Percutaneous cerclage wiring for reduction of periprosthetic and difficult femoral fractures. A technical note.

Abstract 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.