TY - JOUR
T1 - Three-dimensional fluoroscopy-navigated percutaneous screw fixation of acetabular fractures
AU - Schwabe, Philipp
AU - Altintas, Burak
AU - Schaser, Klaus Dieter
AU - Druschel, Claudia
AU - Kleber, Christian
AU - Haas, Norbert P.
AU - Maerdian, Sven
N1 - Publisher Copyright:
© 2014 Lippincott Williams & Wilkins.
PY - 2014/12/11
Y1 - 2014/12/11
N2 - Objective: Anatomic reduction and articular restoration after acetabular fractures occur (Ac-Fxs) are accepted predictors for good function and slow progression of posttraumatic osteoarthritis of the hip. The aim of this study was to retrospectively analyze Ac-Fxs, which were treated with closed reduction and percutaneous (threedimensional) fluoroscopy-based navigated screw fixation.Design: Level 4, retrospective clinical and radiographic assessment.\r\nSetting: Level 1 trauma center.\r\nPatients: Twelve patients (male/female: 9/3; mean age: 60 years; range: 16-80 years) with moderately displaced Ac-Fxs were included. Intervention: In enrolled patients, the treatment involved percutaneous three-dimensional fluoroscopy-based navigated lag screw positioning. Closed reduction was achieved by lag screws, or reduction was aided by the insertion of percutaneous Schanz pins. Main Outcome Measurements: The quality of the reduction and screw positions were assessed using intraoperative and postoperative computed tomography scans. Functional outcome was assessed using the Harris hip score, the visual analog scale for pain, and the Tegener activity scale.\r\nResults: A total of 22 periacetabular screws were placed (mean: 1.8 ± 1.1 screws/patient, range: 1-5). The mean follow-up was done for 30 (16-72) months. The postoperative reduction was anatomical in all patients, and the mean fracture displacement was significantly reduced (gap: 4.1 ± 1.8 mm to 0.4 ± 0.7 mm/step: 1.4 ± 0.6 mm to 0.2 ± 0.4 mm). No secondary dislocations or malunions/nonunions were found. All screws correctly addressed the fracture morphology and corresponded to preoperative planning. The Harris hip score, the visual analog scale (motion), and Tegener activity scale showed excellent to very good results (92.4 ± 6.8, 1.9 ± 1.3, and 3.8 ± 1.6, respectively).\r\nConclusions: The navigated, percutaneous screw fixation of selected Ac-Fxs is a promising method that allows for closed reduction and fixation while obtaining a very good radiographic and functional outcome.
AB - Objective: Anatomic reduction and articular restoration after acetabular fractures occur (Ac-Fxs) are accepted predictors for good function and slow progression of posttraumatic osteoarthritis of the hip. The aim of this study was to retrospectively analyze Ac-Fxs, which were treated with closed reduction and percutaneous (threedimensional) fluoroscopy-based navigated screw fixation.Design: Level 4, retrospective clinical and radiographic assessment.\r\nSetting: Level 1 trauma center.\r\nPatients: Twelve patients (male/female: 9/3; mean age: 60 years; range: 16-80 years) with moderately displaced Ac-Fxs were included. Intervention: In enrolled patients, the treatment involved percutaneous three-dimensional fluoroscopy-based navigated lag screw positioning. Closed reduction was achieved by lag screws, or reduction was aided by the insertion of percutaneous Schanz pins. Main Outcome Measurements: The quality of the reduction and screw positions were assessed using intraoperative and postoperative computed tomography scans. Functional outcome was assessed using the Harris hip score, the visual analog scale for pain, and the Tegener activity scale.\r\nResults: A total of 22 periacetabular screws were placed (mean: 1.8 ± 1.1 screws/patient, range: 1-5). The mean follow-up was done for 30 (16-72) months. The postoperative reduction was anatomical in all patients, and the mean fracture displacement was significantly reduced (gap: 4.1 ± 1.8 mm to 0.4 ± 0.7 mm/step: 1.4 ± 0.6 mm to 0.2 ± 0.4 mm). No secondary dislocations or malunions/nonunions were found. All screws correctly addressed the fracture morphology and corresponded to preoperative planning. The Harris hip score, the visual analog scale (motion), and Tegener activity scale showed excellent to very good results (92.4 ± 6.8, 1.9 ± 1.3, and 3.8 ± 1.6, respectively).\r\nConclusions: The navigated, percutaneous screw fixation of selected Ac-Fxs is a promising method that allows for closed reduction and fixation while obtaining a very good radiographic and functional outcome.
KW - Acetabulum fracture
KW - Computerassisted surgery
KW - Fluoroscopy-based navigation
KW - Navigation
KW - Percutaneous screw
KW - Three-dimensional
KW - Trauma
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U2 - 10.1097/BOT.0000000000000091
DO - 10.1097/BOT.0000000000000091
M3 - Article
C2 - 24662989
AN - SCOPUS:84896434248
SN - 0890-5339
VL - 28
SP - 700
EP - 706
JO - Journal of orthopaedic trauma
JF - Journal of orthopaedic trauma
IS - 12
ER -