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Safe zone for transacetabular screw fixation using a Kerboull cross-plate: A CT-scan templating prospective study
T Ohmori1, T Kabata1, Y Kajino1
1Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Takaramachi 13-1, 920-8641 Kanazawa Ishikawa Japan.
Orthopaedics & Traumatology, Surgery & Research : OTSR
|November 5, 2016
Summary
This study defines a safe zone for Kerboull plate screw fixation, recommending specific angles to avoid injury to pelvic structures and iliac vessels during acetabular reinforcement.
Area of Science:
- Orthopedic surgery
- Anatomical studies
- Surgical safety
Background:
- Kerboull acetabular reinforcement plates pose risks to pelvic vascular structures and organs.
- Previous studies have not anatomically assessed these risks for the Kerboull plate design.
Purpose of the Study:
- To determine the safe zone for transacetabular screw fixation with Kerboull plates.
- To assess anatomical relationships between the plate, iliac vessels, and pelvic structures.
Main Methods:
- Prospective CT-based 3D templating study of 18 patients with Kerboull plates.
- Measurements included distances to vessels and inner cortex, and angles of insertion.
- Simulations used two plate alignments (A: 45° abduction, B: vertical to X-axis).
Main Results:
- Shortest distance to vascular structures increased with screw insertion angle (85.8mm for A, 111.4mm for B at 45°).
- Screws at ≥40° insertion angles typically passed through muscle.
- Anterior-posterior angles ≤-10° increased risk of sacroiliac joint penetration.
Conclusions:
- The safe zone for Kerboull plate screw fixation is an insertion angle ≥40°.
- An anterior-posterior angle between 0° and -10° is recommended for safe screw placement.
