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Cerclage performance analysis - a biomechanical comparison of different techniques and materials
L M Hägerich1, F G E Dyrna1, J C Katthagen1
1Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building W1, 48149, Münster, Germany.
BMC Musculoskeletal Disorders
|December 1, 2022
Summary
Metallic and non-metallic cerclages offer reliable fracture fixation stability. Non-metallic options provide elasticity with comparable stability to metallic constructs, potentially offering biologic benefits.
Area of Science:
- Orthopedic biomechanics
- Surgical implant technology
Background:
- Wire cerclages are crucial for fracture fixation.
- A wide array of cerclage designs are commercially available, necessitating comparative analysis.
- The biomechanical properties of metallic and non-metallic cerclages require investigation.
Purpose of the Study:
- To investigate the biomechanical properties of various metallic and non-metallic cerclage constructs.
- To evaluate the influence of different application techniques on cerclage performance.
- To assess the impact of muscular interposition on cerclage stability.
Main Methods:
- Testing of Titanium Cable Cerclage (CC), Steel Wire Cerclage (SWC), Suture Tape (ST), and Suture Tape Cerclage (STC) on 3D printed and cadaveric humeri.
- Cyclic loading to 1 kN followed by linear loading to 3 kN.
- Analysis of constructs with and without muscular interposition.
Main Results:
- All cerclage types withstood high loads, with CC and double-loop STC (dSTC) reaching the maximum 3000 N without failure.
- SWC achieved an average load of 2977.5 N, ST 1970.8 N, and single-loop STC (sSTC) 1617.0 N.
- Muscular interposition and bone quality did not significantly affect biomechanical properties.
Conclusions:
- All tested cerclage constructs provide reliable stability but vary in compression forces.
- Non-metallic cerclages offer comparable stability to metallic options with potentially greater elasticity and biologic benefits.
- Careful installation is crucial, especially with poor bone quality, due to high tightening forces.
