Distal Locking Plate Fixation With vs Without Cerclage Cables for Periprosthetic Femoral Fractures .
Periprosthetic fracture around a stable femoral stem treated with locking plate osteosynthesis: distal femoral locking plate alone versus with cerclage cable
Eur J Orthop Surg Traumatol. 2017 Jul;27(5):623-630.Twenty-four patients with periprosthetic fractures of the femoral stem were randomized to receive surgical fixation with cerclage cables (n=12) or without cerclage cables (n=12) for the maintenance of fracture reduction and fixation. The outcomes of interest included the Harris Hip Score (HHS), time to fracture union, operative time, incidence of fracture healing, ambulatory status, and the incidence of adverse events. Mean follow-up time was 24.7 and 25.3 months in the control group and cerclage cable group, respectively. Study findings revealed statistically significantly longer operative time in the cerclage cable group compared to the control group (p=0.019). No statistical significant differences were observed in HHS scores at final follow-up (p=0.844) or time to fracture union (p=0.198). In addition, 1 case of non-union and 1 case of infection were observed in the cerclage cable group. Also, 2 patients in the cerclage cable group required a walker for ambulation, and 1 patient in the control group required a cane for ambulation.
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