Key result
Cable fixation during cephalomedullary nailing of subtrochanteric fractures significantly reduced the mean time to union to 5.4-5.7 months compared to 7.3 months without cables.
Why the study?
The study aimed to examine the effect of cable cerclage on reduction quality and union time in patients treated with cephalomedullary nails for subtrochanteric fractures.
Does cable fixation reduce union time and residual gap in patients with subtrochanteric femur fractures treated with cephalomedullary nailing?
Cohort (n=75)
No
Does cable fixation reduce union time and residual gap in patients with subtrochanteric femur fractures treated with cephalomedullary nailing?
Using cable fixation during cephalomedullary nailing of subtrochanteric fractures significantly reduces the residual fracture gap and shortens the time to union compared to nailing without cables.
Answers are grounded in this paper and cite their sources.
Cable cerclage may improve reduction quality and shorten union time; leaves open need for randomized trials before changing practice.
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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Can et al. (2025) conducted a cohort in Subtrochanteric femur fractures (n=75). Cable fixation vs. Closed cephalomedullary nailing without cables was evaluated on Mean time to union (p=0.007 and 0.001). Cable fixation during cephalomedullary nailing of subtrochanteric fractures significantly reduced the mean time to union to 5.4-5.7 months compared to 7.3 months without cables.
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