Accuracy and safety of percutaneous periacetabular screw insertion using screw view model of navigation in acetabular fracture

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Abstract

Rationale:

The purpose of this study was to estimate the efficacy and safety of percutaneous periacetabular screw (PPS) insertion assisted by screw view model of navigation (SVMN) to treat fracture of acetabulum.

Patient concerns:

A 61-year-old male patient was injured in a motorcycle accident, which caused pain, swelling, deformity and limited mobility on his right hip.

Diagnoses:

He was diagnosed with fracture of acetabulum.

Interventions:

We used PPS insertion assisted by SVMN to treat fracture of acetabulum in this patient.

Outcomes:

The follow up lasted 24 months. Totally 2 screws were inserted into anterior and posterior column of acetabulum respectively and both of them displayed grade 0. Compared with the preoperative gap and step of fracture displacement, the postoperative ones were significantly reduced. It took 11.7 minutes for designing the screws, 6.7 minutes for implanting the guide wire, and 45.5 minutes for placing the screws. Intraoperative blood loss was 29 mL and total fluoroscopic time was 4.1 minutes. No clinical complications such as nerve vascular injury, infection and screw loosening were found after the operation.

Lessons:

The study indicated that SVMN is favorable to the PPS insertion for acetabular fracture. Our lesson is that the relative position between the acetabular and the patient tracker must be static to ensure the accuracy of the entire system throughout the operation.

Related collections

Most cited references 28

Record: found
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Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury.

R Matta (1996)

The results were reviewed for 259 patients who had open reduction and internal fixation of 262 displaced acetabular fractures within twenty-one days after the injury. Two hundred and fifty-five hips were followed for a mean of six years (range, two to fourteen years) after the injury; the remaining seven, which clearly had a poor result, were followed for less than two years. According to the classification of Letournel and Judet, associated fracture types accounted for 208 (79 per cent) of the fractures, with both-column fractures being the most common type (ninety-two hips; 35 per cent). Two hundred and fifty-eight hips were operated on with a single operative approach (Kocher-Langenbeck, ilioinguinal, or extended iliofemoral). The four remaining hips were operated on with a Kocher-Langenbeck as well as an ilioinguinal approach. The reduction was graded as anatomical in 185 hips (71 per cent). The rate of anatomical reduction decreased with increases in the complexity of the fracture, the age of the patient, and the interval between the injury and the reduction. The over-all clinical result was excellent for 104 hips (40 per cent), good for ninety-five (36 per cent), fair for twenty-one (8 per cent), and poor for forty-two (16 per cent). The clinical result was related closely to the radiographic result. The clinical result was adversely affected by associated injuries of the femoral head, an older age of the patient, and operative complications. It was positively affected by an anatomical reduction and postoperative congruity between the femoral head and the acetabular roof. Osteonecrosis of the femoral head was noted in eight hips (3 per cent), and progressive wear of the femoral head was seen in thirteen (5 per cent). Subsequent operations included a total replacement of seventeen hips (6 per cent), an arthrodesis in four (2 per cent), and excision of ectopic bone in twelve (5 per cent). These findings indicate that in many patients who have a complex acetabular fracture the hip joint can be preserved and post-traumatic osteoarthrosis can be avoided if an anatomical reduction is achieved. An increase in the rate of anatomical reduction and a decrease in the rate of operative complications should be the goals of surgeons who treat these fractures.

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Record: found
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Early prediction of late incisional hernias.

V Pollock, Sydney M. Evans (1989)

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Retroperitoneal anatomy of the iliohypogastric, ilioinguinal, genitofemoral, and lateral femoral cutaneous nerve: consequences for prevention and treatment of chronic inguinodynia.

W. Reinpold, A D Schroeder, M. A. Schroeder … (2015)

Chronic inguinodynia is one of the most frequent complications after groin herniorrhaphy. We investigated the retroperitoneal anatomy of the iliohypogastric, ilioinguinal, genitofemoral, and lateral femoral cutaneous nerve to prevent direct nerve injury during hernia repairs and to find the most advantageous approach for posterior triple neurectomy.

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Author and article information

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Wolters Kluwer Health

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: December 2018

Publication date (Electronic): 10 December 2018

Volume: 97

Issue: 49

Electronic Location Identifier: e13316

Affiliations

[a ]Department of Orthopaedics

[b ]Department of Radiology

[c ]Department of Gynecology, The Second Hospital of Jilin University, Changchun, Jilin Province, China.

Author notes

[∗ ]Correspondence: Dong-Sheng Wang, Department of orthopaedics, The Second Hospital of Jilin University, Changchun, Jilin Province, China (e-mail: jianwu@ 123456jlu.edu.cn ).

Article

Publisher ID: MD-D-18-04960 Accession ID: 13316

DOI: 10.1097/MD.0000000000013316

PMC ID: 6310583

PubMed ID: 30544391

SO-VID: 90633cc0-9b90-41c7-bde8-eb4a946d2144

License:

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0

History

Date received : 18 July 2018

Date accepted : 25 October 2018

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Keywords: acetabular fracture,navigation,percutaneous,periacetabular screw

Data availability:

Keywords: acetabular fracture, navigation, percutaneous, periacetabular screw

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Accuracy and safety of percutaneous periacetabular screw insertion using screw view model of navigation in acetabular fracture : A case report

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Abstract

Rationale:

Patient concerns:

Diagnoses:

Interventions:

Outcomes:

Lessons:

Related collections

Fracture and Structural Integrity

Most cited references 28

Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury.

Early prediction of late incisional hernias.

Retroperitoneal anatomy of the iliohypogastric, ilioinguinal, genitofemoral, and lateral femoral cutaneous nerve: consequences for prevention and treatment of chronic inguinodynia.

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Cited by 3

Most referenced authors 216