Percutaneous Fixation of Anterior and Posterior Column Acetabular Fractures

Bozzio, Anthony E.; Wydra, Frank B.; Mitchell, Justin J.; Ackerson, Richard M.; Mauffrey, Cyril

doi:10.3928/01477447-20140924-04

Cited by 26 publications

(8 citation statements)

References 11 publications

(14 reference statements)

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“…reported that percutaneous fixation of anterior and posterior column acetabular fractures has the advantage of limiting soft tissue disruption, length of surgery and blood loss when compared with ORIF. 24 We believe that percutaneous fixation of anterior column, when combined with modified K-L approach for fixation of complex acetabular fractures, shall provide anatomical reduction and also reduce operative time, blood loss and prevent complications associated with open reduction techniques.…”

Section: Discussionmentioning

confidence: 99%

Modified Kocher-Langenbeck approach in combined surgical exposures for acetabular fractures management

Magu

Rohilla

Singh

et al. 2016

IJOO

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Background:Displaced fractures of the acetabulum are best treated with anatomical reduction and rigid internal fixation. Adequate visualization of some acetabular fracture types may necessitate extensile or combined anterior and posterior approaches. Simultaneous anterior iliofemoral and posterior Kocher-Langenbeck (K-L) exposures with two surgical teams have also been described. To assess whether modified Kocher-Langenbeck (K-L) approach can substitute standard K-L approach in the management of elementary acetabular fractures other than the anterior wall and anterior column fractures and complement anterior surgical approaches in the management of complex acetabular fractures.Materials and Methods:20 patients with transverse and associated acetabular fractures requiring posterior exposure were included in this prospective study. In 9 cases (7 transverse, 1 transverse with posterior wall, and 1 posterior column with posterior wall), stabilization was done through modified K-L approach. In 11 cases (3 transverse and 8 associated fractures), initial stabilization through iliofemoral approach was followed by modified K-L approach.Results:The average operative time was 183 min for combined approach and 84 min for modified K-L approach. The postoperative reduction was anatomical in 17 patients and imperfect in 3 patients. The radiological outcome was excellent in 15, good in 4, and poor in one patient. The clinical outcome was excellent in 15, good in 3 and fair and poor in 1 each according to modified Merle d’Aubigne and Postel scoring system.Conclusion:We believe that modified K-L approach may be a good alternative for the standard K-L approach in the management of elementary fractures and associated fractures of the acetabulum when combined with an anterior surgical approach. It makes the procedure less invasive, shortens the operative time, minimizes blood loss and overcomes the exhaustion and fatigue of the surgical team.

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Section: Discussionmentioning

confidence: 99%

Modified Kocher-Langenbeck approach in combined surgical exposures for acetabular fractures management

Magu

Rohilla

Singh

et al. 2016

IJOO

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“…tas, que complicaría o evitaría las técnicas abiertas. [5][6][7] • Se puede usar como complemento en la reducción abierta en patrones complejos de fracturas. 6,7 Las complicaciones de la fijación pélvica percutánea son variadas y se dividen en errores relacionados con el cirujano, la técnica y el paciente.…”

Section: Level Of Evidence: IVunclassified

Fijación percutánea con tornillos en fracturas de pelvis y acetábulo. Experiencia en el Hospital de Traumatología ''Dr. Victorio de la Fuente Narváez''

Lucio¹,

González²,

Ayup³

2021

Ortho-Tips

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Introducción: La fijación percutánea ofrece ventajas en relación con la reducción abierta en fracturas de pelvis y acetábulo. El objetivo de este artículo es describir la seguridad de la cirugía percutánea con tornillos en pacientes con fracturas de pelvis y acetábulo. Material y métodos: Se realizó un estudio observacional, retrospectivo, longitudinal y descriptivo. Se revisó el expediente de adultos hospitalizados con fracturas de pelvis y acetábulo con desplazamiento menor a 3 mm, a quienes se les practicó una intervención quirúrgica percutánea del 2009 al 2018. Se estudió el mecanismo de lesión, traumatismos asociados, tipo de fractura, días de estancia en el nosocomio, muerte intrahospitalaria, complicaciones transquirúrgicas o postquirúrgicas y grado de consolidación ósea. Resultados: Se registraron 531 pacientes, 454 cumplieron con los criterios de inclusión. El promedio de edad fue de 41.7 años, el mecanismo de lesión de alta energía tuvo una mayor prevalencia, 52% de los analizados tuvieron alguna lesión asociada, la más frecuente en miembros pélvicos. La fractura más común fue la fractura tipo AO 61B2 con 38.1%. Se tuvo un promedio de 10.7 días de estadía intrahospitalaria. Tuvieron alguna complicación 15 pacientes (3.3%), siendo la principal la malposición del material de osteosíntesis. Dos pacientes presentaron muerte intrahospitalaria a causa de lesiones asociadas. De los pacientes, 100% presentaron consolidación ósea grados III o IV en la clasificación de Montoya. Conclusiones: La cirugía percutánea en fracturas de pelvis y acetábulo es un procedimiento quirúrgico seguro, ya que se asocia con una baja mortalidad intrahospitalaria, tiene un bajo porcentaje de tropiezos, disminuye la estadía en el nosocomio y tiene una alta tasa de consolidación ósea. Es un método que requiere de entrenamientos especiales y tiene una curva de aprendizaje prolongada.

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“…Open reduction and internal fixation is considered the gold standard of treatment, especially in displaced fractures involving the weight-bearing surface or the posterior wall. For acetabular fractures in the elderly as well as less-or undisplaced fractures in patients aiming for an early return activity, percutaneous techniques with cannulated screws [36] or minimally invasive plate osteosynthesis (MIPO) using preshaped 3D plates [37] are on a rise. Although long-term outcomes are limited, most advanced treatment methods including minimally invasive fixation under computer-assisted navigation [38] and 3D printing, simulating the plate preflex and screw length [39], are promising to improve surgical accuracy and safety and to shorten the operation time.…”

Section: Pelvismentioning

confidence: 99%

Minimally Invasive Techniques in Orthopedic Trauma

Thaeter

Kobbe

Verhaven³

et al. 2016

Curr Trauma Rep

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Purpose of Review This review focuses on the evolution of minimally invasive techniques in orthopedic surgery and provides an overview of the evidence-based knowledge of the last decade. Recent Findings Implants and surgical techniques for minimally invasive osteosynthesis in periarticular, spinal and pelvic fractures underwent rapid improvement. They show adequate healing along with low complication rates and satisfactory outcome. Computer-assisted insertion of implants and navigation offer new possibilities and are particularly advantageous in difficult anatomical regions, such as the pelvis or spine. Summary The treatment purpose in minimally invasive orthopedic surgery consists of anatomic reconstruction and stabilization of the articular surface, length, axis and rotation with minimal soft-tissue trauma. This review article highlights the surgical evolution and discusses recent advances in techniques and technology implementing minimally invasive approaches as the gold standard of treatment in the near future.

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Percutaneous Fixation of Anterior and Posterior Column Acetabular Fractures

Cited by 26 publications

References 11 publications

Modified Kocher-Langenbeck approach in combined surgical exposures for acetabular fractures management

Modified Kocher-Langenbeck approach in combined surgical exposures for acetabular fractures management

Fijación percutánea con tornillos en fracturas de pelvis y acetábulo. Experiencia en el Hospital de Traumatología ''Dr. Victorio de la Fuente Narváez''

Minimally Invasive Techniques in Orthopedic Trauma

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