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Mechanical analysis of twelve toggle suture constructs for stabilization of coxofemoral luxations
Shantibhushan Jha1, Michael P Kowaleski
1Orthopedic Research Laboratory, Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, Foster Hospital for Small Animals, North Grafton, MA 01536, USA.
Objective:
To compare the mechanical performance of 12 commonly used toggle suture constructs (TSCs).
Study Design:
In vitro biomechanical study.
Sample Population:
Toggle suture constructs (n = 136).
Methods:
TSC evaluated included #5 OrthoFiber, double strand of 5 Ethibond sutures (polyethylene terephthalate suture), 80 lb monofilament nylon, or #5 FiberWire, combined with Piermattei toggle (3/32" Steinmann pin), modified Piermattei toggle (0.045" Kirschner wire), and 1/8" Securos toggle rod for a total of 12 test groups. Acute and cyclic testing were performed using a servohydraulic testing machine and load at failure and cycles to failure were determined.
Results:
In acute testing, modified Piermattei TSCs failed by toggle deformation and Piermattei and Securos TSCs failed by suture breakage at the eyelet. Mean failure load of Piermattei-#5 OrthoFiber TSC (1416 ± 74 N) was significantly greater than that of Piermattei-#5 Ethibond (883 ± 38 N); both were significantly greater than all other TSCs. Only the Piermattei TSC with #5 OrthoFiber, #5 Ethibond, and 80 lb monofilament nylon did not fail during cyclic testing.
Conclusion:
A combination of the Piermattei toggle and #5 OrthoFiber or #5 Ethibond achieved a higher load at failure than all other groups, and resisted the greatest number of cycles to failure. Long-term mechanical testing of these TSCs are warranted to further define their durability.
