Is suture-based cerclage biomechanically superior to traditional metallic cerclage for fixation of periprosthetic femoral fractures: A matched pair cadaveric study

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-10-16 DOI:10.1016/j.clinbiomech.2024.106362

Shuyang Han , Robert Frangie , Nicholas D. Lanfermeijer, Jonathan E. Gold, Sabir K. Ismaily, Andrew Yoo, Camryn A. Pletka, David Rodriguez-Quintana

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Abstract

Background

While traditional metallic cerclage remains the primary method in clinical application, non-metallic cerclage systems have recently gained popularity due to low risks of soft tissue irritation and bone intrusion. The objective of this study was to assess the performance of a novel non-metallic suture-based cerclage in comparison to traditional metallic cerclage cables for fixation of periprosthetic femoral fractures.

Methods

An extended trochanteric osteotomy was performed on eight pairs of cadaveric femora, followed by reduction using either metallic cerclages (Group I) or the suture-based cerclage (Group II). A modular tapered fluted stem was then implanted in each specimen. The fragment translation during canal preparation and stem implantation was quantified using laser-scanning. Subsequently, each specimen underwent 500 cycles of multiaxial loading, with fragment translation and stem subsidence measured using a motion capture system.

Findings

Following stem implantation, specimens in Group II exhibited a significantly greater lateral fragment translation (466 μm vs 754 μm, p = 0.017). However, there were no significant differences in anterior and distal translation between groups (p > 0.05). During multiaxial loading, the average stem subsidence in Group I was 0.36 mm (range, 0.04–1.42 mm), compared to 0.41 mm (range, 0.03–1.29) in Group II (p > 0.05). No significant difference was found in fragment translations between the two groups (p > 0.05).

Interpretation

The suture-based cerclage system exhibited comparable biomechanical performance in fixation stability to conventional metallic cerclage cables. Yet, it was associated with a larger residual lateral gap between the fragments following stem implantation. Ultimately, the choice of fixation method should account for multiple factors, including patient characteristics, surgeon preference, and bone quality.

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在固定股骨假体周围骨折时，缝合式陶瓷包扎在生物力学上是否优于传统的金属陶瓷包扎：一项配对尸体研究。

背景：尽管传统的金属颅内固定仍是临床应用的主要方法，但非金属颅内固定系统因其对软组织刺激和骨侵入的风险较低而在近期受到欢迎。本研究的目的是评估一种新型非金属缝合型cerclage与传统金属cerclage钢缆在固定股骨假体周围骨折方面的性能比较：在八对尸体股骨上进行了股骨粗隆截骨术，然后使用金属铈环（I组）或缝合铈环（II组）进行复位。然后在每个标本中植入模块化锥形凹槽柄。使用激光扫描量化了牙槽预备和牙杆植入过程中的片段平移。随后，每个标本接受了500个周期的多轴加载，并使用运动捕捉系统测量了片段平移和骨干下沉：结果：植入骨干后，II组标本显示出明显更大的侧向片段平移（466 μm vs 754 μm，p = 0.017）。不过，各组之间的前移和远移没有明显差异（p > 0.05）。在多轴加载期间，I组的骨干平均下沉0.36毫米（范围：0.04-1.42毫米），而II组为0.41毫米（范围：0.03-1.29）（p > 0.05）。两组患者的骨折片移位无明显差异（P>0.05）：解读：缝合线cerclage系统在固定稳定性方面的生物力学表现与传统金属cerclage电缆相当。解读：缝合式cerclage系统在固定稳定性方面的生物力学性能与传统的金属cerclage电缆相当，但在植入骨干后，碎片之间的残留侧向间隙较大。最终，固定方法的选择应考虑多种因素，包括患者特征、外科医生偏好和骨质。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.