Percutaneous retrograde screwing for stabilisation of acetabular fractures

• Published in: Injury Vol. 36; no. 11; pp. 1330 - 1336
• Main Authors: Mouhsine, E., Garofalo, R., Borens, O., Wettstein, M., Blanc, C.-H., Fischer, J.-F., Moretti, B., Leyvraz, P.-F.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-11-2005; Elsevier
• Subjects: Acetabular fracture; Acetabulum - diagnostic imaging; Acetabulum - injuries; Aged; Aged, 80 and over; Biological and medical sciences; Bone Screws; Female; Fracture Fixation - methods; Fractures, Bone - diagnostic imaging; Fractures, Bone - surgery; Humans; Injuries of the limb. Injuries of the spine; Male; Medical sciences; Minimally invasive retrograde; Minimally Invasive Surgical Procedures - methods; Percutaneous fixation; Postoperative Complications; Radiography; Traumas. Diseases due to physical agents; Treatment Outcome; Wound Healing - physiology; Acetabular fracture; Minimally invasive retrograde; Percutaneous fixation; Chair; Diseases of the osteoarticular system; Fracture; Review; Percutaneous route; Prevention; Posterior; Complication; Age; Failure; Weight bearing; Human; Bed; Postoperative; Radiodiagnosis; Radioscopy; Acetabulum; Intraoperative; Method; Trauma; Displacement; Fixation; Screw; Screwing; Soft tissue; Bibliographic review; Geriatrics
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2004.09.016

To evaluate the results of retrograde percutaneous screw fixation (PSF) in minimally or undisplaced acetabular fractures in a geriatric population.
Between July 1998 and July 2001, 21 consecutive patients with an acetabular fracture underwent fluoroscopic guided percutaneous fixation. The mean age was 81 years (range 67–90 years). In all cases, the fracture was minimally or undisplaced (<2
mm). Two cannulated cancellous 7.3
mm screws were inserted in a retrograde fashion to stabilise the posterior and the anterior column. Bed to chair transfer began after 24
h. Weight bearing as tolerated was allowed at 4 weeks.
Eighteen patients were reviewed at a mean of 3.5 years (range 2–5 years). Soft tissue dissection was minimal. There were no intraoperative or postoperative complications. At the latest follow-up there was no radiographical evidence of secondary displacement of fragments, degenerative changes, or screw failure. Fractures healed at a mean time of 12 weeks (range 8–15 weeks). Clinical results were satisfactory in 17 patients.
Our results show that percutaneous screw fixation under fluoroscopic control is a safe technique to treat some pattern of acetabular fracture.