University of Texas Medical Branch, Department of Orthopaedic Surgery & Rehabilitation, Galveston, Texas.
Max Biedermann Institute for Biomechanics, Mount Sinai Medical Center, Department of Research, Miami Beach, Florida.
J Surg Orthop Adv. 2020 Winter;29(4):209-211.
Cerclage fixation following intraoperative fracture of the proximal femur during total hip arthroplasty (THA) carries a risk of compromising the femoral blood supply. Thus, we sought to determine the minimum cerclage cable tension required to restore the stability of a cementless femoral stem. Cementless femoral prostheses were implanted in seven proximal femoral cadaver specimens, and a periprosthetic fracture was simulated in the medial cortex. A single cerclage cable was placed just above the lesser trochanter and tensioned and tested at increasing intervals. The implant's torsional stability was determined in the intact bone, prior to fixation, and at each level of cable tension. We found that a single cerclage cable placed above the lesser trochanter can significantly improve, but not fully restore, torsional stability following intraoperative periprosthetic femur fracture during THA. The optimal position for a single cerclage cable appears to be above the lesser trochanter. (Journal of Surgical Orthopaedic Advances 29(4):209-211, 2020).
全髋关节置换术中股骨近端骨折内固定后行环扎固定，存在影响股骨血供的风险。因此，我们旨在确定恢复非骨水泥股骨柄稳定性所需的最小环扎索张力。在 7 个股骨近端尸体标本中植入非骨水泥股骨假体，并在股骨内侧皮质模拟假体周围骨折。在小转子上方放置一根单根环扎索，并在逐渐增加的间隔处进行张力测试。在完整的骨骼中，在固定之前以及在每个电缆张力水平下，确定植入物的扭转稳定性。我们发现，在全髋关节置换术中股骨近端假体周围骨折内固定后，在小转子上方放置一根单根环扎索可以显著提高，但不能完全恢复扭转稳定性。单根环扎索的最佳位置似乎在小转子上方。（《外科矫形进展杂志》29(4):209-211, 2020 年）。
