Abstract

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.

Keywords: subtrochanteric fractures, cephalomedullary nailing, cable fixation, residual gap, union time

Copyright and license

Copyright © 2025 The Author(s). This is an open-access article published by Bolu İzzet Baysal Training and Research Hospital under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Can Fİ, Gültaç E, Kılınç RM, Kılınç CY. The effect of cable fixation on union time in subtrochanteric femur fractures treated with cephalomedullary nailing. Northwestern Med J. 2025;5(1):1-8. https://doi.org/10.54307/2025.NWMJ.140

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