12/03/2025
Cerclage fracture repair is used in for managing complex bone fractures, particularly periprosthetic fractures that can occer joint replacements. Cerclage fixation involves wrapping cable or suture material around fractured bone segments to compress/stabilize fragments, functioning as an effective adjunct to plate fixation or as standalone treatment for specific fracture patterns. Traditional cerclage employs stainless steel wire or titanium cable systems tensioned to specific loads (~150-400 N) depending on bone quality/fracture characteristics. Metallic systems provide excellent initial stability + compression forces - potential periosteal blood supply disruption always a consideration.
FiberTape cerclage is a newer alternative using ultra-high molecular weight polyethylene suture material - a non-metallic that is radiolucent for improved postop imaging and lowering risk of corrosion/allergic reactions. The broader surface area helps distribute compressive forces more evenly across the fracture. FiberTape can achieve comparable strength to metallic cables while potentially offering superior elastic properties that may facilitate physiologic bone healing. Clinical uses extend beyond hip replacement to include humeral fractures during shoulder replacement, comminuted clavicle fractures, femoral fractures, and complex periarticular injuries requiring fragment reduction. The choice between wire vs FiberTape can depend on multiple factors including fracture pattern, bone quality, surgeon preference, and specific anatomical considerations. The key to successful cerclage application lies in proper patient selection, accurate fracture classification, meticulous surgical technique minimizing soft tissue trauma, appropriate tensioning to achieve compression without excessive force causing bone damage, and postoperative rehabilitation protocols allowing early protected mobilization while ensuring adequate healing time.
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