title: Os acromiale fixation: a biomechanical comparison of polyethylene suture versus stainless steel wire tension band.
abstract: BACKGROUND
  Symptomatic hardware is a commonly reported complication after surgical fixation of an unstable meso-type os acromiale. This study compared the biomechanical properties of a cannulated screw tension band construct using a metal wire tension band vs. a suture tension band, considering that the suture construct could allow for decreased hardware burden in the clinical setting.
  
  
  METHODS
  A meso-type os acromiale was created in 16 cadaveric shoulders. Two cannulated 4-mm screws were placed in each specimen. Tension band augmentation was accomplished with a 1-mm stainless steel wire (wire group) or a #5 braided polyethylene suture (suture group), with 8 specimens in each group. An inferiorly directed force was applied to the anterior acromion at 1 mm/s on a materials testing machine. Stiffness and ultimate failure load were recorded and analyzed.
  
  
  RESULTS
  No significant difference (P = .22) was observed in the ultimate failure load between the wire (228  ± 85 N; range, 114-397 N) and the suture (275 ± 139 N; range, 112-530 N). No significant difference (P = .17) was observed in the stiffness between the wire (28  ± 12 N/mm; range, 18-53 N/mm) and the suture (38  ± 25 N/mm; range, 10-83 N/mm).
  
  
  CONCLUSIONS
  Stainless steel wire and polyethylene suture have similar biomechanical strength in the cannulated screw tension band fixation of meso-type os acromiale at time zero.
authors.affiliation: Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Shiu
authors.affiliation: Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Xuyang
authors.initials: X
authors.lastname: Song
authors.affiliation: Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Abigail
authors.initials: A
authors.lastname: Iacangelo
authors.affiliation: Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Hyunchul
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Jazini
authors.affiliation: Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: R Frank
authors.initials: RF
authors.lastname: Henn
authors.affiliation: Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Mohit N
authors.initials: MN
authors.lastname: Gilotra
authors.affiliation: Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: ahasan@umoa.umm.edu.
authors.forename: S Ashfaq
authors.initials: SA
authors.lastname: Hasan
mesh_terms: D000174:Acromion / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D001863:Bone Screws; D001864:Bone Wires; D002102:Cadaver; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D011095:Polyethylenes; D012785:Shoulder Joint / Q000601:surgery; D013193:Stainless Steel; D013537:Sutures
chemical_list: D011095:Polyethylenes; D013193:Stainless Steel
keywords: Biomechanics; Os acromiale; Polyethylene suture; Stainless steel wire; Suture tension band; Tension band