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The Use of Biodegradable Sutures for the Fixation of Tibial Eminence Fractures in Children: A Comparison Using PDS II, Vicryl and FiberWire

Schneppendahl, Johannes MD*; Thelen, Simon MD*; Twehues, Sören MD*; Eichler, Christian MD; Betsch, Marcel MD*; Windolf, Joachim MD, PhD*; Hakimi, Mohssen MD, PhD*; Wild, Michael MD, PhD

Journal of Pediatric Orthopaedics: June 2013 - Volume 33 - Issue 4 - p 409–414
doi: 10.1097/BPO.0b013e31827d0c67

Background: Arthroscopic suture fixation of tibial eminence fractures using FiberWire is a favorable therapeutic option. The application of biodegradable material may be of advantage especially during childhood. The aim of this study was to evaluate the biomechanical properties using the biodegradable suture materials PDS II and Vicryl compared with FiberWire.

Methods: Bone mineral density was evaluated by pqCT in 18 human knee specimens and 3 similar groups were formed. A standardized anterior tibial eminence fracture was created and suture fixation was performed using each suture material (PDS II, Vicryl, FiberWire) in 6 specimens. Cyclic testing and destructive loading to failure was conducted.

Results: Both testing modalities showed PDS II to be inferior to the other evaluated suture materials. Although significantly higher failure loads were seen with FiberWire sutures, Vicryl yielded comparable stiffness in load-to-failure testing. No significant differences between Vicryl and FiberWire could be observed under nondestructive cyclic conditions.

Conclusions: Even though FiberWire yields a superior ultimate failure load, Vicryl presented comparable results under cyclic conditions.

Clinical Relevance: For tibial eminence fractures in children, Vicryl should be considered as an alternative biodegradable suture material. The use of PDS II cannot be advocated.

*Department of Trauma and Hand Surgery, Heinrich Heine University Hospital Düsseldorf, Düsseldorf

Department of Anatomy II, University of Cologne, Cologne

Department of Trauma and Orhopaedic Surgery, Klinikum Darmstadt, Darmstadt, Germany

None of the authors received financial support for this study.

The authors declare no conflict of interest.

Reprints: Simon Thelen, MD, Department of Trauma and Hand Surgery, Heinrich Heine University Hospital Düsseldorf, Moorenstrasse 5, Düsseldorf 40225, Germany. E-mail:

© 2013 by Lippincott Williams & Wilkins