The Experts below are selected from a list of 120 Experts worldwide ranked by ideXlab platform
Lionel G Ripley - One of the best experts on this subject based on the ideXlab platform.
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a new and effective tension band braided Polyester Suture technique for transverse patellar fracture fixation
Injury-international Journal of The Care of The Injured, 2007Co-Authors: Sea C A Hughes, Philip M Sto, Anthony J Hearnde, Lionel G RipleyAbstract:Objectives: Concerning the tension-band principle of internal fixation, this study aims to establish whether any difference in interfragmentary gap exists after bone-reducing forceps are released, when a recommended Suture-knot technique and a new technique are tested in vitro on a purpose built machine that features a model of a transverse fracture of the patella. In addition, a standard tension-band wiring technique has also been tested as one form of control. Background: Satisfactory compression at a fracture site reduces the risk of failure of fixation, loss of reduction (interfragmentary gap >2 mm) and subsequent risks of malunion, delayed union, and ultimately non-union from excessive movement. Stainless-steel wire can provide a stable rigid construct but is associated with complications. Tension-band fixation employing a braided Polyester non-absorbable Suture provides a less rigid construct. However, satisfactory clinical results and fewer complications are reported. The method by which a Suture is tied has an effect on initial compression provided the fracture is reduced. However, it also has an effect on the degree of fracture gap once it is subject to biomechanical distraction. Methods: By measuring the output of a strain gauge Wheatstone bridge of a purpose built rig that had been calibrated against fracture gap and compression force, the various tension-band fixation techniques as discussed above were evaluated. Results: The tension-band Suture technique examined in this work (the modified Wagoner's Hitch) has been evaluated. It has quantitatively shown less fracture gap than other recognised tension-band Suture and wire techniques. The results exhibit statistical significance (p < 0.001). Conclusions: This evaluation study has produced quantitative and comparable data of fracture gap as observed with the model of a transverse patella fracture, for both new and established surgical techniques. The contribution this study has made to the knowledge of the subject is that a testing device similar to the one in this study may be useful in the future for conducting preliminary studies of new or established tension-band techniques. The proposed tension-band Suture method tested in this dissertation provided statistically significant quantitative data, which may after further work, support its use as an alternative method in the clinical setting.
Riyaz H Jinnah - One of the best experts on this subject based on the ideXlab platform.
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fixation of patella fractures with braided Polyester Suture a biomechanical study
Injury-international Journal of The Care of The Injured, 2000Co-Authors: Vipul R Patel, E G Parks, Yingbo Wang, Frank R Ebe, Riyaz H JinnahAbstract:Abstract We tested the quality of fixation of displaced transverse patella fractures using braided Polyester Suture to investigate the suitability of this material as an alternative to stainless steel wire for fixation of these fractures. Osteotomies were created to simulate fractures of the patella in ten cadaveric knee specimens and were sequentially fixed using two techniques: the modified tension-band technique and the longitudinal anterior band (Lotke) technique. Each technique was implemented using either 1.25-mm stainless steel wire or 7-metric braided Polyester Suture (No. 5 Ethibond). The quality of fixation for each technique was tested by measuring the fracture gap during three simulated extensions of the knee against gravity on a materials testing machine. All techniques behaved comparably under the loading conditions used. In the four groups, there was no fixation failure (fracture gap >3 mm) nor any significant difference between the mean maximum fracture gaps. The quality of fixation for braided Polyester Suture was comparable to that of stainless steel wire for such fractures, providing sufficient stability to withstand loads likely to be encountered during postoperative rehabilitation. Our results support the use of braided Polyester Suture as an alternative to stainless steel wire for fixation of displaced patella fractures.
H M Klinger - One of the best experts on this subject based on the ideXlab platform.
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biomechanical characteristics of single row repair in comparison to double row repair with consideration of the Suture configuration and Suture material
Knee Surgery Sports Traumatology Arthroscopy, 2008Co-Authors: M H Baums, Gottfried H Buchhorn, Gunter Spahn, B Poppendieck, W Schultz, H M KlingerAbstract:The aim of the study was to evaluate the time zero mechanical properties of single- versus double-row configuration for rotator cuff repair in an animal model with consideration of the stitch technique and Suture material. Thirty-two fresh-frozen sheep shoulders were randomly assigned to four repair groups: Suture anchor single-row repair coupled with (1) braided, nonabsorbable Polyester Suture sized USP No. 2 (SRAE) or (2) braided polyblend polyethylene Suture sized No. 2 (SRAH). The double-row repair was coupled with (3) USP No. 2 (DRAE) or (4) braided polyblend polyethylene Suture No. 2 (DRAH). Arthroscopic Mason–Allen stitches were used (single-row) and combined with medial horizontal mattress stitches (double-row). Shoulders were cyclically loaded from 10 to 180 N. Displacement to gap formation of 5- and 10-mm at the repair site, cycles to failure, and the mode of failure were determined. The ultimate tensile strength was verified in specimens that resisted to 3,000 cycles. DRAE and DRAH had a lower frequency of 5- (P = 0.135) and 10-mm gap formation (P = 0.135). All DRAE and DRAH resisted 3,000 cycles while only three SRAE and one SRAH resisted 3,000 cycles (P 0.05). Double-row Suture anchor repair with arthroscopic Mason–Allen/medial mattress stitches provides initial strength superior to single-row repair with arthroscopic Mason–Allen stitches under isometric cyclic loading as well as under ultimate loading conditions. Our results support the concept of double-row fixation with arthroscopic Mason–Allen/medial mattress stitches in rotator cuff tears with improvement of initial fixation strength and ultimate tensile load. Use of new polyblend polyethylene Suture material seems not to increase the initial biomechanical aspects of the repair construct.
Sea C A Hughes - One of the best experts on this subject based on the ideXlab platform.
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a new and effective tension band braided Polyester Suture technique for transverse patellar fracture fixation
Injury-international Journal of The Care of The Injured, 2007Co-Authors: Sea C A Hughes, Philip M Sto, Anthony J Hearnde, Lionel G RipleyAbstract:Objectives: Concerning the tension-band principle of internal fixation, this study aims to establish whether any difference in interfragmentary gap exists after bone-reducing forceps are released, when a recommended Suture-knot technique and a new technique are tested in vitro on a purpose built machine that features a model of a transverse fracture of the patella. In addition, a standard tension-band wiring technique has also been tested as one form of control. Background: Satisfactory compression at a fracture site reduces the risk of failure of fixation, loss of reduction (interfragmentary gap >2 mm) and subsequent risks of malunion, delayed union, and ultimately non-union from excessive movement. Stainless-steel wire can provide a stable rigid construct but is associated with complications. Tension-band fixation employing a braided Polyester non-absorbable Suture provides a less rigid construct. However, satisfactory clinical results and fewer complications are reported. The method by which a Suture is tied has an effect on initial compression provided the fracture is reduced. However, it also has an effect on the degree of fracture gap once it is subject to biomechanical distraction. Methods: By measuring the output of a strain gauge Wheatstone bridge of a purpose built rig that had been calibrated against fracture gap and compression force, the various tension-band fixation techniques as discussed above were evaluated. Results: The tension-band Suture technique examined in this work (the modified Wagoner's Hitch) has been evaluated. It has quantitatively shown less fracture gap than other recognised tension-band Suture and wire techniques. The results exhibit statistical significance (p < 0.001). Conclusions: This evaluation study has produced quantitative and comparable data of fracture gap as observed with the model of a transverse patella fracture, for both new and established surgical techniques. The contribution this study has made to the knowledge of the subject is that a testing device similar to the one in this study may be useful in the future for conducting preliminary studies of new or established tension-band techniques. The proposed tension-band Suture method tested in this dissertation provided statistically significant quantitative data, which may after further work, support its use as an alternative method in the clinical setting.
Li Jia - One of the best experts on this subject based on the ideXlab platform.
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double fixation of displaced patella fractures using bioabsorbable cannulated lag screws and braided Polyester Suture tension bands
Injury-international Journal of The Care of The Injured, 2011Co-Authors: Cao Chang, Pei Fu Xing, Yang Tianfu, Zhong Gang, Li JiaAbstract:Summary Purpose To evaluate the effectiveness and safety of a new double fixation technique for displaced patellar fractures using bioabsorbable cannulated lag screws and braided Polyester Suture tension bands. Methods Fifteen patients (mean age of 46.2 years) with displaced transverse or comminuted patella fractures were enrolled in this prospective study. All of the patients were treated via the open reduction internal fixation (ORIF) procedure using bioabsorbable cannulated lag screws and braided Polyester Suture tension bands. The patients were followed post-surgery to evaluate (1) the time required for radiographic bone union, (2) the knee joint range of motion at the time of radiographic bone union, (3) the degree of pain assessed using the visual analogue scale (VAS), (4) the function of the knee using the Lysholm score and (5) the presence of any additional complications from the surgery. Results All of the patients were followed post-treatment for more than 1 year (range, 12–19 months; mean post-treatment follow up time, 14 months). The bone union of the fractures as seen radiographically occurred approximately 3 months from surgery in all cases without implant failure or redisplacement of the fractured site. The mean knee joint range of motion was from 0 to 134.6°, and the mean VAS score was 0.7 at the time of bone union. The mean Lysholm scores at the time of bone union and 12 months post-surgery were 86.7 and 95.7, respectively. No postoperative complications, such as infection, dislocation or breakage of the implants, were observed. Moreover, all of the patients returned to their previous activity level. Conclusion This new double fixation technique using bioabsorbable cannulated lag screws and braided Polyester Suture tension bands resulted in satisfactory outcomes for patella fractures without any obvious complications.