This study supports existing limited clinical data suggesting no functional differences exist between 2 common repair methods. Further biomechanical and clinical investigations directly comparing the results of distal biceps tendon repairs made to the anterior aspect versus the posterior aspect of the tuberosity are necessary to definitely determine if differences exist in resultant elbow flexion and forearm supination functions.

The goal of this study was to determine whether a difference in cycles to failure or mode of failure would be observed among specimens of 3 high-strength suture materials, and whether different suture configurations would affect knot security. Ten representative specimens of Ethibond (Ethicon, Inc, Somerville, New Jersey), FiberWire (Arthrex, Inc, Naples, Florida), MaxBraid (Biomet, Inc, Warsaw, Indiana), and Orthocord (DePuy Orthopaedics, Warsaw, Indiana) were tied in 6 different knot configurations commonly used in orthopedic procedures. Each specimen was cyclically loaded between 9 and 180 N at a rate of 1 Hz until the specimen failed or reached a maximum of 3500 cycles. Each suture material was subjected to tensile loading until failure at a rate of 1.25 mm/s. The 3 most secure knots all included the 3 reverse half-hitch on alternating posts (3-RHAP) configuration. All specimens tied with these 3 knot types failed by suture rupture. All knots using the overhand with 3 of the same half-hitches on the same post (O-3SHSP) configuration failed by knot slippage regardless of suture material. When the 3 strongest knots were combined, FiberWire resisted a significantly greater number of fatigue cycles than Orthocord or MaxBraid. In the single load to failure tests, Orthocord, FiberWire, and MaxBraid all had significantly higher ultimate strength than Ethibond. Knots using the 3-RHAP configuration provide security superior to that of those without this configuration. All 3 high-strength sutures tested outperformed Ethibond in single load to failure testing, with FiberWire resisting the greatest number of cycles. Postoperative strength and reliability of a soft tissue repair is inherently dependent on the properties of the suture materials used.

Although much has been written on the evaluation and management of pelvic ring injuries, only a single case of anterior sacroiliac joint dislocation exists in the literature and was reported in 1976. This article describes 2 additional cases, 1 of a pure anterior sacroiliac dislocation in a 25-year-old man, and 1 of an anterior sacroiliac fracture-dislocation in an 18-year-old man, each treated by a different orthopedic traumatologist at neighboring trauma centers. Both cases were the result of high-energy trauma, and both patients had significant complications resulting from severity of their injuries, including wound dehiscence and causalgia in 1 case and persistent L5-S1 paresthesias and paresis in the other. Closed reduction can be attempted, but in our experience was unsuccessful even with the use of external fixation pins for leverage. We recommend open reduction by an orthopedic traumatologist who will perform definitive fixation. The decision to use an anterior external fixation frame to assist during the patient's resuscitation should be based on the patient's hemodynamic status and concomitant injuries. Despite a high complication rate, operative intervention can return patients to a functional level with minimal residual pain.