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

Archives of Orthopaedic and Trauma Surgery
Paul PuchweinWolfgang Pichler

Abstract

Percutaneous retrograde screw fixation for acetabular fractures is a demanding procedure due to the complex anatomy of the pelvis and the varying narrow safe bony corridors. Limited information is available on optimal screw placement and the geometry of safe zones for screw insertion in the pelvis. Three-dimensional reconstructions of 50 consecutive CT scans of polytrauma patients (35 males, 15 females) were used to introduce three virtual CAD bolts (representing screws) into the anterior column (superior ramus of the pubic bone), posterior column (the ischial bone) and the supraacetabular region, as performed during percutaneous screw fixation. The three-dimensional (3D) position of these screws was evaluated with a computer software (MIMICS) after virtual optimal insertion. The 3D position, the narrowest zone and the distance to the hip joint of the two columns and the supraacetabular region were defined. The mean maximal screw length for the three virtual screws measured between 107.4 and 148 ± 18.7 mm. The narrowest zone of the pelvic bone (superior pubic ramus) had a width of 9.2 ± 2.4 mm. The average distances between the bolts and the hip joint were 3.9 and 19.4 ± 7.4 mm. For the anterior column (superior pubic ramus) sc...Continue Reading

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Citations

Dec 5, 2012·International Orthopaedics·Sanjay Meena, Vijay Kumar Digge
Dec 3, 2014·Archives of Orthopaedic and Trauma Surgery·Zhanle ZhengYingze Zhang
Oct 20, 2015·International Journal of Computer Assisted Radiology and Surgery·Ye PengPeifu Tang
Nov 20, 2014·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Florian GrasIvan Marintschev
Jan 13, 2015·International Journal of Computer Assisted Radiology and Surgery·XiaoReng FengBin Chen
Mar 17, 2015·The Orthopedic Clinics of North America·Leonard T BullerFernando E Vilella
Jan 15, 2014·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Hua ChenYan Wang
Sep 28, 2014·Clinical Orthopaedics and Related Research·Florian GrasRainer Burgkart
Oct 31, 2015·Injury·Theodoros H Tosounidis, Peter V Giannoudis
Oct 9, 2016·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Nicholas QuercettiMichael J Prayson
Oct 24, 2017·Physics in Medicine and Biology·J GoerresJ H Siewerdsen
Jun 14, 2019·The Journal of the American Academy of Orthopaedic Surgeons·Daniel BanaszekKelly A Lefaivre
May 3, 2020·The Journal of Bone and Joint Surgery. American Volume·Songxiang LiuDehao Fu
Aug 11, 2018·Journal of Orthopaedic Trauma·Jonathan G Eastman, Milton L Chip Routt
Jul 1, 2017·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Theodoros H TosounidisPeter V Giannoudis
Jan 16, 2021·Journal of Orthopaedic Surgery and Research·Zhongye SunBei Zhao
Jun 18, 2021·BMC Musculoskeletal Disorders·Bei ZhaoWeidong Mu

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