Abstract
The present study introduces a knotless tension band construct and compares its biomechanical
behavior with that of a traditional stainless steel tension band construct. Fourth-generation
composite tibial Sawbones® were used in the present study. Fracture models were created to mimic Orthopaedic
Trauma Association type 44-B2.2 ankle fractures. A total of 20 specimens were randomized
evenly into a stainless steel tension band group (control group); or a knotless tension
band group. The fixation constructs were mechanically tested, and the stiffness and
failure strengths were calculated. Two failure strengths were determined: the engineering-based
failure strength, defined as the greatest tensile load tolerated by the construct;
and the clinical failure strength, defined as the force required to displace the fracture
by 2 mm. We used 2-tailed independent samples t tests to compare and identify significant differences. The knotless tension band
construct was 7.7% stronger and 33.2% stiffer and required a 36.7% greater force to
displace the fracture by 2 mm. Independent sample t tests confirmed that differences in mean stiffness (p = .003) and clinical failure strength (p = .003) were statistically significant. Although the mean engineering strength for
the knotless group was greater than that for the stainless steel group, this difference
was not statistically significant (p = .170). This knotless tension band construct could potentially offer both clinical
and biomechanical advantages compared with the current stainless steel standard.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: December 18, 2012
Footnotes
Financial Disclosure: Arthrex, Inc., Naples, FL, donated the implant materials and plastic bone models, although none of the investigators were paid by the company to participate in the study, and the company did not participate in the design, execution, analysis, or writing or report of this investigation.
Conflict of Interest: None reported.
Identification
Copyright
© 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
