ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022
Supplemental cerclage wiring in angle stable plate fixation of distal tibial spiral fractures enables immediate post-operative full weight-bearing: a biomechanical analysis.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Plain X-ray is insufficient for correct diagnosis of tibial shaft spiral fractures: a prospective trial.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Trial
- Immediate full weightbearing with additive cerclage improves early mobility after tibial shaft spiral fractures.Scientific reports · 2025Article
- Biomechanical evaluation of cerclage wiring in plated tibia fractures using human and synthetic specimens.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Relaxation Behavior of Cerclage Cables and Its Effect on Bone Clamping Force.Bioengineering (Basel, Switzerland) · 2024Article
- Cerclage Wiring Improves Biomechanical Stability in Distal Tibia Spiral Fractures Treated by Intramedullary Nailing.Journal of clinical medicine · 2023Article
- New ways of treatment of fractures of the humeral shaft: does the combination of intramedullary nail osteosynthesis and cerclage improve the healing process?European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- A minimally invasive cerclage of the tibia in a modified Goetze technique: operative technique and first clinical results.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- [Compromising due to additive cerclages : Can surgical treatment of humeral shaft fractures cause damage to the radial nerve?]Der Unfallchirurg · 2022Article
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Authors and funding
6 authors.
Funding
Abstract
purposeDistal tibial fractures generally require post-operative weight-bearing restrictions. Especially geriatric patients are unable to follow these recommendations. To increase post-operative implant stability and enable early weight-bearing, augmentation of the primary osteosynthesis by cerclage is desirable. The purpose of this study was to identify the stabilizing effects of a supplemental cable cerclage following plate fixation of distal tibial spiral fractures compared to solitary plate osteosynthesis.
methodsIn eight synthetic tibiae, a reproducible spiral fracture (AO/OTA 42-A1.1c) was stabilized by angle stable plate fixation. Each specimen was statically loaded under combined axial and torsional loads to simulate partial (200 N, 2 Nm) and full (750 N, 7 Nm) weight-bearing. Tests were repeated with supplemental cable cerclage looped around the fracture zone. In a subsequent stepwise increased dynamic load scenario, construct stiffness and interfragmentary movements were analyzed.
resultsWith supplemental cable cerclage, construct stiffness almost tripled compared to solitary plate osteosynthesis (2882 ± 739 N/mm vs. 983 ± 355 N/mm; p < 0.001). Under full weight-bearing static loads, a supplemental cerclage revealed reduced axial (- 55%; p = 0.001) and shear movement (- 83%; p < 0.001), and also lowered shear movement (- 42%; p = 0.001) compared to a solitary plate under partial weight-bearing. Under dynamic loads supplemental cerclage significantly reduced axial (p = 0.005) as well as shear movements (p < 0.001).
conclusionSupplemental cable cerclage significantly increases fixation stiffness and reduces shear movement in distal tibial spiral fractures. This stabilizing effect enables from a biomechanical point of view immediate mobilization without any weight-bearing restrictions, which may improve the quality of care of orthopedic patients and may trigger a change towards early weight-bearing regimes, especially geriatric patients would benefit from.
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