Percutaneous Fixation of the Columns of the Acetabulum: A New Technique

Abstract

A technique for percutaneous placement of cannulated screws in the acetabulum is presented. Surgical technique is described, and fluoroscopic imaging techniques used to guide screw placement are also illustrated. The technique was used to limit soft tissue dissection in three patients. Results and examples are presented.

Closed reduction and percutaneous fixation of anterior column acetabular fractures

“…5,6 Recently, closed reduction with percutaneous fixation of nondisplaced or minimally displaced acetabular fractures using computed tomography (CT) or fluoroscopic guidance has attracted interest. [7][8][9][10] Computer-assisted closed reduction and percutaneous fixation of displaced acetabular fractures has not been reported previously.…”

Fix and replace; an emerging paradigm for treating acetabular fractures

“…Strong osteosynthesis is vital, and even if initial fixation is obtained, hip arthroplasty components may subside as a result of subsequent instability at the fracture site (24,35,39). Percutaneous reduction and fixation has been advocated using large cannulated 6.5 mm or 7.3 mm screws (40,41). This technique requires considerable expertise, but in the elderly may have a role to allow sufficient stability to allow early mobilisation (7).…”

Treatment of Acetabular Column Fractures with Limited Open Reduction and Screw Fixation

“…또한 고령층의 비전위성 비구 골절에서 동반된 전신 질환 및 마취의 위험성으로 보존적 치료를 시행하게 되는 경우에는 오랜 침상 안정으로 인한 욕창, 심부 정맥 혈전증, 심폐 기능 저하 등이 발생할 수 있 골반환 손상에서의 경피적 고정술은 널리 시행되고 있고, 전방 골반환 손상에서 경피적 방법으로 역행성 상 치골 나사 못 고정술이 보고된 바 있지만 18) , 비구 골절에서의 나사못 고정술의 결과에 대한 보고는 많지 않다 4,15,16,21,22) . Gay 등 , 금속판에 나사 못이 편심성 (eccentric)으로 삽입이 되는 경우에는 골절편의 전위를 유발할 수 있다 23) .…”