Rolling Hitch Cerclage Suture Technique for Fixation of Round Bone Comminuted Fractures

I recently dealt with a nice young patient who suffered from a comminuted fifth metatarsal shaft fractures. I don’t know about you guys, but in my experience, these fractures always tend to be worse than the X-ray shows.

I learned a new technique that I wanted to share with you; it is called the rolling hitch cerclage technique. I don't use it arthroscopically as it was originally designed but it is something used by a well-known arthroscopic surgeon named Peter Millett. He uses it to cerclage reduce clavicle fractures but it works pretty well in any round bone that is easy to pass a stitch around.

I used this technique to fix the fifth metatarsal shaft and had great outcomes with it. I have a few X-rays/CT and some instructional videos here to show you how it’s done!