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Retrograde Ischiopubic Ramus Screw Internal Fixation of a Periprosthetic T-type Acetabular Fracture: A Case Report
Daniel Rusu1, Soroush Shabani1, Sahil Dhandi1
1Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Case:
A 79-year-old man with a left total hip arthroplasty presented with left hip pain following a fall. Radiographs and CT scan demonstrated a displaced, T-type, periprosthetic acetabular fracture involving the anterior and posterior columns and disruption of the ischiopubic segment. The inferior pubic ramus and the posterior column fractures were stabilized with percutaneous internal fixation using retrograde fully-threaded 6.5-mm cannulated screws. The patient demonstrated full recovery, obviating a revision hip arthroplasty and permitting early weight-bearing.
Conclusion:
Retrograde percutaneous inferior pubic ramus screw fixation is an effective adjunct to posterior column fixation for periprosthetic acetabular fractures, preventing further displacement, facilitating early weight-bearing, and avoiding revision arthroplasty.
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