The effect of cable fixation on union time in subtrochanteric femur fractures treated with cephalomedullary nailing

Aim: This study aimed to examine the effect of cable cerclage on reduction quality and union time in patients treated with cephalomedullary nails for subtrochanteric fractures. Materials and Methods: 75 closed subtrochanteric fractures treated with cephalomedullary nails by two different surgeons...

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Main Authors: Fatih İlker Can, Emre Gültaç, Rabia Mihriban Kılınç, Cem Yalın Kılınç
Format: Article
Language:English
Published: Izzet Baysal Training and Research Hospital 2025-01-01
Series:Northwestern Medical Journal
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Online Access:https://nwmedj.org/article/view/140
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author Fatih İlker Can
Emre Gültaç
Rabia Mihriban Kılınç
Cem Yalın Kılınç
author_facet Fatih İlker Can
Emre Gültaç
Rabia Mihriban Kılınç
Cem Yalın Kılınç
author_sort Fatih İlker Can
collection DOAJ
description Aim: This study aimed to examine the effect of cable cerclage on reduction quality and union time in patients treated with cephalomedullary nails for subtrochanteric fractures. Materials and Methods: 75 closed subtrochanteric fractures treated with cephalomedullary nails by two different surgeons with at least 10 months of follow-up were included in the study. Patients operated by Surgeon 1 were grouped as Group 1 (closed cephalomedullary nailing without cables, n=43), patients operated by Surgeon 2 with 1-2 cables as Group 2 (n=20), and those operated with 3-4 cables were grouped as Group 3 (open cephalomedullary nailing + cable fixation, n=12). Postoperative radiographs were evaluated for the presence of cables, the number of cables used, deformity, the residual gap between the fracture ends, and the union time. Results: The cable fixation rate was calculated as 42.6%. There was a statistically significant relationship between cable use and the amount of gap (p=0.033). The average gap was 3.97 mm in patients without cables, 0.65 mm in patients with 1-2 cables, and 0.66 mm in patients with 3-4 cables. A positive correlation was found between the amount of gap and the time to union (Spearman's rho= 0.468, p=0.001). A statistically significant difference was found between Group 1 and Group 2 and also between Group 1 and Group 3 regarding the union time (p=0.007, p=0.001, respectively). The mean time to union was determined as 7.3 months in Group 1, 5.4 months in Group 2, and 5.7 months in Group 3. Conclusion: Reducing the gap in the fracture line by using cables provides a better reduction, stability, and a shorter union time than fixation without a cable in subtrochanteric fractures treated with cephalomedullary nailing.
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publishDate 2025-01-01
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spelling doaj-art-7f02fe640d1f40558f61c85bd4d3af202025-02-04T12:17:07ZengIzzet Baysal Training and Research HospitalNorthwestern Medical Journal2979-95382025-01-015110.54307/2025.NWMJ.140The effect of cable fixation on union time in subtrochanteric femur fractures treated with cephalomedullary nailingFatih İlker Can0https://orcid.org/0000-0001-5880-5336Emre Gültaç1https://orcid.org/0000-0003-1943-2199Rabia Mihriban Kılınç2https://orcid.org/0000-0002-6845-5496Cem Yalın Kılınç3https://orcid.org/0000-0003-2568-0500Orthopedics and Traumatology, Muğla Training and Research Hospital, Muğla, TürkiyeDepartment of Orthopedics and Traumatology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, TürkiyeDepartment of Radiology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, TürkiyeCaria Orthopedics and Traumatology Private Clinic, Muğla, Türkiye Aim: This study aimed to examine the effect of cable cerclage on reduction quality and union time in patients treated with cephalomedullary nails for subtrochanteric fractures. Materials and Methods: 75 closed subtrochanteric fractures treated with cephalomedullary nails by two different surgeons with at least 10 months of follow-up were included in the study. Patients operated by Surgeon 1 were grouped as Group 1 (closed cephalomedullary nailing without cables, n=43), patients operated by Surgeon 2 with 1-2 cables as Group 2 (n=20), and those operated with 3-4 cables were grouped as Group 3 (open cephalomedullary nailing + cable fixation, n=12). Postoperative radiographs were evaluated for the presence of cables, the number of cables used, deformity, the residual gap between the fracture ends, and the union time. Results: The cable fixation rate was calculated as 42.6%. There was a statistically significant relationship between cable use and the amount of gap (p=0.033). The average gap was 3.97 mm in patients without cables, 0.65 mm in patients with 1-2 cables, and 0.66 mm in patients with 3-4 cables. A positive correlation was found between the amount of gap and the time to union (Spearman's rho= 0.468, p=0.001). A statistically significant difference was found between Group 1 and Group 2 and also between Group 1 and Group 3 regarding the union time (p=0.007, p=0.001, respectively). The mean time to union was determined as 7.3 months in Group 1, 5.4 months in Group 2, and 5.7 months in Group 3. Conclusion: Reducing the gap in the fracture line by using cables provides a better reduction, stability, and a shorter union time than fixation without a cable in subtrochanteric fractures treated with cephalomedullary nailing. https://nwmedj.org/article/view/140subtrochanteric fracturescephalomedullary nailingcable fixationresidual gapunion time
spellingShingle Fatih İlker Can
Emre Gültaç
Rabia Mihriban Kılınç
Cem Yalın Kılınç
The effect of cable fixation on union time in subtrochanteric femur fractures treated with cephalomedullary nailing
Northwestern Medical Journal
subtrochanteric fractures
cephalomedullary nailing
cable fixation
residual gap
union time
title The effect of cable fixation on union time in subtrochanteric femur fractures treated with cephalomedullary nailing
title_full The effect of cable fixation on union time in subtrochanteric femur fractures treated with cephalomedullary nailing
title_fullStr The effect of cable fixation on union time in subtrochanteric femur fractures treated with cephalomedullary nailing
title_full_unstemmed The effect of cable fixation on union time in subtrochanteric femur fractures treated with cephalomedullary nailing
title_short The effect of cable fixation on union time in subtrochanteric femur fractures treated with cephalomedullary nailing
title_sort effect of cable fixation on union time in subtrochanteric femur fractures treated with cephalomedullary nailing
topic subtrochanteric fractures
cephalomedullary nailing
cable fixation
residual gap
union time
url https://nwmedj.org/article/view/140
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