BACKGROUND
Intramedullary cable bone transport with the Ilizarov ring fixator is being increasingly used to treat lower extremity bone defects.1,2 The intramedullary stainless steel cable used for bone transport consists of a band of stranded interwoven fine wires. The cable is flexible and it is, therefore, problematic to pass it through the skin, subcutaneous tissue, bone cortex and finally through the intramedullary canal of a long bone.3
EXPERIMENTAL
The stainless steel cable is unthreaded by twisting using two simple pliers to unravel the interwoven threads proximal to the cable end (Fig. 1). A strong curved needle is passed through the unthreaded cable attached to a braided nylon suture (Fig. 1). The cable is then twisted back into its original form. The needle and suture are passed through the eye of a stiff Meier wire and the ends of the suture are knotted to anchor the stainless steel cable to the Meier wire (Fig. 2). The Meier wire acts as a guide for intramedullary passage of the stainless steel cable (Fig. 3).
Figure 1.
Unravelling the interwoven threads proximal to the cable end.
Figure 2.
Anchoring the stainless steel cable to the Meier wire.
Figure 3.
The Meier wire acts as a guide for intramedullary passage of the stainless steel cable.
DISCUSSION
We have been able to guide intramedullary wires repeatedly through both the tibia and femur successfully and easily with this technique. We believe that this new method can facilitate ‘catheterisation’ into and through the intramedullary canal of long bones with these flexible wires. This system is easy to assemble using ubiquitous and inexpensive items and provides secure wire passage in reconstructive orthopaedic surgery.
References
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