Mechanical assessment of novel versus state of the art high-strength sutures and tapes, and cerclage wires - A comparative study.

Abstract

Elongation and loss of compression in suture, tape and cerclage materials can lead to loss of reduction and inferior clinical outcomes. This study aimed to evaluate the mechanical properties of novel dynamic high-strength silicone-based sutures and tapes, conventional high-strength sutures and tapes, and cerclage wires with three diameters (1.0, 1.25, 1.5 mm) focusing on tensile strength and elongation in a knotless configuration. Six 360 mm long specimens from each material underwent tensile force to failure tests at 0.1 mm/s quasi-static loading in a dry environment, without knots or twists to eliminate confounding factors. Tensile strength and elongation were recorded and assessed at 90% of maximum force level. Elongation of silicone-based sutures (51.14 ± 4.32 mm) and tapes (75.32 ± 5.33 mm) was significantly greater vs. conventional sutures (20.21 ± 1.97 mm) and tapes (29.97 ± 4.56 mm), p < 0.001. Conventional tapes achieved highest tensile strength (453.06 ± 48.24 N), outperforming silicone-based tapes (300.75 ± 19.66 N), p < 0.001. Tensile strength of conventional sutures (209.55 ± 11.44 N) did not differ significantly from silicone-based sutures (185.56 ± 25.73 N), p = 0.172. Tensile strength of cerclage wires increased significantly with each successive diameter increase, p < 0.001. Elongation increased significantly between diameters of 1.0 mm (21.11 ± 2.49 mm) and 1.50 mm (32.46 ± 3.30 mm), as well as between diameters of 1.25 mm (25.82 ± 3.22 mm) and 1.50 mm (p = 0.028), with no significant increase between diameters of 1.0 mm and 1.25 mm (p = 0.081). Silicone-based materials offer greated elongation but lower tensile strength. Conventional materials demonstrate higher mechanical resistance. Larger cerclage diameters substantially increase loading capacity. Material selection should balance elasticity and mechanical strength demands based on clinical needs.