Delayed Onset Iatrogenic Femur fracture in a Child Primarily treated with Cerclage Wires: Unrecorded Complications of an Unconventional Treatment Method

Journal of Clinical Orthopaedics | Vol 8 | Issue 2 |  Jul-Dec 2023 | page: 91-93 | Amol Gharote, N S Laud, Bhavika Mehta, Ashok Shyam

DOI: https://doi.org/10.13107/jcorth.2023.v08i02.616

---

Authors: Amol Gharote [1], N S Laud [2], Bhavika Mehta [3], Ashok Shyam [3]

[1] Gharote Clinic, Thane Maharashtra, India.
[2] Laud Clinic, Dadar, Mumbai, Maharashtra, India.
[3] Sancheti Institute for Orthopaedics & Rehabilitation, Pune, Maharashtra, India.

Address of Correspondence
Dr. Bhavika Mehta
Sancheti Institute for Orthopaedics & Rehabilitation, Pune, Maharashtra, India..
E-mail: mehtabolismforyou@gmail.com

---

Abstract

Paediatric femur shaft fractures are common bony injuries in children. Although there are set protocol for these fractures, sometimes a deviation from standard methods may lead to unpredicted consequences. We report a case of femoral shaft fracture in a 8 years old boy which was primarily treated with 3 cerclage wires. The fracture healed over next few months but the child presented with refracture at the same site 11 months post first surgery. There was vascular compromise at the cerclage site which caused the fracture. This was treated with plate fixation and fracture finally healed. In this case report we highlight how not following the basic principles of treatment and management can lead to further complications. We also bring to light a previously unreported complication of one such unfavoured and rather unconventional method of fixation.
Keywords: Pediatric Femur Fracture, Cerclage, Nonunion, iatrogenic

---

References

1. Rockwood and Wilkins’ Fracture in Children, 9th Edition (2020) Wolters Kluwer, China (Chapter 24-Page 1458).
2. Duffy S, Gelfer Y, Trompeter A, Clarke A, Monsell F. The clinical features, management options and complications of paediatric femoral fractures. Eur J Orthop Surg Traumatol. 2021Jul;31(5):883-892.
3. Liau GZQ, Lin HY, Wang Y, Nistala KRY, Cheong CK, Hui JHP. Pediatric Femoral Shaft Fracture: An Age-Based Treatment Algorithm. Indian J Orthop. 2020 Oct 10;55(1):55-67.
4. P. NIEMEYER and N. P. SÜDKAMP, “Principles and Clinical Application of the Locking Compression Plate (LCP),” ACTA CHIRURGIAE ORTHOPAEDICAE ET TRAUMATOLOGIAE ČECHOSL., p. 221–228, 2006.
5. Wallace ME, Hoffman EB. Remodelling of angular deformity after femoral shaft fractures in children. J Bone Joint Surg Br. 1992Sep;74(5):765-9.
6. John R, Sharma S, Raj GN, Singh J, C V, Rhh A, Khurana A. Current Concepts in Paediatric Femoral Shaft Fractures. Open Orthop J. 2017 Apr 28;11:353-368.
7. G. Harasen, “Orthopedic hardware and equipment for the beginner: Part 1. Pins and wires,” Orthopedics Orthopédie, vol. 52, no. -, pp. 1025-1026, 2011.
8. M. van Steijn and J. Verhaar, “Osteonecrosis caused by percutaneous cerclage wiring of a tibial fracture: Case report,” Journal of Trauma, Injury, Infection, and Critical Care, vol. Volume 43 , no. 3 , pp. 521- 522 , 1997.
9. P.Croniera, G.Pietub, C.Dujardinc, N.Bigorrea, F.Ducelliera and R.Gerardd, “The concept of locking plates,” Orthopaedics & Traumatology: Surgery & Research, vol. 96, no. 4, pp. S17-S36, 2010.
10. C. Y. Lo, T. H. Lui and Y. K. Sit, “Split Fracture: A Complication of Cerclage Wiring of Acute Patellar Fracture,” Archives of Trauma Research, vol. 3, 2014.

.

How to Cite this article: Gharote A, Laud NS, Mehta B, Shyam A. Delayed Onset Iatrogenic Femur fracture in a Child Primarily treated with Cerclage Wires: Unrecorded Complications of an Unconventional Treatment Method. Journal of Clinical Orthopaedics 2023;8(2):91-93.

---

(Abstract Text HTML)   (Download PDF)

---