Cerclage Wiring Through a Mini-Open Approach to Assist Reduction of Subtrochanteric Fractures Treated With Cephalomedullary Fixation: Surgical Technique

Summary: Despite advances in the management of subtrochanteric fractures, in particular with the use of cephalomedullary nails, outcomes remain worse than other fractures of the proximal femur. Because an anatomic reduction is needed to offer the best results, several methods of reduction, using clamps and wires have been described. Reduction of fractures in elderly patients is especially complicated because of poor bone quality, comorbidities, and unfavorable fracture patterns. We describe a new technique of reduction and cerclage wiring through a mini-open approach for isolated subtrochanteric, as well as intertrochanteric fractures with extension into the subtrochanteric area, and report our results in a series of patients.