on the method of fixation and diameter of wires. The 4 arms were: 1) power tool method using 0.8 mm cerclage wires, 2) power tool method using 1.0 mm cerclage wires, 3) conventional manual method using 0.8 mm cerclage wires, and 4) conventional manual method using 1.0 mm cerclage wires. Synthetic femur bones were employed in our study. Six specimens were prepared for each arm. Each specimen was cut lengthwise and pressure sensors were placed in between. For the power tool method, while maintaining tension, wires were coiled using the Colibri power tool until just before secondary coiling occurred. For the conventional manual method, each specimen was compressed by plier twisting for 10 rounds, while maintaining tension. Cerclaging and data recording was done thrice for each specimen, giving a total of 18 readings per arm. Peak and steady-state forces were recorded.
  
  
  RESULTS
  There was no significant difference between the peak forces recorded between the power drill and manual methods. The steady-state forces achieved using the power tool method were significantly higher than that achieved in the manual fixation method (0.8 mm wires: 54.89N vs 27.26N, P = 0.037; 1.0 mm wires: 71.59N vs 39.66N, P = 0.025).
  
  
  CONCLUSIONS
  The power tool method achieved a superior steady-state force of compression across the fracture site for both 0.8 mm and 1 mm wires.
authors.affiliation: Department of Orthopaedic Surgery, Academia, Singapore.
authors.forename: Kevin
authors.initials: K
authors.lastname: Koo
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Zhou
authors.forename: Andy Ks
authors.initials: AK
authors.lastname: Yew
authors.forename: Joyce Sb
authors.initials: JS
authors.lastname: Koh
authors.forename: Tet Sen
authors.initials: TS
authors.lastname: Howe
mesh_terms: D001696:Biomechanical Phenomena; D001864:Bone Wires; D005269:Femur / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008953:Models, Anatomic