Comparison of cannulated screws with FiberWire or stainless steel wire for patella fracture fixation: A pilot study

Abstract

Patella Fracture Fixation a b s t r a c tPurpose: This pilot study tested whether FiberWire provides similar protection to steel wire against repair displacement in patella fractures.Methods: Thirteen cadaver knees were cyclically loaded with 10 cycles (0e90 flexion) and fracture displacement was recorded. Fixation methods were also tested in load to failure (>3 mm displacement).Results: There was no difference between wire types in fracture displacement (1.4 mm AE 0.33 mm vs 1.2 mm AE 0.34 mm, respectively; p ¼ 0.418) or in the load to failure (714.7 N AE 110.9 N vs 744.5 N AE 92.8 N, respectively; p ¼ 0.360).

Cannulated Screws and Braided Polyester Tension Band as an Alternative for Fixation of Transverse Patella Fracture: A Finite Element Analysis Study

“…To simulate the knee environment, prior cadaveric studies applied the traction on the cadaver's quadriceps muscle 9,10,40,43 and flexion of knee cadavers created actual patella gliding mechanism. Patellofemoral joint is subjected to dynamic stress.…”

“…We attempted to create an environment as close to the actual physiological condition as possible. The PF joint reaction was maximum at 45 o 6 and 400 N is required to get full knee extension, 43 so we simulated a 45 o knee flexion. The loading forces on each fragment were equivalent at 400N and 67.5 o relative to the axial plane in order to get a resultant force perpendicular to the joint.…”

“…A systematic review, by Camarda et al, 63 showed that non-metallic implants are able to deliver good clinical outcomes reducing the rate of surgical complications and re-operation. Bryant et al, 43 has investigated a combination of stainless-steel or FiberWire with cannulated screw. His resulted showed that there was no difference between wire types in fracture displacement and the load to failure.…”

“…10,18,20,[27][28][29][30][31][32][33][34][35][36] In place of two parallel K-wires, some authors performed different interfragmentary fixations by using cancellous screws, cannulated screws or bioabsorbable cannulated screws. 9,20,25,30,[37][38][39][40][41][42][43] Several in vitro 9,39,40,43 and clinical studies proved that screw fixation yielded satisfactory outcomes, 38,41 lower painful hardware and implant loosening. 25,37,42 For the figure-of-eight loop, several authors have advocated non-metallic implants such as braided polyester.…”

“…To our knowledge, there was only one literature focusing on this configuration, which was a biomechanical study in 13 cadavers. 43 Bryant et al, 43 compared anterior tension band through cannulated screws using stainless steel wire and FiberWire and found no difference between wire types in fracture displacement and load-to-failure. However, this study did not compare their techniques with the traditional modified tension band technique.…”