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Are Subtrochanteric Cerclage Wires Really the Work of the Devil?

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Are Subtrochanteric Cerclage Wires Really the Work of the Devil?

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10

Bruce H. Ziran, MD (n); Thomas F. Hull, BA (n); Mary-Kate Barrette-Grischow, MA, MPH (n); Daneen M. Mace, BSN (n); James A. Shaer, MD (n); St. Elizabeth Health Center, Youngstown, Ohio, USA Background/Purpose: Subtrochanteric fractures are usually treated with indirect reduction using either plates or nails. In certain spiral/long oblique patterns, there is a significant deforming force of the proximal fragment that tends to flex/abduct/externally rotate. With­out attention to reduction of this deformity, problems such as reaming of posterior-lateral cortex, deformity, and nonunion may occur. Anecdotally, we have noted common use of cerclage wires or cables by the community surgeons in our area for these vexing patterns. Traditional teaching has been that such devices are detrimental to bone healing and require excessive surgical dissection. The purpose of this study was to evaluate the use of cerclage wires or cables for such fractures. Methods: From a prospectively entered registry,

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