Evaluation of the cerclage cable force
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Date
2020-12
Authors
Mofokeng, Jabulani Ephraim
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Free State
Abstract
INTRODUCTION: Cerclage cable systems are manufactured by different companies to assist in fracture reduction and fixation; their usefulness extends to various specialties, including trauma, tumour surgery and arthroplasty, especially in revision total hip replacements. Two types of systems exist, namely, monofilament and multifilament systems. Multifilament cables grip systems are reported to have good outcomes; however, these attractive fixation devices are not without complications, with a reported failure rate that ranges from 27% to 44%. Loosening is one the modes of failure that can occur intraoperatively, after clamp fixation, or postoperatively because of micro motion and displacement caused by soft tissue interposition and bone resorption. The aim of this study is to determine whether the initial force that is applied to the cylindrical structure reflects the value of the force indicated by the manufacturer of the tensioning device. METHOD: This is a descriptive study that was undertaken during January 2020 at the University of the Free State, Universitas Academic Hospital’s Department of Orthopaedics. A measuring device was manufactured to measure the true force exerted by the cable systems. The researcher used five different cerclage cable systems from different companies in order to evaluate the forces exerted by these systems. The measuring device had a cylindrical structure to which these forces we applied at four different sites. The force applied was measured and compared to the forces indicated by the manufacturer of the tensioning device. These values were recorded on the data collection sheet.RESULTS: Out of the five cable systems evaluated, only one cable system indicated the correct force at all four different sites. However the other four cable systems reflected higher forces on the tensioning device when the true measured forces were lower. Retensioning the cables more than twice caused fraying of the cables. CONCLUSION: The force applied to the bone by the cerclage cable system is not a true reflection of the force indicated by the manufacturer of the tensioning device. Cables should not be retensioned more than twice as this may cause fraying and lead to failure of the implant.
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Keywords
Dissertation (M.Med. (Orthopaedic Surgery)--Univesity of the Free State, 2020, Orthopaedics, Orthopaedic surgeon, Monofilament cable, Multifilament cable, Periprosthetic fracture, Implant failure, Cerclage cable systems