Cerclage Passer
Dankward Höntsch, Alberto Fernandez Dell'Oco
The cerclage passer enables the minimal invasive passing of wires or cables in combination with periprosthetic fracture or simply when temporary or additional fixation is required. The system uses dividable forceps and is available in two sizes (23 mm and 30 mm diameter).
The technique for the application of cerclage wires and cables used today is rather invasive and associated with massive soft tissue damage. In contrast to this, minimally invasive surgical techniques aim to reduce the soft tissue damage by using instruments which leave minimal footprints. As a result, better preservation of the blood supply and therefore faster healing times can be expected. This benefit is very important especially for elderly patients, because suboptimal preconditions like osteoporosis, cardiovascular diseases or diabetes may be present. Besides the application in combination with periprosthetic fractures, cable or wire cerclages are used often for additional or temporary fixation. The application of a cerclage can also be very helpful for fracture reduction.
The system includes the respective cerclage tunneling device (mainly for passing fascia on the linea aspera of the femur), trocars for cerclage passer forceps to protect them from filling up with soft tissue material, the cerclage passer forceps in two sizes, and for those who do not use wires but cables, a cable passing tube with a length of 400 mm, sterile packed, single use. First the cable passing tube passes the forceps and second with this tube the wire can pass around the bone. The crimp or olive at the beaded end of the cable allows no direct passage through the cerclage passer.
The system makes cerclage passing easy and minimally invasive. The learning curve is very short. The system has been successfully used very often (almost daily) by those who have it. These surgeons now like to have this helpful tool.
Technique:
a Incision with tunneling device.
b Cerclage passer insertion 1.
c Cerclage passer insertion 2.
d Cerclage passer insertion 3 insertion cable passing tube.
e Cerclage passer insertion 4 cable.
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