Femoral artery entrapment after cerclage wiring of distal femoral shaft fracture: A case report

Gunadham, Ukris; Kongkreangkrai, Thumrong

doi:10.1016/j.jotr.2018.05.004

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…However, the 360-degree wrap around the bone has the potential nerve and blood vessel damage. [14][15][16] By contrast, the C-clip does not require a 360-degrees wrap and so avoids large vessel and nerve injury and so, has advantages over cerclage wiring. In addition, the C-clip will enable early rehabilitation because unlike cerclage wiring, it preserves the linea aspera and so is beneficial for the movement of thigh muscles.…”

Section: Discussionmentioning

confidence: 99%

Unstable Vancouver B1 periprosthetic femoral fracture fixation: A biomechanical comparison between a novel C-shaped memory alloy implant and cerclage wiring

Oh,

Suh,

Eghan-Acquah

et al. 2024

J Int Med Res

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Background To compare the biomechanical stability of a novel, C-shaped nickel–titanium shape memory alloy (SMA) implant (C-clip) with traditional cerclage wiring in the fixation of a Vancouver B1 (VB1) periprosthetic femoral fracture (PFF). Methods In total, 18 synthetic femoral fracture models were constructed to obtain unstable VB1 fracture with an oblique fracture line 8 cm below the lesser trochanter. For each model, the distal portion was repaired using a 10-hole locking plate and four distal bi-cortical screws. The proximal portion was repaired using either three, threaded cerclage wirings or three, novel C-shaped implants. Specimens underwent biomechanical testing using axial compression, torsional and four-point bending tests. Each test was performed on three specimens. Results The C-clip was statistically significantly stronger (i.e., stiffer) than cerclage wiring in the three biomechanical tests. For axial compression, medians (ranges) were 39 (39–41) and 35 (35–35) N/mm, for the C-clip and cerclage wiring, respectively. For torsion, medians (ranges) were, 0.44 (0.44–0.45) and 0.30 (0.30–0.33) N/mm for the C-clip and cerclage wiring, respectively. For the four-point bending test, medians (ranges) were 39 (39–41) and 28 (28–31) N/mm; for the C-clip and cerclage wiring, respectively. Conclusion Results from this small study show that the novel, C-shaped SMA appears to be biomechanically superior to traditional cerclage wiring in terms of stiffness, axial compression, torsion and four-point bending, and may be a valuable alternative in the repair of VB1 PFF. Further research is necessary to support these results.

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Section: Discussionmentioning

confidence: 99%

Unstable Vancouver B1 periprosthetic femoral fracture fixation: A biomechanical comparison between a novel C-shaped memory alloy implant and cerclage wiring

Oh,

Suh,

Eghan-Acquah

et al. 2024

J Int Med Res

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“…38,39 However, they risk disrupting the blood supply to the bone when stripping the periosteum to pass the wire and possibly injuring neurovascular structures. [40][41][42] Furthermore, their use has been questioned since their contribution to overall construct stiffness is in-…”

Section: Discussionmentioning

confidence: 99%

The Biomechanical Performance of Different Plate Fixation Configurations to Repair Vancouver Type C Periprosthetic Femur Fractures

Kheir,

Abbasian,

Momenzadeh

et al. 2023

SurgiColl

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Objectives The incidence of femoral periprosthetic fractures (PPF) is rising. Vancouver type C PPFs compromise the majority type of fracture associated with high complication rates. The complexity of Vancouver C-type PPFs lies in the presence of the femoral stem in the proximal fracture fragment. This study compares the biomechanical performance of four plate fixation configurations to repair Vancouver type C periprosthetic femur fractures. Methods Six large adult 4th generation biomechanical low-density femur Sawbones instrumented with cemented femoral stems were used to conduct this study. A comminuted Vancouver-type C PPF was simulated and fixed with a plate. Four proximal fragment construct configurations were studied with combinations of unicortical screws, bicortical screws, and cerclage cable fixation. Constructs were loaded in axial compression and four-point bending, and the stiffness was calculated. Results Constructs with bicortical screw fixation had significantly greater stiffness than those with unicortical screw and cerclage cable fixation in axial and four-point bending loads. Constructs with cerclage cable and unicortical screw fixation had greater stiffness than ones with unicortical screw fixation. Conclusion Using bicortical screws in the proximal construct of Vancouver type C PPFs increases construct stiffness in axial and bending loads. Though controversial, using cerclage cables might have a place for construct augmentation when using only unicortical screws or a combination of unicortical and bicortical screws.

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“…Although some recently developed wire clamp for minimal invasive aimed was used, it has to be used under the uoroscopy and in uenced by the surgeon's feeling 15 . Therefore, it is not possible to be free from radiation hazards and the complication of large vessel injury 16,17 . Of course, C-clip has not only advantages.…”

Section: Discussionmentioning

confidence: 99%

Unstable Vancouver B1 Periprosthetic Femoral Fracture Fixation: A Biomechanical Comparison Between Cerclage Wiring and C-Shaped Shape Memory Alloy Implant

Suh

Eghan-Acquah

et al. 2020

Preprint

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Although cerclage wiring is a very useful implant, it has many problems. We manufactured an alphabet C-shaped clip with nitinol (C-clip) that has superelastic property to replace the cerclage wiring.This study aimed to compare the biomechanical stability of cerclage cable and the C-clip. Eighteen synthetic femora were tested. An unstable VB1 fractures model was constructed that oblique fracture line was 8cm below the lesser trochanter with fracture gab. The distal fixation was repaired with a locking plate and four bi-cortical screws. The proximal fixation was repaired two different methods: (1) four-threaded cerclage cables and (2) four new C-clip. In axial compression test, the C-clip was stiffer than the cerclage cable (median stiffness of C-clip = 39.28 N/mm [IQR; 38.84-41.19], cerclage cable = 34.90 N/mm [34.84-35.08], p<0.05). In the torsion test, the C-clip was 0.44 Nm/° [IQR; 0.44-0.45] and cerclage cable = 0.30 Nm/° [0.30-0.33], p<0.05). In the four-point bending test, the C-clip = 39.35 N/mm [IQR; 38.91-40.97] and cerclage cable = 28.38 N/mm, [28.33-30.79], p<0.05) The C-clip may be biomechanically superior to cerclage wiring in terms of stiffness, axial compression, torsion, and four-point bending tests and is a valuable alternative in Vancouver type B1 periprosthetic femoral fracture.

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Femoral artery entrapment after cerclage wiring of distal femoral shaft fracture: A case report

Cited by 6 publications

References 9 publications

Unstable Vancouver B1 periprosthetic femoral fracture fixation: A biomechanical comparison between a novel C-shaped memory alloy implant and cerclage wiring

Unstable Vancouver B1 periprosthetic femoral fracture fixation: A biomechanical comparison between a novel C-shaped memory alloy implant and cerclage wiring

The Biomechanical Performance of Different Plate Fixation Configurations to Repair Vancouver Type C Periprosthetic Femur Fractures

Unstable Vancouver B1 Periprosthetic Femoral Fracture Fixation: A Biomechanical Comparison Between Cerclage Wiring and C-Shaped Shape Memory Alloy Implant

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