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Cerclage, evolution and potential of a Cinderella Technology : an overview with reference to periprosthetic fractures

Perren, S., Fernandez Dell'oca, A., Lenz, M., & Windolf, M. (2011) Cerclage, evolution and potential of a Cinderella Technology : an overview with reference to periprosthetic fractures. Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca, 78(3), pp. 190-199.

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Abstract

Periprosthetic fractures are increasingly frequent. The fracture may be located over the shaft of the prosthesis, at its tip or below (21). The treatment of explosion fractures is difficult because the shaft blocks the application of implants, like screws, which need to penetrate the medullary cavity. The cerclage, as a simple periosteal loop, made of wire or more recently cable, does not only avoid the medullary cavity. Its centripetal mode of action is well suited for reducing and maintaining radially displaced fractures. Furthermore, the cerclage lends itself well for minimally invasive internal fixation. New insight challenges the disrepute of which the cerclage technology suffered for decades. The outcome of cerclage fixation benefits from an improved understanding of its technology, mechano-biology and periosteal blood supply. Preconceived and generally accepted opinions like "strangulation of blood supply" need to be re-examined. Recent mechanical evaluations (22) demonstrate that the wire application may be improved but cable is superior in hand- ling, maintenance of tension and strength. Beside the classical concepts of absolute and relative stability a defined stability condition needs consideration. It is typical for cerclage. Called "loose-lock stability" it specifies the situation where a loosened implant allows first unimpeded displacement changing abruptly into a locked fixation preventing further dislocation.

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14 citations in Scopus
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13 citations in Web of Science®

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ID Code: 46396
Item Type: Journal Article
Additional URLs:
Keywords: fracture treatment, Periprosthetic, cerclage
ISSN: 0001-5415
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Orthopaedics (110314)
Divisions: Current > Institutes > Institute of Health and Biomedical Innovation
Deposited On: 11 Oct 2011 22:51
Last Modified: 11 Oct 2011 22:51

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