Finite Element Analysis of Tendon-loop Tension Band Fixation in Simple Patellar Fractures Using Cannulated Screws and FiberWire
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Abstract
OBJECTIVES: To compare the biomechanical performance of stainless steel and FiberWire in a tendon-loop tension band wiring (TBW) construct with cannulated screws using finite element analysis.
MATERIALS AND METHODS: A three-dimensional finite element analysis model of a mid-pole transverse patellar fracture was reconstructed from CT data. Two models combined stainless steel cannulated screws with a figure-of-eight tendon loop made of either 1.25-mm stainless steel wire or 0.75-mm FiberWire No. 5. Under a 400-N load at 45° of knee flexion, von Mises stress and maximum deformation were evaluated for the complete fixation assembly (“cannulated construct”) and the isolated loop component (“figure-of-eight tendon-loop construct”).
RESULTS: Both fixation models demonstrated stable behavior under the simulated loading condition. Peak von Mises stresses in the cannulated constructs were 435.87 MPa for stainless steel and 451.55 MPa for FiberWire, whereas the corresponding values in the figure-of-eight tendon-loop constructs were 329.18 and 319.03 MPa, respectively. Maximum deformation remained below 0.3 mm in all analyses. FiberWire demonstrated stress distribution and deformation patterns comparable to those of stainless steel.
CONCLUSION: The finite element analysis indicated that FiberWire provides fixation stability comparable to that of stainless steel in tendon-loop TBW constructs combined with cannulated screws. By modeling the tendonloop technique rather than screw-loop modifications, this study reflects the most common surgical practice and supports FiberWire as a clinically relevant alternative to stainless steel. However, the clinical significance of these findings requires further investigation.
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