{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:01Z","timestamp":1787755561903,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS Case Connector"],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>We report the case of an 82-year-old woman with diabetes, arteriosclerosis, chronic heart failure, and hypertension treated with an anatomical locking plate and multiple cables for a spiral-wedged periprosthetic fracture of the distal femur which was complicated by direct occlusion of the femoral artery and crush of the sciatic nerve, resulting in leg necrosis and, ultimately, through-knee disarticulation despite early recognition and arterial repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Neurovascular injury is a potential complication of cerclage cables placement around the femoral shaft during complex fracture fixation. Devastating complications cannot always be corrected despite early vascular intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.19.00194","type":"journal-article","created":{"date-parts":[[2020,2,21]],"date-time":"2020-02-21T14:44:39Z","timestamp":1582296279000},"page":"e0194-e0194","source":"Crossref","is-referenced-by-count":0,"title":["Neurovascular Bundle Entrapment and Through Knee Amputation After Cerclage Cabling of Distal Femoral Peri-implant Fracture"],"prefix":"10.2106","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8215-9327","authenticated-orcid":false,"given":"Andreas","family":"Panagopoulos","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, University Hospital, Patras Medical School, Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9299-0184","authenticated-orcid":false,"given":"Ioannis","family":"Lachanas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, General Army Hospital of Athens, Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2742-5995","authenticated-orcid":false,"given":"Antonis","family":"Kouzelis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University Hospital, Patras Medical School, Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4545-8675","authenticated-orcid":false,"given":"Zinon T.","family":"Kokkalis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University Hospital, Patras Medical School, Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1810-6703","authenticated-orcid":false,"given":"Minos","family":"Tyllianakis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University Hospital, Patras Medical School, Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020]]},"reference":[{"issue":"4","key":"bib1-20230720","doi-asserted-by":"crossref","first-page":"249","DOI":"10.3928\/01477447-20160610-06","article-title":"Vascular injury in orthopaedic trauma","volume":"39","author":"Mavrogenis","year":"2016","journal-title":"Orthopaedics."},{"issue":"6","key":"bib2-20230720","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1007\/s00402-018-2905-1","article-title":"Non-prosthetic peri-implant fractures: classification, management and outcomes","volume":"138","author":"Chan","year":"2018","journal-title":"Arch Orthop Trauma Surg."},{"issue":"1","key":"bib3-20230720","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/2309499018762616","article-title":"Vascular injuries due to cerclage Passer: relevant anatomy and note of caution","volume":"26","author":"Devendra","year":"2018","journal-title":"J Orthop Surg (Hong Kong)."},{"issue":"3","key":"bib4-20230720","doi-asserted-by":"crossref","first-page":"190","DOI":"10.55095\/achot2011\/031","article-title":"Cerclage, evolution and potential of a cinderella technology. An overview with reference to periprosthetic fractures","volume":"78","author":"Perren","year":"2011","journal-title":"Acta Chir Orthop Traumatol Cech."},{"issue":"3","key":"bib5-20230720","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1177\/1602400319","article-title":"Effect of cable cerclage on regional blood circulation in rabbits: a scintigraphic study","volume":"24","author":"Karakoyaun","year":"2016","journal-title":"J Orthop Surg (Hong Kong)."},{"issue":"2","key":"bib6-20230720","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.injury.2012.10.016","article-title":"Percutaneous cerclage wiring, does it disrupt femoral blood supply? A cadaveric injection study","volume":"44","author":"Apivatthakakul","year":"2013","journal-title":"Injury."},{"issue":"12","key":"bib7-20230720","doi-asserted-by":"crossref","first-page":"1964","DOI":"10.1016\/j.injury.2014.09.023","article-title":"Radiological assessment of the safe zone for medial minimally invasive plate osteosynthesis in the distal femur with computed tomography angiography","volume":"45","author":"Kim","year":"2014","journal-title":"Injury."},{"issue":"1","key":"bib8-20230720","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s00402-017-2804-x","article-title":"Safe zones and a technical guide for cerclage wiring of the femur: a computed topographic angiogram (CTA) study","volume":"138","author":"Apivatthakakul","year":"2018","journal-title":"Arch Orthop Trauma Surg."},{"issue":"3","key":"bib9-20230720","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/s00402-003-0618-5","article-title":"Position of the superficial femoral artery i closed hip nailing","volume":"124","author":"Yang","year":"2004","journal-title":"Arch Orthop Trauma Surg."},{"issue":"4","key":"bib10-20230720","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s00402-015-2406-4","article-title":"Vascular complications in plating of the proximal femur: review","volume":"136","author":"Neubauer","year":"2016","journal-title":"Arch Orthop Trauma Surg."},{"issue":"12","key":"bib11-20230720","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1007\/s00402-016-2580-z","article-title":"Amputated limb by cerclage wire of femoral diaphyseal fracture: a case report","volume":"136","author":"Won","year":"2016","journal-title":"Arch Orthop Trauma Surg."},{"issue":"6","key":"bib12-20230720","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1016\/j.arth.2004.12.050","article-title":"Femoral artery and vein injury after cerclage wiring of the femur: a case report","volume":"20","author":"Mehta","year":"2005","journal-title":"J Arthroplasty"},{"issue":"1","key":"bib13-20230720","first-page":"39","article-title":"Femoral artery entrapment after cerclage wiring of distal femoral shaft fracture. A case report","volume":"26","author":"Gunadham","year":"2019","journal-title":"J Orthop Trauma Rehabil."},{"issue":"1","key":"bib14-20230720","first-page":"1","article-title":"Delayed arterial complication following femoral cerclage cabling: a case report","volume":"22","author":"Raudenbush","year":"2014","journal-title":"Internet J Orthop."},{"issue":"3","key":"bib15-20230720","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.otsr.2017.10.020","article-title":"Vascular complication after percutaneous femoral cerclage wire","volume":"104","author":"Ehlinger","year":"2018","journal-title":"Orthop Traumatol Surg Res."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.19.00194","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:44:48Z","timestamp":1787751888000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.19.00194"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.19.00194","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020]]}}}