ArticleClinical biomechanics (Bristol, Avon)2022
The addition of cerclage wiring does not improve proximal bicortical fixation of locking plates for Type C periprosthetic fractures in synthetic humeri.
Article in Clinical biomechanics (Bristol, Avon), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed, 9 citations in OpenAlex.
- [Biomechanical aspects in the treatment of periprosthetic humeral fractures].Unfallchirurgie (Heidelberg, Germany) · 2026Review
- Pilot study on the feasibility of shape memory alloy implantation for Vancouver type B1 periprosthetic femoral fractures in a canine model: a step toward advancing treatment modalities.Journal of orthopaedic surgery and research · 2024Article
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Authors and funding
5 authors at 2 institutions in 1 country.
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Abstract
backgroundTreatment of proximal humerus periprosthetic fractures is challenging. It remains difficult to achieve robust fixation of the proximal fragment to the locking plate using cerclage wiring and/or unicortical screws. Use of polyaxial tangentially directed bicortical locking screws increases screw purchase, but it is unclear if this option provides robust fixation. This biomechanical study compares fixation of constructs using cerclage wires, bicortical locking screws, and a hybrid method utilizing both methods.
methodsUncemented humeral stems were implanted into synthetic humeri and Type C periprosthetic fractures were simulated with a 1 cm transverse osteotomy. Distal ends of locking plates were secured with bicortical non-locking screws. The proximal ends were supported by either isolated cerclage wires, polyaxial locking screws, or a hybrid combination of both (n = 6 for each group). A universal test frame was used for non-destructive torsion and cyclic axial compression tests. 3-D motion tracking was employed to determine stiffnesses and relative interfragmentary motions.
findingsIsolated screw constructs showed significantly increased resistance against torsional movement, bending, and shear, (p < 0.05) in comparison to cerclage constructs. The hybrid construct provided no significant changes in stability over the isolated screw construct.
interpretationAddition of cerclage wires in this synthetic bone model of Type C periprosthetic humerus fractures did not add significant stability to proximal bicortical locking plate fixation. Considering risks of tissue stripping and nerve injury, usage of cerclage wires in a similar clinical setting should be chosen carefully, especially when bicortical fixation around the prosthetic stem can be achieved.
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