Korean Journal of Veterinary Research (대한수의학회지)

The Korean Society of Veterinary Science (대한수의학회)
권호 표지
DOI QR코드

DOI QR Code

Biomechanical comparison of bone staple techniques for stabilizing tibial tuberosity fractures

  • Kyu-Tae Park (Laboratory of Veterinary Surgery, Department of Veterinary Clinical Science, College of Veterinary Medicine, Konkuk University) ;
  • Min-Yeong Lee (Laboratory of Veterinary Surgery, Department of Veterinary Clinical Science, College of Veterinary Medicine, Konkuk University) ;
  • Hwi-Yool Kim (Laboratory of Veterinary Surgery, Department of Veterinary Clinical Science, College of Veterinary Medicine, Konkuk University)
  • Received : 2023.05.15
  • Accepted : 2023.08.28
  • Published : 2023.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

This study compared the biomechanical properties of bone-stapling techniques with those of other fixation methods used for stabilizing tibial tuberosity fractures using 3-dimensionally (3D)-printed canine bone models. Twenty-eight 3D-printed bone models made from computed tomography scan files were used. Tibial tuberosity fractures were simulated using osteotomy. All samples were divided into 4 groups. Group 1 was stabilized with a pin and tension-band wire; group 2, with a pin and an 8 mm-wide bone staple; group 3, with 2 horizontally aligned pins and an 8 mm-wide bone staple; and group 4 with a 10 mm-wide bone staple. Tensile force was applied with vertical distraction until failure occurred. The load and displacement were recorded during the tests. The groups were compared based on the load required to cause displacements of 1, 2, and 3 mm. The maximum failure loads and modes were recorded. The loads at all displacements in group 4 were greater than those in groups 1, 2, and 3. The loads at 1, 2, and 3 mm displacements were similar in groups 1 and 3. There was no significant difference between groups 1 and 3. Groups 1 and 4 provided greater maximum failure loads than groups 2 and 3. Failure occurred because of tearing of the nylon rope, tibial fracture, wire breakage, pin bending, and fracture around the bone staple insertion. In conclusion, these results demonstrate that the bone-stapling technique is an acceptable alternative to tension-band wire fixation for the stabilization of tibial tuberosity fractures in canine bone models.

Keywords

Acknowledgement

The authors thank the Daegu Gyeongbuk Institute of Science and Technology for their assistance with biomechanical testing.

References

  1. Goldsmid S, Johnson KA. Complications of canine tibial tuberosity avulsion fractures. Vet Comp Orthop Traumatol 1991;4:54-58.  https://doi.org/10.1055/s-0038-1633253
  2. von Pfeil DJ, Decamp CE, Ritter M, Probst CW, Dejardin LM, Priddy N 2nd, Hayashi K, Johnston SA. Minimally displaced tibial tuberosity avulsion fracture in nine skeletally immature large breed dogs. Vet Comp Orthop Traumatol 2012;25:524-531.  https://doi.org/10.3415/VCOT-11-12-0170
  3. Hayashi K, Kapatkin AS. 2018. Fractures of the Tibia and Fibula. In: Johnston SA, Tobias KM, eds. Veterinary Surgery: Small Animal. Vol 2. 2nd ed. pp. 1176-1193, Elsevier Health Sciences, St. Louis, 2018. 
  4. Skelly CM, McAllister H, Donnelly WJ. Avulsion of the tibial tuberosity in a litter of greyhound puppies. J Small Anim Pract 1997;38:445-449.  https://doi.org/10.1111/j.1748-5827.1997.tb03437.x
  5. Pratt JN. Avulsion of the tibial tuberosity with separation of the proximal tibial physis in seven dogs. Vet Rec 2001;149:352-356.  https://doi.org/10.1136/vr.149.12.352
  6. DeCamp CE, Flo GL, Piermattei DL, Schaefer SL. The Stifle Joint. In: Brinker, Piermattei and Flo's Handbook of Small Animal Orthopedics and Fracture Repair. 5th ed. pp. 597-669, Elsevier Health Sciences, St. Louis, 2016.
  7. Clements DN, Gemmill T, Corr SA, Bennett D, Carmichael S. Fracture of the proximal tibial epiphysis and tuberosity in 10 dogs. J Small Anim Pract 2003;44:355-358.  https://doi.org/10.1111/j.1748-5827.2003.tb00167.x
  8. Gower JA, Bound NJ, Moores AP. Tibial tuberosity avulsion fracture in dogs: a review of 59 dogs. J Small Anim Pract 2008;49:340-343.  https://doi.org/10.1111/j.1748-5827.2008.00566.x
  9. von Pfeil DJ, Glassman M, Ropski M. Percutaneous tibial physeal fracture repair in small animals: technique and 17 cases. Vet Comp Orthop Traumatol 2017;30:279-287.  https://doi.org/10.3415/VCOT-16-07-0102
  10. von Pfeil DJ, Megliolia S, Malek S, Rochat M, Glassman M. Tibial apophyseal percutaneous pinning in skeletally immature dogs: 25 cases (2016-2019). Vet Comp Orthop Traumatol 2021;34:144-152.  https://doi.org/10.1055/s-0040-1719091
  11. Verpaalen VD, Lewis DD, Billings GA. Biomechanical comparison of three stabilization methods for tibial tuberosity fractures in dogs: a cadaveric study. Vet Comp Orthop Traumatol 2021;34:279-286.  https://doi.org/10.1055/s-0041-1726082
  12. Lai A, Christou C, Bailey C, Tan CJ, Culvenor J, Wang T, Walsh WR. Biomechanical comparison of pin and nitinol bone staple fixation to pin and tension band wire fixation for the stabilization of canine olecranon osteotomies. Vet Comp Orthop Traumatol 2017;30:324-330.  https://doi.org/10.3415/VCOT-17-02-0025
  13. Hausmann JT. Sawbones in biomechanical settings: a review. Osteosynth Trauma Care 2006;14:259-264.  https://doi.org/10.1055/s-2006-942333
  14. Cashmore RG, Havlicek M, Perkins NR, James DR, Fearnside SM, Marchevsky AM, Black AP. Major complications and risk factors associated with surgical correction of congenital medial patellar luxation in 124 dogs. Vet Comp Orthop Traumatol 2014;27:263-270.  https://doi.org/10.3415/VCOT-13-08-0100
  15. Zide AN, Jones SC, Litsky AS, Kieves NR. A cadaveric evaluation of pin and tension band configuration strength for tibial tuberosity osteotomy fixation. Vet Comp Orthop Traumatol 2020;33:9-14.  https://doi.org/10.1055/s-0039-1693968
  16. Toby EB, McGoldrick E, Chalmers B, McIff T. Rotational stability for intercarpal fixation is enhanced by a 4-tine staple. J Hand Surg Am 2014;39:880-887.  https://doi.org/10.1016/j.jhsa.2014.01.044
  17. Neat BC, Kowaleski MP, Litsky AS, Boudrieau RJ. Mechanical evaluation of pin and tension-band wire factors in an olecranon osteotomy model. Vet Surg 2006;35:398-405.  https://doi.org/10.1111/j.1532-950X.2006.00164.x
  18. Davis K, Caldwell P, Wayne J, Jiranek WA. Mechanical comparison of fixation techniques for the tibial tubercle osteotomy. Clin Orthop Relat Res 2000;(380):241-249. 
  19. Halling KB, Lewis DD, Cross AR, Sammy RJ, Rapoff AJ. Biomechanical comparison of a circular external skeletal fixator construct to pin and tension band wire fixation for the stabilization of olecranon osteotomies in dogs: a cadaveric study. Vet Surg 2003;32:324-335.  https://doi.org/10.1053/jvet.2003.50045
  20. Chalidis BE, Sachinis NC, Samoladas EP, Dimitriou CG, Pournaras JD. Is tension band wiring technique the "gold standard" for the treatment of olecranon fractures?: a long term functional outcome study. J Orthop Surg Res 2008;3:9. 
  21. Schnabel B, Scharf M, Schwieger K, Windolf M, Pol Bv, Braunstein V, Appelt A. Biomechanical comparison of a new staple technique with tension band wiring for transverse patella fractures. Clin Biomech (Bristol, Avon) 2009;24:855-859. https://doi.org/10.1016/j.clinbiomech.2009.08.002