Do Cerclage Cables Delay the Time to Bone Union in Patients with an Unstable Humeral Shaft Fracture Treated with Intramedullary Nails?

Han, Kyeong Jin; Lee, Doo‐Hyung; Bang, Joon Young

doi:10.3349/ymj.2017.58.4.837

Cited by 6 publications

(5 citation statements)

References 21 publications

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“…One study was written in German [ 49 ], and the remaining studies were written in English. 24 studies were conducted in Asia [ 11 – 13 , 15 – 18 , 20 , 22 – 25 , 27 , 30 , 31 , 33 , 36 – 38 , 40 – 42 , 44 , 46 , 48 ], six in Europe [ 21 , 32 , 39 , 45 , 47 , 49 ], five in South-America [ 14 , 19 , 26 , 34 , 43 ], three in North-America [ 9 , 10 , 35 ] and one in Africa [ 8 ].…”

Section: Resultsmentioning

confidence: 99%

“…11 studies [ 11 – 13 , 15 , 21 , 30 , 33 , 37 , 38 , 42 , 49 ] assessed the outcome of intramedullary nailing, describing a total of 385 patients. In seven patients (2%), treatment was complicated by secondary RNP (Table 6 ).…”

Section: Resultsmentioning

confidence: 99%

“…21 studies [ 8 , 10 – 15 , 17 , 19 , 21 – 23 , 25 , 27 , 33 , 35 , 36 , 40 , 42 , 44 , 48 ], with a weighted mean follow-up of 19 months, described the recovery from secondary RNP. 51 out of 54 patients with secondary RNPs recovered without reintervention (94%) (Table 5 ).…”

Section: Resultsmentioning

confidence: 99%

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Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients

Hendrickx

Hilgersom

Alkaduhimi

et al. 2020

Arch Orthop Trauma Surg

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Background and purpose Humeral shaft fractures are often associated with radial nerve palsy (RNP) (8-16%). The primary aim of this systematic review was to assess the incidence of primary and secondary RNP in closed humeral shaft fractures. The secondary aim was to compare the recovery rate of primary RNP and the incidence of secondary RNP between operative and non-operative treatment. Methods A systematic literature search was performed in 'Trip Database', 'Embase' and 'PubMed' to identify original studies reporting on RNP in closed humeral shaft fractures. The Coleman Methodology Score was used to grade the quality of the studies. The incidence and recovery of RNP, fracture characteristics and treatment characteristics were extracted. Chi-square and Fisher exact tests were used to compare operative versus non-operative treatment. Results Forty studies reporting on 1758 patients with closed humeral shaft fractures were included. The incidence of primary RNP was 10%. There was no difference in the recovery rate of primary RNP when comparing operative treatment with radial nerve exploration (98%) versus non-operative treatment (91%) (p = 0.29). The incidence of secondary RNP after operative and non-operative treatment was 4% and 0.4%, respectively (p < 0.01). Interpretation One-in-ten patients with a closed humeral shaft fracture has an associated primary RNP, of which > 90% recovers without the need of (re-)intervention. No beneficial effect of early exploration on the recovery of primary RNP could be demonstrated when comparing patients managed non-operatively with those explored early. Patients managed operatively for closed humeral shaft fractures have a higher risk of developing secondary RNP. Level of evidence Level IV; Systematic Review.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients

Hendrickx

Hilgersom

Alkaduhimi

et al. 2020

Arch Orthop Trauma Surg

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“…Documentation of the first use of cerclage wire dates back to 1775 [2]. It has become an option in different areas such as fixation of unstable intertrochanteric, acetabular, periprosthetic fractures of femur, humerus, elbow, revision total hip arthroplasties in combination with other implants [3][4][5][6][7][8][9]. In recent years, the use of cerclage wire has increased as a result of the increase of periprosthetic fractures, and in this situation there is increasing interest in the cerclage wire techniques, which provide augmentation and make fixation more stable.…”

Section: Introductionmentioning

confidence: 99%

Augmentation of cerclage wire strength with a basic knot technique: A biomechanical study

Şahin,

Karakaşlı,

Uzun

et al. 2021

Ann Clin Anal Med

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Aim: Loosing of cerclage wire is a common problem in the fixation of fractures and alternative techniques are required to provide more strength cable systems. The aim of this study was to evaluate the benefit of an additional knot to the cable system to increase durability and strength of wire Material and Methods: Twelve artificial bone fragments were bisected thoroughly in the coronal plane. Two mm diameter CoCr Dall Miles were used in two groups; the first group was the sleeve group (n=6) and the second group was the sleeve + knot group (n=6). All cables were once looped around the saw bone with positioning the sleeve at the beaded end of the cable, and the tensioner knob was used to create tension to 90 lb/in2 (62,05 N/cm2). In the sleeve + knot group, one more simple knot was performed with conventional surgery skill, and the two ends of cerclage wire were put into the tensioner knob to create tension again. Mechanical tension testing was performed at a velocity of 20mm/min. Axial tension force was applied until failure. The maximum force and displacement values were recorded at the failure point. Results: There was a significant difference in the mean rank of applied force between the sleeve and sleeve + knot groups (p=0,025). However, there was no statistical difference in the amount of displacement between the two groups (p=0,378). The ratio of force/displacement displayed a significant difference between the two groups, it was shown that the sleeve + knot group was more durable than the sleeve only group (p=0,01). Discussion: Adding a knot to the cable system increases the durability and strength of the cable system by approximately %40. These findings showed that adding a knot to the cable-domino system had decreased the possibility of loosening and fixation failure.

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“…However, contemporary interlocking nails showed similar results in fracture healing in comparison with plating 15,16 . It can be difficult to perform closed reduction or obtain the required stability from fixation with an intramedullary nail in highly unstable fractures of the humeral shaft in which there are complex or severely displaced fragments, and such difficulties could result in delayed union or non-union 17 . In our study, it was hypothesized that using interlocking neutralization screws through fracture site would improve stability and reduce fracture gap, thus promoting union.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Humeral Shaft Fractures: Antegrade Interlocking Intramedullary Nailing with Additional Interlocking Neutralization Screws through Fracture Site

Vidović

Benčić

Ćuti

et al. 2019

ACC

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The aim of this study was to compare union time between two different nail designs for the treatment of humeral shaft fracture, i.e. antegrade interlocking intramedullary nail with and without additional interlocking neutralization screws. The retrospective study included 51 patients treated with antegrade humeral intramedullary nailing between January 2015 and December 2017. The inclusion criteria of the study were proximal and middle third humeral shaft fractures. Fifty-one patients met the inclusion criteria; 23 patients were treated with antegrade intramedullary nail with additional interlocking neutralization screws through fracture site (group A) and 28 patients were treated with antegrade intramedullary nail without additional interlocking neutralization screws (group B). Medical documentation and radiographic images taken preoperatively and postoperatively were reviewed. Radiological union was defined as cortical bridging of at least three of four cortices in two-plane radiographs, with disappearance of the fracture gap. There were no significant differences in union time between the groups (p>0.05). To our knowledge, this is the first report of antegrade interlocking humeral nailing with additional interlocking neutralization screws through fracture site. Hypothetical advantages of fracture gap reduction by additional interlocking neutralization screws to promote union were not confirmed by this first clinical trial.

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Do Cerclage Cables Delay the Time to Bone Union in Patients with an Unstable Humeral Shaft Fracture Treated with Intramedullary Nails?

Cited by 6 publications

References 21 publications

Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients

Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients

Augmentation of cerclage wire strength with a basic knot technique: A biomechanical study

Treatment of Humeral Shaft Fractures: Antegrade Interlocking Intramedullary Nailing with Additional Interlocking Neutralization Screws through Fracture Site

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