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Percutaneous antegrade screwing for anterior column fracture of acetabulum with fluoroscopic-based computerized navigation

Percutaneous antegrade screwing for anterior column fracture of acetabulum with fluoroscopic-based computerized navigation

Authors :
Peng-Ju Huang
Ping-Cheng Liu
Hsuan-Ti Huang
Lan-Hui Chen
Shao-Hung Hung
Chung-Hwan Chen
Yu-Chuan Lin
Jian-Chih Chen
Je-Ken Chang
Tsung Ying Lee
Source :
Archives of Orthopaedic and Trauma Surgery. 128:223-226
Publication Year :
2007
Publisher :
Springer Science and Business Media LLC, 2007.

Abstract

Open reduction and internal fixation has been the gold standard for displaced fracture involving weightbearing dome and fractures with intra-articular fragments. However, extensile exposure can lead to complications. Fracture with minimal displacement can be fixed by a minimally invasive method. Percutaneous screwing for an anterior column fracture of acetabulum under conventional 2D fluoroscopy is a demanding technique. With fluoroscopic-based computerized navigation, we can determine the position of a screw real time intra-operatively with less exposure to radiation. We proposed that a fluoroscopy-based computerized navigational system would simplify operation procedures. The purpose of this study is to test the application of the fluoroscopy-based computerized navigational system for anterior column fracture of acetabulum.A prospective cohort study was conducted. Three patients with mildly displaced or non-displaced anterior column fracture of acetabulum were treated with a retrograde lag screw under a fluoroscopy-based computer navigation system. There were two males and one female with a mean age of 39 years and all patients were followed up for more than 1 year. Patients were allowed to perform joint movement exercises and to walk with partial weightbearing on the first day post-operatively.The mean operation time was 40 min (range 30-45 min) from the use of fluoroscopy to wound closure and the mean total fluoroscopy time was 38 s (range 35-45 s). Total blood loss was less than 10 ml. The patients were pain free 1 week after the operation and had good functional recovery thereafter. No complication was noted postoperatively.Though the indication for this procedure is limited, we think that there should be potential to apply the screw with less radiation by fluoroscopic-based computerized navigation. Once anatomic reduction can be achieved by the close method in the anterior column fracture of the acetabulum, percutaneous screw fixation under fluoroscopic-based computerized navigation could be a reliable method; however; validating the position of the guide pin and screw by fluoroscopy is suggested.

Details

ISSN :
14343916 and 09368051
Volume :
128
Database :
OpenAIRE
Journal :
Archives of Orthopaedic and Trauma Surgery
Accession number :
edsair.doi.dedup.....9d5ff7379cb9a9016879bdd24c9ca305
Full Text :
https://doi.org/10.1007/s00402-007-0369-9