Preliminary results and complications following limited open reduction and percutaneous screw fixation of displaced fractures of the actabulum

Starr, Adam J.; Jones, Alistair; Reinert, Charles M.; Borer, Drake S.

doi:10.1016/s0020-1383(01)00060-2

Cited by 135 publications

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“…5 Cannulated screw fixation is a safer technique. 1,4,8 In our study, the appropriate length for the pubic screw was approximately 100 to 140 mm. Long screws with bicortical purchase provide stability and avoid screw disengagement, especially in patients with osteopenia, anticipated non-compliance, or requiring early rehabilitation.…”

Section: Discussionmentioning

confidence: 64%

“…5,8,9 Pubic screw fixation is minimally invasive, 1,3,4 but is potentially disastrous because of its proximity to the bladder, iliac artery, and iliac vein. 5,8 Care must be taken to avoid screw penetration in case of anatomic variations (related to curvature of the superior pubic ramus, the diameter of the medullary canal, and the direction of the pubic ramus). 4 We therefore studied the anatomy of the pubic ramus and adjacent structures in 160 Japanese to establish a safer pubic screw fixation technique.…”

Section: Introductionmentioning

confidence: 99%

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Anatomic Study for Pubic Medullary Screw Insertion

Suzuki

Soma

Shindo

et al. 2008

J Orthop Surg (Hong Kong)

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Purpose. To study the anatomy of the pubic ramus and adjacent structures in 160 Japanese to establish a safer pubic screw fixation technique. Methods. 80 male and 80 female Japanese aged 16 to 89 (mean, 50) years (10 persons in each decade of age) underwent 3-dimensional computed tomographic scanning of their pelvises. The angle at which the screw should be targeted, the appropriate length of the screw, the size of the canal for screw insertion, and the proximity to the bladder, iliac artery, and iliac vein were determined. Correlations between the canal diameters (of the acetabular, base, and parasymphyseal areas) and body features (age, height, and weight) were analysed. Results. In men and women respectively, the appropriate mean screw length was 124.6 and 123.8 mm; the guide wire should be targeted at a mean of 66º and 67º cephalad and 54.1º and 55.9º laterally for insertion of a retrograde pubic screw; the minimum distances from the pubis to the bladder/iliac artery/ iliac vein were 0 and 0 mm/4.9 and 4.6 mm/0.8 and 0.2 mm. In both men and women, the canal diameters at the base were positively correlated to weight. In women, the canal diameters at the parasymphyseal area were correlated to height and weight. Canal diameters at the acetabulum were not correlated to height and weight. Conclusion. Pubic screw fixation may be potentially disastrous (owing to joint penetration and iliac vein injury) and should be performed with caution. When the canal diameter at the acetabulum is extremely narrow, plate fixation, computer-assisted surgery, or changing to a smaller-diameter screw is recommended.

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Anatomic Study for Pubic Medullary Screw Insertion

Suzuki

Soma

Shindo

et al. 2008

J Orthop Surg (Hong Kong)

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“…Controversy exists regarding the optimal treatment for these fractures in older and obese patients. Various treatment options have been described including nonoperative management, open reduction and internal fixations using plates and screws, minimally invasive stabilization and acute total hip arthroplasty [3][4][5][6][7]. Early minimally invasive definitive stabilization of selected acetabular fractures is an attractive alternative to major open procedures, especially in the elderly patients who have multiple co-morbidities and a higher perioperative risk [4].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous fixation of acetabular fractures: computer-assisted determination of safe zones, angles and lengths for screw insertion

Puchwein

Enninghorst

Sisák

et al. 2012

Arch Orthop Trauma Surg

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“…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) .…”

Section: 고 찰unclassified

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

Kim

2007

J Korean Fract Soc

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Materials and Methods:Six acetabular fractures were treated with fluoroscopic guided screw fixation. The mean age was 46 years old and mean follow-up period was 18 months. There were 3 anterior column fractures, 2 transverse fractures and 1 both column fracture. Anterior column screw fixation was used in 5 cases and posterior column fixation in 1 case. Limited ilioinguinal approach was used in 4 cases and percutaneous screw fixation in 2 cases. Results: The mean union time was 16.6 weeks. The postoperative radiographic results revealed 2 cases with an anatomic reduction and 4 cases with an imperfect reduction. The clinical results showed 1 case with excellent, 4 cases with good and 1 case with fair. Regarding complication, there was 1 case of SI joint penestration without clinical symptoms. Conclusion:Limited open reduction and screw fixation can be a useful alternative treatment for acetabular fractures in patients with minimally displaced fracture, severe multisystem trauma and soft tissue injury not suitable to traditional treatment.

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Preliminary results and complications following limited open reduction and percutaneous screw fixation of displaced fractures of the actabulum

Cited by 135 publications

References 0 publications

Anatomic Study for Pubic Medullary Screw Insertion

Anatomic Study for Pubic Medullary Screw Insertion

Percutaneous fixation of acetabular fractures: computer-assisted determination of safe zones, angles and lengths for screw insertion

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

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