{"product_id":"periprosthetic-hip-fracture-case-1-trochanteric-plate-cerclage","title":"PERIPROSTHETIC HIP FRACTURE [Case 1] · Trochanteric Plate + Cerclage","description":"\u003cp\u003eThe treatment of periprosthetic hip fractures in stable cemented prostheses requires individualized planning, mastery of re-approach surgery in a fibrotic field, and the technical ability to perform secure hybrid fixation without implant revision.\u003c\/p\u003e\n\u003cp\u003eThis training presents the complete management of a periprosthetic hip fracture with a stable cemented prosthesis using a posterolateral approach associated with osteosynthesis using a trochanteric plate, application of perifemoral cables, and cortical screws, including strategies for proximal anchorage, torque control in osteoporotic bone, and immediate postoperative full weight-bearing, demonstrated in detail from a surgical perspective.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eTRAINING FOCUS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003ePosterolateral approach and anatomical landmarks in re-approach surgery.\u003c\/li\u003e\n\u003cli\u003eSurgical planning for periprosthetic hip fractures.\u003c\/li\u003e\n\u003cli\u003eAssessment of prosthetic stability and decision-making for fixation without revision.\u003c\/li\u003e\n\u003cli\u003eAnatomical exposure in a fibrotic field and identification of tissue planes.\u003c\/li\u003e\n\u003cli\u003eProximal plate anchorage through transtendinous portals.\u003c\/li\u003e\n\u003cli\u003ePerifemoral cable passage technique and cable passer selection.\u003c\/li\u003e\n\u003cli\u003eCable torque control in osteoporotic bone.\u003c\/li\u003e\n\u003cli\u003eFixation with a cortical screw in an oval hole while avoiding the prosthesis.\u003c\/li\u003e\n\u003cli\u003eStabilization of the femoral calcar with a cable proximal to the lesser trochanter.\u003c\/li\u003e\n\u003cli\u003eFluoroscopic control and assessment of implant positioning.\u003c\/li\u003e\n\u003cli\u003ePercutaneous fixation of the distal screw with minimally extended exposure.\u003c\/li\u003e\n\u003cli\u003eFull weight-bearing release and immediate rehabilitation protocol.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003e\u003cstrong\u003eDETAILED CONTENT\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eStructured Surgical Planning:\u003c\/strong\u003e Definition of the operative strategy based on preoperative fluoroscopic images, assessment of cemented component stability, and planning of the fixation sequence without prosthetic revision.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eRe-approach Through the Posterolateral Approach:\u003c\/strong\u003e Technique for re-identification of anatomical planes in a fibrotic field using the posterior superior iliac spine as a continuous reference, with the limb positioned at 45° of flexion for safe diaphyseal alignment.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eAnatomical Exposure in a Fibrotic Field:\u003c\/strong\u003e Strategies for dissection in anatomy altered by previous surgery, including identification of the iliotibial tract, fascia lata, and residual sutures of the external rotators, preserving muscular and vascular structures.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eProximal Anchorage Through Transtendinous Portals:\u003c\/strong\u003e Creation of portals in the gluteus medius and gluteus minimus tendons to position the proximal end of the trochanteric plate directly against the bone, preventing soft-tissue interposition.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eSelection and Passage of Perifemoral Cables:\u003c\/strong\u003e Practical criteria for choosing the cable passer curvature radius according to the diameter of the femoral diaphysis, minimizing muscle trauma and ensuring a bone-hugging trajectory for effective tensioning.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eTorque Control in Osteoporotic Bone:\u003c\/strong\u003e Progressive tactile approach to cable tensioning in bone with low mineral density, preventing cortical fracture due to overload while ensuring firm fixation under continuous fluoroscopic control.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eFixation with a Screw in an Oval Hole:\u003c\/strong\u003e Use of a directional cortical screw in the plate’s oval hole to precisely bypass the cemented femoral component, adding significant stability to the final construct.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eStabilization of the Femoral Calcar:\u003c\/strong\u003e Placement of a cable proximal to the lesser trochanter for fixation of the femoral calcar, with an alternative strategy through the superior region of the plate when direct access to the intended level is anatomically limited.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003ePercutaneous Fixation of the Distal Screw:\u003c\/strong\u003e Placement of the distal screw with minimal extension of the exposure, using digital palpation as a guide for precise positioning and reduction of additional surgical trauma.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eFluoroscopic Assessment and Final Result:\u003c\/strong\u003e Intraoperative confirmation of ideal implant positioning with three cables superior to the fracture, a trochanteric screw, and hook anchorage, validating mechanical stability for immediate full weight-bearing.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003e\u003cstrong\u003eINCLUDED MATERIAL\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDetailed PDF:\u003c\/strong\u003e The PDF provides a complete analysis of the periprosthetic hip fracture, classification criteria and decision-making for fixation without prosthetic revision, sequence of operative steps, biomechanical principles of hybrid fixation with a trochanteric plate, cables, and screws, re-approach strategies in a fibrotic field, torque control in osteoporotic bone, and a rehabilitation protocol with immediate postoperative full weight-bearing.\u003c\/p\u003e\n\u003cp\u003e\u003c!-- notionvc: 0baf064b-bc79-47fa-9a7a-90cce6a412a8 --\u003e\u003c\/p\u003e","brand":"Dr Savio Chami","offers":[{"title":"Default Title","offer_id":43320158486589,"sku":null,"price":30.0,"currency_code":"BRL","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0641\/3664\/2621\/files\/FRATURAPERIPROTETICADOQUADRIL-Caso1_PlacaTrocanterica_Cerclagem.webp?v=1783098825","url":"https:\/\/www.surgie.com\/products\/periprosthetic-hip-fracture-case-1-trochanteric-plate-cerclage","provider":"Surgie","version":"1.0","type":"link"}