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A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique
Published on: January 6, 2023
Percutaneous screw fixation of acetabular fractures with 2D fluoroscopy-based computerized navigation
Gao Hong1, Luo Cong-Feng, Hu Cheng-Fang
1Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Jiaotong University, 600 Yishan Road, Shanghai, People's Republic of China. honggao630@yahoo.com.cn
Archives of Orthopaedic and Trauma Surgery
|April 6, 2010
Summary
Percutaneous screw fixation using 2D fluoroscopy-based navigation offers a viable treatment for acetabular fractures, including displaced types. This minimally invasive technique demonstrates good outcomes with low complication rates.
Area of Science:
- Orthopaedic Surgery
- Medical Technology
- Skeletal Trauma
Background:
- Traditional open reduction and internal fixation for acetabular fractures can lead to complications due to extensile exposure.
- Computerized navigation systems offer real-time guidance for implant placement, potentially improving outcomes.
Purpose of the Study:
- To evaluate the early treatment results and complications of 2D fluoroscopy-based navigation for percutaneous screw fixation in acetabular fractures.
- To assess the clinical applicability of this technique for both non-displaced and displaced acetabular fractures amenable to closed or limited open reduction.
Main Methods:
- Eighteen adult patients with acetabular fractures (12 non-displaced, 8 displaced) underwent percutaneous screw fixation guided by a fluoroscopy-based navigation system.
- Fractures were classified using the AO and Orthopaedic Trauma Association systems.
- Mean follow-up was 21 months, with a mean time from injury to surgery of 4 days.
Main Results:
- Thirty acetabular screws were inserted with an average operative time of 24.6 minutes and average fluoroscopic time of 28.4 seconds.
- Postoperative displacement was significantly reduced compared to preoperative measurements (gap: 3mm vs 10mm; step: 2mm vs 4mm).
- One transient femoral nerve palsy occurred; no infections were reported. Thirteen patients had excellent, 4 good, and 1 fair result.
Conclusions:
- 2D fluoroscopy-based navigation enables percutaneous screw fixation for acetabular fractures.
- The technique is effective for both non-displaced and certain displaced acetabular fractures.
- This approach may reduce complications associated with traditional open surgery.
