Biomechanical comparison of the coracoclavicular space fixation using three different suture techniques

Abstract

Coracoclavicular space fixation with suture loops is a well-known surgical technique for the treatment of dislocations. However, out of 100 different surgical treatments no single one has been established as a gold standard. The following research aims to improve the technique and focuses on a development of new fixation technique using composite sutures, which would withstand forces during ligament healing process. Three different fixation techniques (one loop and two separate suture loops and W-system) were tested on a custom built mechanical testing device. Applied load was continuously increased at a loading rate of 30 N/min until the failure of the sutures. Ultimate tensile strength and suture elongation at failure were measured. The W-system had statistically significant higher load to failure and higher stiffness compared to one loop and two separate loops techniques. Biomechanical properties of a suture fixation technique can be improved by connecting them into one system to create particular arrangement of the sutures. The measurements can be easily repeated and this testing protocol can serve as a good starting point to standardize procedures of evaluation of different joint fixation techniques and to develop new ones.