Biomechanical evaluation of cable and suture cerclages for tuberosity reattachment in a 4-part proximal humeral fracture model treated with reverse shoulder arthroplasty

Knierzinger, Dominik; Heinrichs, Christian Heinz; Hengg, Clemens; Konschake, Marko; Kralinger, Franz; Schmoelz, Werner

doi:10.1016/j.jse.2018.04.003

Cited by 21 publications

(13 citation statements)

References 31 publications

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“…Ethibond was fixed with a nice knot and titanium cable was fixed with a clamp. Ethibond this time had a lower load to failure than the titanium cable and Ethibond showed also a higher fragment motion than the titanium cable [ 8 ].…”

Section: Metallic Versus Non-metallic Cerclagementioning

confidence: 79%

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A review of metallic and non-metallic cerclage in orthopaedic surgery: Is there still a place for metallic cerclage?

Peeters

Depover

Tongel

et al. 2019

Injury

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Section: Metallic Versus Non-metallic Cerclagementioning

confidence: 79%

“…Knierzinger et al [ 8 ] compared Ethibond (size 6) to titanium cable (DePuy) (1.0 mm), again in tuberosity repair. Ethibond was fixed with a nice knot and titanium cable was fixed with a clamp.…”

Section: Metallic Versus Non-metallic Cerclagementioning

confidence: 99%

A review of metallic and non-metallic cerclage in orthopaedic surgery: Is there still a place for metallic cerclage?

Peeters

Depover

Tongel

et al. 2019

Injury

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“…However, studies have shown that when considering the load to failure, that is, the load at which a loss of strength and elasticity occurs and rupture happens, as the strength parameter, non-metallic compositions provide higher load resistance in shoulder prosthetic implant stabilization or tuberosity refixation in shoulder arthroplasty [ 12 , 14 ]; moreover, in proximal femur cerclage, 25% less strain over time has been observed for non-metallic cables [ 13 ]. However, using Ethibond, a different non-metallic cerclage configuration for proximal humerus fractures, Knierzinger reported a lower load to failure compared to metallic cables [ 21 ]. Camarda systematically evaluated the literature regarding patella fracture osteosynthesis with non-metallic cables, reporting a 90% success rate [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Metallic versus Non-Metallic Cerclage Cables System in Periprosthetic Hip Fracture Treatment: Single-Institution Experience at a Minimum 1-Year Follow-Up

Speranza

Massafra

Pecchia

et al. 2022

JCM

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Metallic cerclage cables are reliable and cost-effective internal fixation devices, which are largely used in surgical practice for the treatment of periprosthetic fractures. Nevertheless, complications connected with their use have been described in the literature, including the following: third-body generation, failure and consequent migration, fraying, allergies, and injury to the surgical team. The development of new materials offers alternatives to traditional metallic cables. This study compares the outcomes between two groups of patients affected by periprosthetic hip fractures, treated with titanium cables or with ultra-high-molecular-weight polyethylene (UHMWPe) iso-elastic cables. Our retrospective study aims to compare the clinical and radiological outcomes of titanium cables and UHMWPe iso-elastic cables, isolated or associated with dedicated plates, for the surgical treatment of periprosthetic fractures with stable implants. Two groups of 30 (group A—metallic cables) and 24 (group B—UHMWPe iso-elastic cables) patients have been surgically treated in our institution for hip periprosthetic fractures, between September 2017 and June 2020. The mean age of the patients was 81 years in group A and 80 years in group B. In our study, we included fractures classified as B1 or C, according to the Vancouver postoperative fractures classification; the patients were evaluated retrospectively at 1 year postoperatively, regarding the following: surgery time, blood loss, partial weight-bearing time, radiographical healing time, Harris hip score, and postoperative complications. Comparable outcomes were observed in patients from both groups. Group A showed a higher complication rate compared to group B, at 1 year postoperatively. Non-metallic nylon fiber and ultra-high-molecular-weight polyethylene (UHMWPe) cerclage cables could represent a reliable fixation device, ensuring comparable healing and complication rates with traditional titanium cerclage cables.

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“…This high external rotation is essential to activities in everyday life 37 . In a biomechanical cadaver study, Knierzinger et al determined load-to-failure advantages for 1 mm titanium alloy wire cerclage systems compared to non-resorbable fibre cerclage (1414 ± 372 cycles compared to 1257 ± 230 cycles) 40 . In our procedure we used wound multistrand 1.3 mm wire cerclages 10 .…”

Section: Discussionmentioning

confidence: 99%

Latest Trends in the Current Treatment of Proximal Humeral Fractures – an Analysis of 1162 Cases at a Level-1 Trauma Centre with a Special Focus on Shoulder Surgery

et al. 2021

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Background The management of proximal humeral fracture (PHF) is not only complex but ever changing. Published epidemiological data are often dated and do not factor in demographic changes or the latest developments in implant material and surgical techniques. Aims The primary aim of this study was to evaluate changes in the epidemiology and actual treatment of PHF at a level-1 trauma centre, with a special focus on shoulder surgery. Hypotheses 1. Between 2009 to 2012 and 2014 to 2017, an increase in complex PHF entities can be observed. 2. In correlation with fracture complexity, an increasing number of comorbidities, especially osteoporosis, can be observed. Methods Between 2014 and 2017, a total of 589 patients (73% female; mean age: 68.96 ± 14.9 years) with 593 PHFs were treated. Patient records and imaging (XRs and CTs) of all patients were analysed. Fractures with ad latus displacement of a maximum of 0,5 cm and/or humeral head angulation of less than 20° were classified as non-displaced. Patients with displaced fractures were included in the analysis of the therapeutic algorithm. These results were compared to those of a cohort 2009 to 2012 (566 patients, 569 PHFs), which used the same inclusion criteria. Results The two cohorts showed comparable patient numbers, as well as gender and age distributions. Between 2009 to 2012 and 2014 to 2017, a decrease in 2-part fractures (13.9 to 8.6%) and a simultaneous increase in 4-part fractures (20.4 to 30%), and thus fracture complexity was observed. Further decreases were observed in conservative therapy (27.8 to 20.6%), nail osteosynthesis (10.7 to 2.7%) and anatomic shoulder arthroplasty (5,4 to 1%). Furthermore, there was an increase in the use of locking plate osteosynthesis (43.2 to 56.7%) and reverse shoulder arthroplasty (9 to 18.4%). The general trend shows an increase in surgical therapy between the years (72.2 to 79.4%), as well as an increase in osteoporosis incidence (13 to 20.6%). The greatest numbers of comorbidities were found in 3- and 4-part fractures. Conclusion There is an increase in both the complexity of fractures and the number of surgically treated fractures between 2009 and 2012. Furthermore, an increase in osteoporosis numbers can be observed. New implants (PEEK, fenestrated screws for cement augmentation) and new surgical techniques (double plating osteosynthesis) were used as a result of increasing fracture complexity. Moreover, reverse total shoulder arthroplasty was used more commonly.

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Biomechanical evaluation of cable and suture cerclages for tuberosity reattachment in a 4-part proximal humeral fracture model treated with reverse shoulder arthroplasty

Cited by 21 publications

References 31 publications

A review of metallic and non-metallic cerclage in orthopaedic surgery: Is there still a place for metallic cerclage?

A review of metallic and non-metallic cerclage in orthopaedic surgery: Is there still a place for metallic cerclage?

Metallic versus Non-Metallic Cerclage Cables System in Periprosthetic Hip Fracture Treatment: Single-Institution Experience at a Minimum 1-Year Follow-Up

Latest Trends in the Current Treatment of Proximal Humeral Fractures – an Analysis of 1162 Cases at a Level-1 Trauma Centre with a Special Focus on Shoulder Surgery

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