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Percutaneous cerclage wiring for reduction of periprosthetic and difficult femoral fractures. A technical note
T Apivatthakakul1, C Phornphutkul
1Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. tapivath@gmail.com
Background:
Combining closed reduction techniques with minimally invasive plate osteosynthesis (MIPO) or intramedullary nailing is a technically challenging procedure, especially when dealing with complex femoral fractures such as periprosthetic fractures. Cerclage wiring is a well known adjunct for fracture reduction and fixation. However, it is usually performed by open reduction, requiring wide surgical exposures, that results in soft tissue stripping.
Objectives:
To present how a novel cerclage wiring technique, employing a new percutaneous cerclage system, helped reduce a periprosthetic femoral fracture, fixed with MIPO, and a difficult proximal femoral fracture, stabilized with an intramedullary nail.
Conclusion:
Percutaneous wiring is an alternative reduction technique to facilitate the reduction and maintenance of difficult femoral fractures, which reduces the radiation exposure to the surgeon.

