Fraktur mandibula

Hemicerclage wire

Orthopedic Wire
Orthopedic wire is used as a supplementation for fracture fixation for the reduction of
fragments and the protection of fissures.
The two types of orthopedic wire available are gauge wire and AO wire. Gauge wire comes
in spools or long strips and in sizes 18, 20, 22, and 24 gauge. AO wire is a loop cerclage in
sizes of 1.25, 1.0, and 0.8mm. These correspond to the gauge wire of 18, 20, and 22. For
gauge wire, the smaller the number, the larger the wire. For AO wires, the larger the number,
the larger the wire.
Orthopedic wire can break over time as it cycles. It should be removed if it causes a problem
for the patient. IM pins may also have to be removed, but many animals do well with an
implant in place for their entire life. Each fracture fixation must be dealt with on an
individual case basis. Removal of implants is still a controversial topic.

Cerclage Wiring
Full cerclage wiring is when the wire is placed around the bone completely. The technique is
used for spiral and long oblique fractures and to protect fissures. There are several rules of
cerclage wiring that should always be followed:

1. A minimum of two wires MUST be used; one alone may act as a fulcrum at the
fracture site.
2. The length of the fracture obliquity needs to be at least twice the diameter of the bone.
3. Wire should be placed at least 0.5cm from the fracture ends.
4. Wires should be spaced 1.0cm apart from each other.
5. Lay the wire directly on the bone with no soft tissue interposition.

6. Wires should be placed perpendicular to the long axis of the bone.

7. Place wires before the primary fixation is applied.
8. Use orthopedic wire, not suture wire.
9. Only encircle wire once around the bone.
10. Never use wire as a sole means of fracture repair.
11. Make sure the wire is tight on the bone.
12. Use proper knot twisting rules (i.e., use equal tension and do not bend the knot over).
Hemicerclage wiring is used to counteract forces of rotation and shear in
transverse and short oblique fractures or to hold fragments in place while the
repair is being applied. Drill holes in each bone segment and pass the wire
through the holes. This will allow the wire to only partially encircle the bone.
Tighten the wire with the same principles as mentioned and do not bend over the
knot.

http://cal.vet.upenn.edu/projects/orthopod/csfr/terms/wiring.htm
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