Cable Grip Research Articles

インプラント挿入後における大腿骨骨幹部骨折の治療経験

Aim;The purpose of this study was to assess whether plate and cable-wire can be used in the treatment of periprosthetic femoral shaft fractures.Patient and Methods;We treated 7 cases of 6 patients (all females) who exhibited periprosthetic femoral shaft fractures. The age of the patients ranged from 73 to 94 years (average; 79.1 years). The prostheses that had been inserted before were 6 components of THA or BEA (3 were cemented, 3 non-cemented), and one intramedullar nail. The case involving the intramedullar nail, not with standing, the fractures were categorized by Johansson's classification: 4 cases were type I fracture, and 2 were type III. All cases were treated by open reduction, using the Dall-Miles Cable Grip System (Howmedica product) in 5 cases and the Cable-Ready Cable Grip System (Zimmer product) in 2, and were clinically and radiologically assessed after the open reduction.Results;Regardless of not using external fixation, refractures did not occurr in any of the cases. Except for 2 patients with severe dementia or hemiparesis, the initiation of weight-bearing after open reduction was relatively early, ranging from 14 to 40 days (average; 26.2 days).Conclusion;It was concluded that plate and cable-wire can be used for the treatment of periprosthetic femoral shaft fractures.

Problems of Dall-Miles Cable Grip System in re-attachment of greater trochanter

Problems of Dall-Miles Cable Grip System in re-attachment of greater trochanter

The outcome of trochanteric reattachment in revision total hip arthroplasty with a cable grip system: Mean 6-year follow-up

We have reviewed 251 hips that were revised by the senior authors with subsequent reattachment using the Dall-Miles Cable Grip System. Of these patients, 223 were available for follow-up. A trochanteric slide osteotomy was used for most cases ( n = 170), and the remainder had conventional trochanteric osteotomy to facilitate surgical exposure. Follow-up period was 1 to 8 years. Forty-eight percent ( n = 108) of the hips had a previous trochanteric osteotomy. Thirteen percent ( n = 30) had a prior trochanteric nonunion. Of the 223 hips, 91 % ( n = 204) of the trochanters remained attached to the trochanteric bed when reapproximated by the cable grip system. The 2 multifilament cables were passed medially through drill holes in the lesser trochanter in 67% ( n = 149) of cases. Of the hips, 16% ( n = 35) had 2 cables passed through bone lateral to the prosthesis, and 17% ( n = 39) had cables passed 1 medial and 1 lateral to the prosthesis. Cable breakage was noted in 10% ( n = 23) of cases. Of those 23, 70% ( n = 16) were stainless steel. Unraveling of the cable occurred in 18% ( n = 41) of cases. There were 19 nonunions (9%). Of the 19 nonunions, 74% ( n = 14) were stainless steel. The trochanter was reattached to bone in 9 hips, to cement in 4 hips, and to a proximal femoral allograft in 6 hips ( P = .0001). Eight of the 19 hips (42%) had the cables placed lateral to the prosthesis ( P = .0002). When bone-to-bone apposition was achieved at surgery, the nonunion rate was 4%. In this difficult group of revision procedures, the Dall-Miles Cable Grip has provided reliable trochanteric fixation. Factors associated with successful trochanteric healing include use of vitallium cables, use of a trochanteric slide osteotomy, cables passed medially through the lesser trochanter, cerclage rather than intramedullary placement, and bone-to-bone apposition.

Complications of a cable grip system

From a group of 643 total hip arthroplasties, 98 patients required trochanteric osteotomies, and in 68 the trochanteric osteotomies were repaired with the Dall-Miles cable grip system (Howmedica, Rutherford, NJ). Trochanteric nonunion occurred in 17 of these patients (25%), with fraying and fragmentation of the cable present in 15 (88%). Of the 51 patients with radiographic union, 18 (35%) also had signs of fraying and fragmentation. Bone destruction around the cable in the area of the lesser trochanter was seen in seven patients (10%). Large deposits of metal debris at the inferior border of the acetabulum were seen in eight hips (12%). Multifilament cable did not appear to offer significant advantages over standard monofilament wire, and the potential problems of fraying, fragmentation, and free-floating metallic debris must be considered.

Ｄａｌｌ‐Ｍｉｌｅｓ Ｃａｂｌｅ Ｇｒｉｐ Ｓｙｓｔｅｍによる大転子固定

Due to local bone loss, re-attachment of the greater trochanter is often difficult in revision total hip arthroplasty and pseudoarthrosis of the greater trochanter. We use the Dall-Miles cable grip system (DMCGS) for trochanteric fixation in 17 hips (ten hips with revision, five hips with T. H. R. and two hips with pseudoarthrosis of the greater trochanter). Post-operatively, the trochanter failed to unite in two hips, caused by failure of the position of the cable grip. In all other cases, good radiological and clinical results were achieved. Better results are obtained using the DMCGS in cases of trochanteric bone loss following hip surgery using trochanteric osteotomy.

Early experience with Dall-Miles cable grip system at femur fracture after hip arthroplasty: 3 case report

Early experience with Dall-Miles cable grip system at femur fracture after hip arthroplasty: 3 case report

Trochanteric fixation by cable grip in hip replacement

We used the stainless steel cable grip system described by Dall and Miles in 1983 to fix trochanters in 40 hips after total arthroplasty with trochanteric osteotomy. The cable broke in 32.5% of the hips; the trochanter failed to unite in 37.5%. Significantly more cables broke when placed inside the femoral canal than when the cable was placed round the femoral shaft (58% as against 9.5%, difference p less than 0.01). The high incidence of breakage may have resulted from contact between the stainless steel cable and the titanium prosthesis, from the acute angulation, or because of the lower fatigue strength of stainless steel. Better results have been obtained using cables with a higher fatigue strength, passed outside the proximal femur.

Use of the T-5 Cable Tensiometer Grip Attachment for Measuring Strength of College Men

(1970). Use of the T-5 Cable Tensiometer Grip Attachment for Measuring Strength of College Men. Research Quarterly. American Association for Health, Physical Education and Recreation: Vol. 41, No. 3, pp. 454-456.

Investigation of the T-5 Cable Tensiometer Grip Attachment for Measuring Strength of College Women

(1969). Investigation of the T-5 Cable Tensiometer Grip Attachment for Measuring Strength of College Women. Research Quarterly. American Association for Health, Physical Education and Recreation: Vol. 40, No. 4, pp. 848-850.