Biomechanical Comparison of Surgical Steel Wiring and Suture Tape Tension Band Techniques for Arthrodesis of the Metacarpophalangeal and Proximal Interphalangeal Joint

Abstract

Purpose: The purpose of this study was to evaluate the biomechanical properties of SutureTape as an alternative technique for arthrodesis of the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint arthrodesis when compared with surgical steel wire.

Methods: A total of 32 fingers (index, long, ring, and small) from two matched pair cadaveric hands were used. K-wire and surgical steel wire were used for MCP and PIP joint arthrodesis of the control group (group I), whereas K-wire and SutureTape were used for the experimental group (group II). Each sample was potted in high strength resin and secured to a custom fixture mounted to a hydraulic test frame. Each sample underwent cantilever bending in four directions (flexion, extension, ulnar, and radial) at a rate of 0.01 mm/s until a maximum force of 10 N. Thereafter, ramp to failure in extension at a rate of 20 mm/min was performed. Metrics of interest were bending stiffness (N/mm), displacement (mm), and peak load to failure (N), along with failure modes.

Results: For MCP arthrodesis, during cantilever bending in flexion direction, surgical steel construct was found to be stiffer when compared with suture tape (P = .036) and have less displacement (P = .040). No significant differences were detected for stiffness or displacement in extension, ulnar, or radial bending. During the ramp to failure, no significant differences were found for force, stiffness, or displacement. For PIP arthrodesis, the only significant difference detected was for displacement during ulnar bending (P = .035).

Conclusions: For MCP and PIP arthrodesis, the biomechanical performance of the SutureTape arthrodesis was similar to that of the steel wire across all loading conditions except for flexion and ulnar loading.

Clinical relevance: The use of SutureTape for MCP and PIP joint arthrodesis may provide equivalent biomechanical performance to that of steel wire, making it a viable alternative clinically.

Keywords: Arthrodesis stability; Biomechanics; Fusion; MCP joint; PIP joint.