Introduction: We conducted a biomechanical study comparing cerclage wiring using a power tool with the traditional manual method.Materials and Methods: Our study consisted of 4 experimental arms based on the method of fixation and diameter of wires. The 4 arms were: 1) power tool method using 0.8 mm cerclage wires, 2) power tool method using 1.0 mm cerclage wires, 3) conventional manual method using 0.8 mm cerclage wires, and 4) conventional manual method using 1.0 mm cerclage wires. Synthetic femur bones were employed in our study. Six specimens were prepared for each arm. Each specimen was cut lengthwise and pressure sensors were placed in between. For the power tool method, while maintaining tension, wires were coiled using the Colibri power tool until just before secondary coiling occurred. For the conventional manual method, each specimen was compressed by plier twisting for 10 rounds, while maintaining tension. Cerclaging and data recording was done thrice for each specimen, giving a total of 18 readings per arm. Peak and steady-state forces were recorded. Results: There was no significant difference between the peak forces recorded between the power drill and manual methods. The steady-state forces achieved using the power tool method were significantly higher than that achieved in the manual fixation method (0.8 mm wires: 54.89N vs 27.26N, P = 0.037; 1.0 mm wires: 71.59N vs 39.66N, P = 0.025). Conclusion: The power tool method achieved a superior steady-state force of compression across the fracture site for both 0.8 mm and 1 mm wires.
Cerclage wiring is a valuable technique used widely in orthopaedic surgery to compress and secure bony or soft tissue elements. Its usefulness extends through the various specialties including trauma and fracture fixation, tumour surgery and arthroplasty (especially in revision total hip replacements). Its indications/uses include primary fracture fixation either alone or in combination with other fixation devices (ie. plate, intra-medullary nail, pins, K-wires), provisional fixation, as a reduction tool, as a tension band, allograft fixation and compression, as well as compression arthrodesis. This technique represents a cheap, reliable and versatile method that can be used in various surgical situations, whether primarily or as an augment to other techniques.
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