title: Early catastrophic failure of trochanteric fixation with the Dall-Miles Cable Grip System.
abstract: Multi-filament orthopaedic cerclage cables have been used in clinical practice for several decades, and are commonly utilized to provide greater trochanteric fixation following an osteotomy or fracture. We present the first known report of patients who experienced early catastrophic failure following use of the Dall-Miles Cable Grip System (DMCGS). A root cause analysis determined that the jaws of one crimper had an increased distance at closure, resulting in inadequate ultimate fixation strength. It was discovered that operating room staff had not been trained to perform regular calibration checks and the required calibration tool was not included in any of the institution's DMCGS sets. Surgeons should be aware that these surgical instruments require regular maintenance and should be gauge tested prior to every use.
authors: Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors: Stephen A
authors: SA
authors: Klinge
authors: Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors: Bryan G
authors: BG
authors: Vopat
authors: Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors: Alan H
authors: AH
authors: Daniels
authors: Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors: Jason T
authors: JT
authors: Bariteau
authors: Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors: Lee E
authors: LE
authors: Rubin
authors: Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors: Richard
authors: R
authors: Limbird
mesh_terms: D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects* / Q000295:instrumentation*; D010027:Osteotomy / Q000009:adverse effects / Q000295:instrumentation; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D060891:Root Cause Analysis; D013525:Surgical Instruments / Q000592:standards*
keywords: cerclage cable; early failure; instrument calibration