ArticleBMC musculoskeletal disorders2022
Cerclage performance analysis - a biomechanical comparison of different techniques and materials.
Article in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Treatment of inferior pole patellar fractures with an integrated titanium cable-net construct: a retrospective case series.BMC musculoskeletal disorders · 2026Article
- Response to the letter to the editor: "Outcome of Femoral Fractures Treated with Cerclages and Intramedullary Nailing".European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Letter to the Editor: "Outcome of femoral fractures treated with cerclages and intramedullary Nailing".European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Biomechanical evaluation of cerclage wiring in plated tibia fractures using human and synthetic specimens.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Enhancing recovery and outcomes of sternal closure in cardiac surgery: Early results of a 400-patient comparison of suture tapes and steel wires.JTCVS techniques · 2025Article
- A surgical technique of tibial tuberosity fracture fixation with one suture tape in a figure-of-eight configuration, as a tension band and a single cannulated partial-threaded screw.Trauma case reports · 2025Article
- Wire cerclages as part of osteosynthesis- examination for optimal placement.Archives of orthopaedic and trauma surgery · 2025Article
- Improving Sternal Closure Outcomes in Cardiac Surgery: Polyethylene Suture Tapes vs. Steel Wires.Journal of clinical medicine · 2025Article
- Relaxation Behavior of Cerclage Cables and Its Effect on Bone Clamping Force.Bioengineering (Basel, Switzerland) · 2024Article
- Biomechanical evaluation of double-stranded knot configurations in high-strength sutures and tapes.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Titanium Cable Cerclage Increases the Load to Failure in Plate Osteosynthesis for Distal Femoral Fractures.Medicina (Kaunas, Lithuania) · 2024Article
- Effectiveness of laser welding in cerclage wiring fixation: a biomechanical study.Frontiers in surgery · 2023Article
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Authors and funding
9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundWire cerclages play a fundamental role in fracture fixation. With an increasing variety of designs being commercially available the question arises which cerclage should be used. This study investigates the biomechanical properties of metallic and non-metallic cerclages and their different application-types. Furthermore, potential influence of muscular interposition between bone and cerclage constructs was tested.
methodsSamples of the following four different cerclage types were tested on 3D printed models of human humeri as well as on human cadaveric humeri with and without muscular interposition: Titanium Cable Cerclage (CC), Steel Wire Cerclage (SWC), Suture Tape (ST), Suture Tape Cerclage (STC) with both single- (sSTC) and double-loop application (dSTC). A preinstalled self-locking mechanism secured by the provided tensioner in the STCs being the main difference to the STs. Cyclic loading was performed to 1 kN and then linearly to a maximum load of 3 kN. Statistical analysis was performed using either one-way ANOVA and post-hoc Tukey or Kruskal-Wallis and post-hoc Dunn test depending on normalization of data (p < 0.05).
resultsWhilst all cerclage options could withstand high loads during failure testing, only within the CC and dSTC group, all samples reached the maximal testing load of 3000 N without any failure. The SWC reached 2977.5 ± 63.6 N, the ST 1970.8 ± 145.9 N, and the sSTC 1617.0 ± 341.6 N on average. Neither muscular interposition nor bone quality showed to have a negative influence on the biomechanical properties of the cerclage constructs, presenting no significant differences.
conclusionAll tested cerclage constructs produce reliable stability but differ in their resulting compression forces, in a simplified fracture model. Therefore, non-metallic cerclage alternatives can provide similar stability with less compression and stiffness to metallic cable constructs, but they may offer several advantages and could possibly provide future benefits. Especially, by offering more elasticity without losing overall stability, may offer a biologic benefit. Installing any cerclage constructs should be performed carefully, especially if poor bone quality is present, as the tightening process leads to high forces on the construct.
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