OBJECTIVE: To evaluate the effect of altering pin and wire diameter, wire position and configuration, and osteotomy angle on applied load and absorbed strain energy in a pin and tension-band wire (PTBW) fixation model. STUDY DESIGN: In vitro mechanical study. SAMPLE POPULATION: Delrin models (n=96). METHODS: PTBW was applied to Delrin olecranon osteotomy models. A control configuration was defined and then altered, 1 variable (wire diameter, pin diameter, wire-hole position, wire configuration, osteotomy angle) at a time, to create 11 test configurations. Tensile force was applied and displacement at the caudal aspect of the osteotomy was measured. Fixation strength, in terms of tensile load and strain energy, was compared between control and each test configuration at 4 osteotomy displacements. RESULTS: Models with larger wire, pins, or combined figure-of-eight/lateral wires were stronger than control, whereas those with smaller wire, pins, or a solitary lateral wire were weaker. The superior strength of the larger wire was apparent for all assessed osteotomy displacement. CONCLUSIONS: PTBW fixation strength increases as implant diameter is increased, with wire diameter having greatest effect. Lateral wire configuration is weaker than figure-of-eight, but can be added to figure-of-eight configuration to increase strength. Wire-hole position and osteotomy angle have little effect on PTBW strength. CLINICAL RELEVANCE: Wire diameter is the key determinant of PTBW strength, whereas pin diameter is somewhat less critical. Wire passage through an additional hole proximally provides equivalent strength and may avoid soft-tissue entrapment and subsequent loosening.
OBJECTIVE: To evaluate the effect of altering pin and wire diameter, wire position and configuration, and osteotomy angle on applied load and absorbed strain energy in a pin and tension-band wire (PTBW) fixation model. STUDY DESIGN: In vitro mechanical study. SAMPLE POPULATION: Delrin models (n=96). METHODS: PTBW was applied to Delrin olecranon osteotomy models. A control configuration was defined and then altered, 1 variable (wire diameter, pin diameter, wire-hole position, wire configuration, osteotomy angle) at a time, to create 11 test configurations. Tensile force was applied and displacement at the caudal aspect of the osteotomy was measured. Fixation strength, in terms of tensile load and strain energy, was compared between control and each test configuration at 4 osteotomy displacements. RESULTS: Models with larger wire, pins, or combined figure-of-eight/lateral wires were stronger than control, whereas those with smaller wire, pins, or a solitary lateral wire were weaker. The superior strength of the larger wire was apparent for all assessed osteotomy displacement. CONCLUSIONS: PTBW fixation strength increases as implant diameter is increased, with wire diameter having greatest effect. Lateral wire configuration is weaker than figure-of-eight, but can be added to figure-of-eight configuration to increase strength. Wire-hole position and osteotomy angle have little effect on PTBW strength. CLINICAL RELEVANCE: Wire diameter is the key determinant of PTBW strength, whereas pin diameter is somewhat less critical. Wire passage through an additional hole proximally provides equivalent strength and may avoid soft-tissue entrapment and subsequent loosening.