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Mechanical Analysis of Twelve Toggle Suture Constructs for Stabilization of Coxofemoral Luxations

Authors

  • Shantibhushan Jha BVSc & AH MS,

    1. Orthopedic Research Laboratory, Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, Foster Hospital for Small Animals, North Grafton, MA
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  • Michael P. Kowaleski DVM Diplomate ACVS & ECVS

    Corresponding author
    • Orthopedic Research Laboratory, Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, Foster Hospital for Small Animals, North Grafton, MA
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  • Funded in part by a grant from the Fund for Companion Animal Health, Cummings School of Veterinary Medicine at Tufts University and materials donated by Securos Veterinary Orthopedics, Inc., Fiskdale, MA; Arthrex Vet Systems Inc., Naples, FL; and Novartis Animal Health US Inc., East Hanover, NJ.

  • Presented in part at the 39th Annual Conference Veterinary Orthopedic Society, Crested Butte, CO, March 2012.

Corresponding Author

Michael P. Kowaleski, DVM, Diplomate ACVS & ECVS, Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA 01536

E-mail: mike.kowaleski@tufts.edu

Abstract

Objective

To compare the mechanical performance of 12 commonly used toggle suture constructs (TSCs).

Study Design

In vitro biomechanical study.

Sample Population

Toggle suture constructs (n = 136).

Methods

TSC evaluated included #5 OrthoFiber, double strand of 5 Ethibond sutures (polyethylene terephthalate suture), 80 lb monofilament nylon, or #5 FiberWire, combined with Piermattei toggle (3/32" Steinmann pin), modified Piermattei toggle (0.045" Kirschner wire), and 1/8" Securos toggle rod for a total of 12 test groups. Acute and cyclic testing were performed using a servohydraulic testing machine and load at failure and cycles to failure were determined.

Results

In acute testing, modified Piermattei TSCs failed by toggle deformation and Piermattei and Securos TSCs failed by suture breakage at the eyelet. Mean failure load of Piermattei-#5 OrthoFiber TSC (1416 ± 74 N) was significantly greater than that of Piermattei-#5 Ethibond (883 ± 38 N); both were significantly greater than all other TSCs. Only the Piermattei TSC with #5 OrthoFiber, #5 Ethibond, and 80 lb monofilament nylon did not fail during cyclic testing.

Conclusion

A combination of the Piermattei toggle and #5 OrthoFiber or #5 Ethibond achieved a higher load at failure than all other groups, and resisted the greatest number of cycles to failure. Long-term mechanical testing of these TSCs are warranted to further define their durability.

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