Risk of Injury to Neurovascular Structures During Open Cerclage Wiring of the Femur: A Cadaveric Study.

The objective of this study was to examine the risk to the sciatic nerve and femoral artery during open passage of cerclage wires and to evaluate the safest techniques. After a standard lateral approach, cerclage passes along the femur were made in cadaveric specimens. Distance to the sciatic nerve and femoral artery was recorded. Careful technique resulted in an increase in distance to the sciatic nerve and femoral artery. There was an increase in the distance to the femoral artery with passes in an anterior to posterior direction. There was decreased distance to structures proximally and distally. There was a trend toward increased safety with smaller passers. Open cerclage wiring of the femur is safest if proper technique is used, care is taken at the proximal and distal ends of the femur, passes are made in an anterior to posterior direction, and the smallest cerclage passer that can be passed is utilized.