Percutaneous fixation of acetabular fractures

Caviglia, Horacio; Mejail, Adrian; Landro, María Eulalia; Vatani, Nosratolah

doi:10.1302/2058-5241.3.170054

Cited by 44 publications

(33 citation statements)

References 45 publications

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“…Although 3.5-mm or 4.5-mm diameter lag screws are more common for column fixation, there is precedent in the clinical literature for using 6.5-mm diameter lag screws as done presently. 23 For AA and AAAC specimens, the surgical approach involved anterior plate fixation using a leftsided suprapectineal quick locking system (QLS) plate (Product no. 425912S; Stryker Canada, Hamilton, ON, Canada) and nine 3.5-mm diameter cortical screws (Product nos.…”

Section: Specimen Characteristics and Preparationmentioning

confidence: 99%

“…1 The use of 3.5-mm or 4.5-mm diameter screws as lag screws is more common for column fixation, although there is precedent in the clinical literature for the current application of 6.5-mm diameter lag screws. 23 Moreover, 6.5-mm lag screws can provide higher purchase strength and, hence, construct stiffness, which may be particularly important for osteoporotic bone. Furthermore, 6.5-mm lag screws were used in all test groups in this study, so there was no biasing of the results to favor one repair construct over another.…”

Section: Addressing Possible Limitationsmentioning

confidence: 99%

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Biomechanical analysis of transverse acetabular fracture fixation in the elderly via the posterior versus the anterior approach with and without a total hip arthroplasty

Moktar

Machin

Bougherara

et al. 2020

Proc Inst Mech Eng H

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This study provides the first biomechanical comparison of the fixation constructs that can be created to treat transverse acetabular fractures when using the “gold-standard” posterior versus the anterior approach with and without a total hip arthroplasty in the elderly. Synthetic hemipelvises partially simulating osteoporosis (n = 24) were osteotomized to create a transverse acetabular fracture and then repaired using plates/screws, lag screws, and total hip arthroplasty acetabular components in one of four ways: posterior approach (n = 6), posterior approach plus a total hip arthroplasty acetabular component (n = 6), anterior approach (n = 6), and anterior approach plus a total hip arthroplasty acetabular component (n = 6). All specimens were biomechanically tested. No differences existed between groups for stiffness (range, 324.6–387.3 N/mm, p = 0.629), clinical failure load at 5 mm of femoral head displacement (range, 1630.1–2203.9 N, p = 0.072), or interfragmentary gapping (range, 0.67–1.33 mm, p = 0.359). Adding a total hip arthroplasty acetabular component increased ultimate mechanical failure load for posterior (2904.4 vs. 3652.3 N, p = 0.005) and anterior (3204.9 vs. 4396.0 N, p = 0.000) approaches. Adding a total hip arthroplasty acetabular component also substantially reduced interfragmentary sliding for posterior (3.08 vs. 0.50 mm, p = 0.002) and anterior (2.17 vs. 0.29 mm, p = 0.024) approaches. Consequently, the anterior approach with a total hip arthroplasty may provide the best biomechanical stability for elderly patients, since this fixation group had the highest mechanical failure load and least interfragmentary sliding, while providing equivalent stiffness, clinical failure load, and gapping compared to other surgical options.

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Section: Specimen Characteristics and Preparationmentioning

confidence: 99%

Section: Addressing Possible Limitationsmentioning

confidence: 99%

Biomechanical analysis of transverse acetabular fracture fixation in the elderly via the posterior versus the anterior approach with and without a total hip arthroplasty

Moktar

Machin

Bougherara

et al. 2020

Proc Inst Mech Eng H

View full text Add to dashboard Cite

show abstract

“…However, these methods might increase operation time and cause iatrogenic trauma [8][9][10]. Therefore, finding accurate points of insertion, lengths and angles of screws are of high value before surgery [11].…”

Section: Introductionmentioning

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

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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.

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“…However, these methods might increase operation time and cause iatrogenic trauma [8][9][10]. Therefore, how to find the accurate points of insertion, lengths and the angles of screws are of high value before the surgery [11].…”

Section: Introductionmentioning

confidence: 99%

Digital anatomical study of screw placement for quadrilateral plate through the middle window of ilioinguinal approach

Zhao

Mu²

2019

Preprint

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Background Screw placement directly for quadrilateral plate fractures 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 ilioinguinal approach in Chinese patients. Methods We randomly collected the pelvic computed tomography (CT) scans of 50 adults. DICOM-formatted CT-scan images were imported into Mimics software. The three-dimensional reconstruction (3D) digital model of the semi-pelvic was established. In the coronal and sagittal planes, 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 four angles: medial inclination, lateral 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 C was -5.31°±3.69° in males and 1.75°±8.95° in females, and the intersex difference was significant. There were no differences in all the angles between males and females in insertion point B. Conclusions Preoperative measurement and calculation by digital tools before the screw placement for quadrilateral plate fractures of the acetabulum are feasible. Double cortical screws could be placed safely through the middle window of ilioinguinal approach to increase the stability of acetabulum.

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Percutaneous fixation of acetabular fractures

Cited by 44 publications

References 45 publications

Biomechanical analysis of transverse acetabular fracture fixation in the elderly via the posterior versus the anterior approach with and without a total hip arthroplasty

Biomechanical analysis of transverse acetabular fracture fixation in the elderly via the posterior versus the anterior approach with and without a total hip arthroplasty

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

Digital anatomical study of screw placement for quadrilateral plate through the middle window of ilioinguinal approach

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