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Butare-Smith et al: Double-loop cerclage resists greater loads for more cycles than twist and single-loop cerclage
Veterinary Surgery 2, 2022

🔍 Key Findings

  • Double-loop cerclage resisted the highest peak load (805 N) and maintained tension longer than twist (488 N) and single-loop (397 N) configurations.
  • Double-loop cerclage sustained 500,000 cycles at 60–80% of peak load in some cases without loosening, outperforming other types.
  • Twist knots loosened rapidly, often within 10 cycles even at low loads (100–390 N).
  • Single-loop knots performed better than twist, with partial resistance up to 100,000 cycles at 160 N, but showed wide variability.
  • All loosening occurred before wire breakage, indicating clinical failure would happen from slack, not fracture.
  • Double-loop cerclage had highest initial tension (323 N) compared to single-loop (124 N) and twist (69 N).
  • Fatigue limit was not identified for twist, since they all loosened early at even 20% of peak load.
  • Clinical recommendation: double-loop cerclage is best for resisting repeated subfailure loading, ideal for fissure prevention or fragment stabilization.

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← Articles

Butare-Smith et al: Double-loop cerclage resists greater loads for more cycles than twist and single-loop cerclage
Veterinary Surgery 2, 2022

🔍 Key Findings

  • Double-loop cerclage resisted the highest peak load (805 N) and maintained tension longer than twist (488 N) and single-loop (397 N) configurations.
  • Double-loop cerclage sustained 500,000 cycles at 60–80% of peak load in some cases without loosening, outperforming other types.
  • Twist knots loosened rapidly, often within 10 cycles even at low loads (100–390 N).
  • Single-loop knots performed better than twist, with partial resistance up to 100,000 cycles at 160 N, but showed wide variability.
  • All loosening occurred before wire breakage, indicating clinical failure would happen from slack, not fracture.
  • Double-loop cerclage had highest initial tension (323 N) compared to single-loop (124 N) and twist (69 N).
  • Fatigue limit was not identified for twist, since they all loosened early at even 20% of peak load.
  • Clinical recommendation: double-loop cerclage is best for resisting repeated subfailure loading, ideal for fissure prevention or fragment stabilization.

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Multiple Choice Questions on this study

In Butare-Smith 2022 et al., on cerclage knot biomechanics, what was concluded about the clinical use of double-loop cerclage?

A. Unsuitable for clinical use
B. Inferior to twist knots
C. Equivalent to single-loop
D. Best for resisting repeated loads
E. Not used in orthopedic applications

Answer: Best for resisting repeated loads

Explanation: Authors concluded double-loop cerclage is most secure for managing fissures or fragment stabilization.
In Butare-Smith 2022 et al., on cerclage knot biomechanics, what was the peak load resisted by double-loop cerclage in single-load testing?

A. 397 N
B. 488 N
C. 640 N
D. 805 N
E. 124 N

Answer: 805 N

Explanation: Double-loop cerclage resisted a mean peak load of 805 N, the highest among all groups.
In Butare-Smith 2022 et al., on cerclage knot biomechanics, which cerclage knot had the **highest initial tension** before testing?

A. Twist knot (69 N)
B. Single-loop knot (124 N)
C. Double-loop knot (323 N)
D. Square knot (45 N)
E. All were equal

Answer: Double-loop knot (323 N)

Explanation: Double-loop had significantly higher resting tension, contributing to better fatigue resistance.
In Butare-Smith 2022 et al., on cerclage knot biomechanics, what was the typical failure mode of the twist cerclage under cyclic loading?

A. Wire breakage at knot
B. Wire slippage through bone
C. Knot tightening too much
D. Wire elongation over 3 mm
E. Knot untwisting and loosening

Answer: Knot untwisting and loosening

Explanation: Twist cerclage consistently failed by untwisting, often within 10 cycles.
In Butare-Smith 2022 et al., on cerclage knot biomechanics, which knot type demonstrated the highest resistance to cyclic loading before loosening?

A. Twist cerclage
B. Single-loop cerclage
C. Double-loop cerclage
D. Square knot cerclage
E. Knot-twist cerclage

Answer: Double-loop cerclage

Explanation: Double-loop cerclage resisted up to 500,000 cycles at high loads, outperforming other configurations.

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