The pullout strength of titanium alloy MRI-compatible and stainless steel MRI-incompatible Gardner-Wells tongs.

The stainless steel Gardner-Wells tongs and pins previously employed to reduce cervical spine fractures are increasingly being replaced by magnetic resonance imaging (MRI)-compatible graphite tongs and titanium pins. Concern regarding the relative pullout strengths of these two systems, however, prompted the performance of a cadaver study in which tongs and pins were placed in 10 cadaver skulls and tested to failure. The MRI-compatible tongs failed due to plastic deformation of the titanium pin tips resulting in tong slippage and loss of fixation, whereas the stainless steel tongs and pins failed when the skull fractured. These results indicated that MRI-compatible systems must be used with extreme caution, particularly when traction exceeds 50 pounds.