Percutaneous cerclage wiring for reduction of periprosthetic and difficult femoral fractures. A technical note

Intraoperative Periprosthetic Femur Fracture: A Biomechanical Analysis of Cerclage Fixation

“…Additionally, very little biomechanical information is available for intraoperative periprosthetic femur fractures repaired using synthetic cerclage cables in comparison with metallic cerclage systems. Although cerclage cable provides more strength than twisted monofilament wire, cable use can be more challenging in less invasive surgery as the cable crimping instrument cannot pass through a small incision [18][19][20][21]. The growing popularity of minimally invasive procedures has led to a renewed interest in wire cerclage systems.…”

“…A number of options have been proposed ranging from combinations of long stem femoral components, extramedullary fixation with cerclage cables, plates, and strut grafts [6][7][8]15,17]. Several studies have previously demonstrated differences in fixation technique and biomechanical advantages of various cerclage constructs in fixation of periprosthetic femur fractures [8,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Although metallic cerclage cables have been previously shown to provide more strength than twisted monofilament wire, cable use is associated with other complications and limitations in minimally invasive applications [18][19][20][21][22]32].…”

“…Several studies have previously demonstrated differences in fixation technique and biomechanical advantages of various cerclage constructs in fixation of periprosthetic femur fractures [8,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Although metallic cerclage cables have been previously shown to provide more strength than twisted monofilament wire, cable use is associated with other complications and limitations in minimally invasive applications [18][19][20][21][22]32]. As a result, there has been a renewed interest in wire cerclage systems and newer materials such as synthetic cables have emerged as potential alternatives to traditional metallic cables [23][24][25][33][34][35].…”

The outcome in early Cases of Treatment of Subtrochanteric Fractures with Proximal Femur locking Compression Plate

“…19,20 Unlike cephalomedullary nail, PF-LCP allows circumferential wire without additional incision. Cerclage wiring is an alternative technique to achieve reduction in difficult fractures 21,22 From recent cadaveric study, cerclage wiring resulted in only minimal disruption of femoral blood supply 23 . In this study, cerclage wiring was used to achieve near-anatomic reduction in some cases and had less complication statistically compared with the group without cerclage wire ( Figure 3).…”

Minimally Invasive Plate Osteosynthesis for Periprosthetic and Interprosthetic Fractures Associated with Knee Arthroplasty: Surgical Technique and Review of Current Literature

“…Percutaneous cerclage wiring has been found to result in minimal disruption of the femoral blood supply including the associated perforators. 5 However, the neurovascular structures are at great risk in the distal half of the femur and reduction techniques utilizing percutaneous cerclage should be performed with caution. Typically, one wire loop for an oblique fracture, two separate wire loops for a spiral fracture, and two or three independent loops for a comminuted fracture are required.…”