Definition of a safe zone for antegrade lag screw fixation of fracture of posterior column of the acetabulum by 3D technology

Feng, Xiaoreng; Zhang, Sheng; Luo, Qiang; Fang, Jintao; Lin, Chao-Wen; Leung, Frankie; Chen, Bin

doi:10.1016/j.injury.2016.01.026

Cited by 31 publications

(38 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mimics software has been widely used in 3D reconstruction for the development of digital orthopedics technology. In our study, we applied the 3D method of axial perspective as described in previous studies [10,11,21]. We found the largest secure screw path along the longitudinal axis of the anterior part of posterior column after reducing the transparency of the 3D model.…”

Section: Discussionmentioning

confidence: 78%

“…Due to the complex characteristic of pelvic anatomy, the safe region of screw placement is far away from the acetabulum, which will reduce the peri-acetabular stability [7]. The common xation methods for acetabular fractures are lag screw xation and plate osteosynthesis [10]. During the past research, lag screw xation has achieved good outcomes [19.20].…”

Section: Discussionmentioning

confidence: 99%

“…At present, there are many studies on the application of CT data into various software for the xation of periacetabular screws [7,9,[10][11][12][13]. In previous studies, the method of axial perspective can help to nd a larger anterior and posterior column screw path [10,11]. The purpose of the study is to specify the ideal insertion point, the largest secure diameter and length, and the accurate angle of the infra-acetabular screw through the method of axial perspective.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The largest secure corridor of the infra-acetabular screw — a 3-D axial perspective analysis

Zhao

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background The infra-acetabular screw is placed from the pubis to the ischium and can be used as a special lag screw of the posterior column of the acetabulum. This study was performed to simulate the surgical procedure and try to obtain the ideal insertion point, diameter, length and angle of the screw through the method of axial perspective in Chinese patients. Methods We randomly collected the pelvic computed tomography (CT) scans of 100 adults. DICOM-formatted CT-scan images were imported into Mimics software. The 3D digital model of the right semi-pelvic was established. A virtual cylinder representing the screw was placed from the pubis to the ischium to fix the posterior column. The largest secure diameter and length of the virtual screw were measured. The position of the insertion point and the directions of the screw were also researched. Results The screw insertion safe zone can exhibit an irregular “tear drop” from the reconstructed pelvic model. The mean maximum diameter of screws was 4.03 ± 0.93 mm, and the mean maximum length of screws was 96.05 ± 7.19 mm. The screw insertion corridor with a diameter of at least 3.5 mm was found in 48 of 50 males (96%). We found gender-dependent differences for the mean maximum diameter and the maximum length of the screw. The position between insertion point and eminelntia iliopectinea was statistically significant in different genders. Conclusions The study provides a valuable guideline for the largest secure corridor of infra-acetabular screw. We suggest an individual preoperative 3D reconstruction simulation for the ideal screw placement. Further biomechanical studies are needed to verify the function of the screw.

show abstract

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The largest secure corridor of the infra-acetabular screw — a 3-D axial perspective analysis

Zhao

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…First, we reduced the transparency of the semi-pelvis models and observed the 3D model through the perspective method described in previous studies [16,17]. According to the anatomical structure of the pelvis, the special area of the quadrilateral surface (under the arcuate line and behind the obturator foramen) is flat.…”

Section: Methodsmentioning

confidence: 99%

Digital anatomical study and clinical application of screw placement for quadrilateral plate fractures in the danger zone

Zhao

Sun

Zhang

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background: Direct screw placement for quadrilateral plate fractures in the danger zone of the acetabulum is very difficult. This study was performed to simulate the surgical procedure and try to obtain effective and safe screw angles through the middle window of the ilioinguinal approach in Chinese patients. Methods: We randomly collected the pelvic computed tomography (CT) scans of 100 adults. DICOM-formatted CTscan images were imported into Mimics software. The three-dimensional reconstruction (3D) digital model of the semi-pelvis was established. A 3.5 mm cylinder was used to simulate the pathway of the screw from the designated insertion point. The angles of insertion and intersex differences were explored by statistical analyses. Results: The screws could be inserted via three angles: medial inclination, anterior inclination and posterior inclination. The mean minimum medial inclination angle (MIMIA) of insertion point A was 4.96°± 1.11°in males and 8.66°± 3.40°in females, and the intersex difference was significant. The mean minimum medial inclination angle (MIMIA) of insertion point B was − 5.31°± 3.69°in males and 1.75°± 8.95°in females, and the intersex difference was significant. There were no differences between any of the angles for males and females at insertion point O. Conclusions: Preoperative measurement and calculation by digital tools before screw placement for quadrilateral plate fractures of the acetabulum are feasible. Double cortical screws could be placed safely in the danger zone through the middle window of the ilioinguinal approach to increase the stability of the acetabulum.

show abstract

“…In recent years, the application of computer-aided technology has enabled the rapid development of digital orthopedics. Bio-morphological study of screw corridors around the acetabulum can be performed easily and quickly by computer-aided techniques [12][13][14]. Our team has proposed the use of "axial perspective" to study the largest anterior and posterior column screw corridors of the acetabulum [13,15].…”

Section: Introductionmentioning

confidence: 99%

Infra-Acetabular Screw Exited Between Ischial Tuberosity and Ischial Spine is more Suitable for Asian Population: A 3D Morphometric Study

Liu

Feng

Xiao

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background Recently, the infra-acetabular screw was proposed for acetabular fractures as a part of a periacetabular fixation frame. Biomechanical studies showed that an additional infra-acetabular screw placement can enhance the fixation strength of acetabular fracture internal fixation. At present, the reported exit point of the infra-acetabular screw was all located at the ischial tuberosity. However, through great experience in placing the infra-acetabular screw, we realized that when the exit point was located between the ischial tuberosity and the ischial spine, the placement of a 3.5 mm infra-acetabular screw is easier in some patients. Methods This study used axial perspective based on 3D models to study the anatomical parameters of the two different infra-acetabular screw corridors. Placed the largest diameter virtual screw in the two different screw corridors. The data obtained in this study present the maximum diameters, length, directions, and distances between the entry point and the center of IPE. Results In 65.31% males and 40.54% females, a Screw I corridor with a diameter of at least 5 mm was found, while in Screw II it was 77.55% in males and 62.16% in females. Compared with screw I, the length of screw II is reduced, the angle with the coronal plane is significantly reduced, and the angle with the transverse plane is significantly increased.Conclusions For East Asians, changing the exit point of the infra-acetabular screw can increase the scope of use of the infra-acetabular screw, especially for females.

show abstract

Definition of a safe zone for antegrade lag screw fixation of fracture of posterior column of the acetabulum by 3D technology

Cited by 31 publications

References 19 publications

The largest secure corridor of the infra-acetabular screw — a 3-D axial perspective analysis

The largest secure corridor of the infra-acetabular screw — a 3-D axial perspective analysis

Digital anatomical study and clinical application of screw placement for quadrilateral plate fractures in the danger zone

Infra-Acetabular Screw Exited Between Ischial Tuberosity and Ischial Spine is more Suitable for Asian Population: A 3D Morphometric Study

Contact Info

Product

Resources

About