PubMed · 3268486
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1988. Craniofacial trauma.. https://pubmed.ncbi.nlm.nih.gov/3268486/
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AIM: This investigation was carried out to compare Dimac wires with arch bars for interdental immobilization. MATERIAL AND METHODS: The assessment was conducted on 50 patients who had mandibular fractures and in whom intermaxillary fixation was required as a part of the treatment. The time required for applying each method of fixation, the needle-stick injuries that occurred during their application, and the periodontal damage that followed interdental immobilization was investigated. RESULTS: The mean time required for the application of Dimac wires was significantly less than that required for arch bars. The needle-stick injuries were significantly less with Dimac wires. Patients reported difficulty with oral hygiene with arch bars in place. This was associated with periodontal damage following removal of fixation. CONCLUSION: Dimac wires is safer to use and less traumatic to the periodontium
The increase in violent crime has lead to an increase in gunshot-induced fractures in the United States. Injuries to the upper extremity are common. The treatment of gunshot injuries depends on the extent of soft tissue disruption and the type and location of fracture. Most of these injuries are a result of low-energy gunshot wounds that may be treated conservatively under the appropriate conditions. Low-energy fractures that require operative stabilization may be done with predictable results for achieving union with intramedullary fixation or compression plating. Complex open fractures from gunshot wounds associated with neurovascular injuries present a therapeutic challenge to the orthopaedic surgeon. The fractures associated with these injuries often are comminuted and unstable. Bone loss is common. Soft tissue disruption plays a more important role in high-energy gunshot-induced fractures. In these cases, external fixation is the treatment of choice for stabilization. Recent advances in the use of external fixation have led to quick fracture stabilization, stability for vascular repair, and access to the wound for debridement and subsequent soft tissue surgery.
OBJECTIVES: This study determined the tensile properties of 18-gauge stainless steel wire, 5-mm woven polyester (Mersilene) tape, and multiple loop configurations of No. 5 braided polyester suture (Ethibond). DESIGN: Mechanical property testing. INTERVENTION: Single loops of stainless steel wire, Mersilene, and Ethibond were tested to determine their mechanical properties. Ethibond was tested with different numbers of loops and different knot configurations. MAIN OUTCOME MEASURES: Stiffness, load at failure, and elongation at failure. RESULTS: One loop of Mersilene and two loops of Ethibond had similar loads at failure, but the load at failure was significantly higher for stainless steel wire. Four loops of Ethibond withstood a similar failure load to stainless steel wire, but the failure load of the Ethibond suture was greater than the yield load of stainless steel wire. Stainless steel wire had a higher stiffness than both Ethibond and Mersilene. No difference was found in the failure load between different Ethibond knot configurations. The individually tied suture configuration resulted in a higher stiffness than the single-knot configuration. The elongation at failure was not statistically different among the different knot configurations and materials, with the exception of Mersilene tape. Mersilene tape demonstrated a significant increase in elongation at failure as compared to the other materials and knot configurations. CONCLUSION: It appears that multiple loops of Ethibond can substitute for stainless steel wire in situations where a compliant repair is suitable (support of a patellar tendon repair), but may not be satisfactory for rigid fixation (tension band fixation of a fracture). There appears to be no significant difference in strength but a small decrease in stiffness between tying multiple suture loops in one knot as opposed to individual knots.