Optimizing Percutaneous Reduction and Fixation with Guidewire Modification in Pelvic and Acetabular Fractures: Surgical Technique and Case Series

Overview

Journal Eur J Orthop Surg Traumatol

Specialty Orthopedics

Date 2024 Mar 29

PMID 38548873

Authors

Aiman Mudawi

Osama Alzobi

Jawad Nouraldeen Derbas

Ghalib Ahmed

Maamoun Abousamhadaneh

Affiliations

Soon will be listed here.

Abstract

Background: Minimally invasive percutaneous screw fixation for pelvic ring and acetabular fractures has become increasingly popular due to its numerous benefits. However, the precise placement of the screw remains a critical challenge, necessitating a modification of the current techniques. This paper introduces a refined technique employing a modified guidewire to enhance the precision and efficiency of percutaneous fixation in pelvic and acetabular fractures.

Methods: This study details the surgical techniques implemented for correcting guidewire misdirection in percutaneous screw fixation and includes a retrospective analysis of patients treated with this modified approach over a three-year period.

Results: In this study, 25 patients with pelvic ring and acetabular fractures underwent percutaneous screw fixation. The cohort, predominantly male (23 out of 25), had an average age of 38 years. The majority of injuries were due to traffic accidents (18 out of 25). Types of injuries included pelvic ring (6 cases), acetabular fractures (8 cases), and combined injuries (11 cases). Various screw types, including antegrade and retrograde anterior column screws, retrograde posterior column screws, and lateral compression screws, were used, tailored to each case. Over an average follow-up of 18 months, there were no additional procedures or complications, such as neurovascular injury or hardware failure, indicating successful outcomes in all cases.

Conclusions: This study introduces a simple yet effective method to address guidewire misdirection during percutaneous fixation for pelvic and acetabular fractures, offering enhanced precision and potentially better patient outcomes. Further research with a larger patient cohort is required for a more comprehensive understanding of its efficacy compared to traditional methods.

Level Of Evidence: IV. Therapeutic Study (Surgical technique and Cases-series).

Citing Articles

Experimental study of fractures of the posterior pelvic ring C1.1 using LC-II screws and internal fixation by plate.

Liu Y, Wang X, Tian B, Yao H, Liu G J Orthop Surg Res. 2024; 19(1):761.

PMID: 39543607 PMC: 11566199. DOI: 10.1186/s13018-024-05229-2.

[Effectiveness of reduction robot combined with navigation robot-assisted minimally invasive treatment for Tile type B pelvic fractures].

Liao J, Dai Y, Wu Z, Zeng Y, Li C, Wang X Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024; 38(8):954-960.

PMID: 39175317 PMC: 11335582. DOI: 10.7507/1002-1892.202404049.

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