Fixation of patella fractures with braided polyester suture: a biomechanical study

We tested the quality of fixation of displaced transverse patella fractures using braided polyester suture to investigate the suitability of this mate rial as an alternative to stainless steel wire for fixation of these fractu res. Osteotomies were created to simulate fractures of the patella in ten c adaveric knee specimens and were sequentially fixed using two techniques: t he modified tension-band technique and the longitudinal anterior band (Lotk e) technique. Each technique was implemented using either 1.25-mm stainless steel wire or 7-metric braided polyester suture (No. 5 Ethibond). The qual ity of fixation for each technique was tested by measuring the fracture gap during three simulated extensions of the knee against gravity on a materia ls testing machine. All techniques behaved comparably under the loading con ditions used. In the four groups, there was no fixation failure (fracture g ap >3 mm) nor any significant difference between the mean maximum fracture gaps. The quality of fixation for braided polyester suture was comparable t o that of stainless steel wire for such fractures, providing sufficient sta bility to withstand loads likely to be encountered during postoperative reh abilitation. Our results support the use of braided polyester suture as an alternative to stainless steel wire for fixation of displaced patella fract ures. (C) 2000 Elsevier Science Ltd. All rights reserved.