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Computer-assisted surgery and planning in percutaneous pelvic screw fixation.

Mehdi Boudissa1, Gael Kerschbaumer1, Jérôme Tonetti1

  • 1CHU de Grenoble-Alpes, Université de Grenoble-Alpes, Laboratoire TIMC-IMAG, Unité de Chirurgie Orthopédique et Traumatologique, CNRS UMR 5525, Boulevard de la Chantourne, 38700 La Tronche, France.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|September 6, 2025
PubMed
Summary

Percutaneous pelvic screwing (PPS) offers a minimally invasive approach for pelvic fractures and tumor fixation, with evolving indications and lower morbidity than open surgery. Careful preoperative planning using CT imaging is crucial for successful outcomes.

Keywords:
Computer-assisted surgeryImagingPelvic ringPercutaneous screwingPlanningacetabulum

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Area of Science:

  • Orthopedic Surgery
  • Minimally Invasive Techniques
  • Medical Imaging

Background:

  • Percutaneous pelvic screwing (PPS) is an evolving technique for pelvic fracture fixation and tumor lesion stabilization.
  • It offers lower morbidity compared to traditional open surgery.
  • Advancements in imaging have expanded its indications.

Purpose of the Study:

  • To review the indications, planning, and outcomes of percutaneous pelvic screwing.
  • To highlight the role of preoperative planning and emerging technologies.

Main Methods:

  • Review of percutaneous pelvic screwing techniques, including posterior (iliosacral, trans-sacral, supra-acetabular) and anterior (pubic ramus, iliac wing, gluteal pillar) approaches.
  • Emphasis on preoperative planning using CT DICOM viewer software for multiplane reconstruction and 3D analysis.
  • Discussion of percutaneous acetabular screwing (transverse acetabular, retrograde posterior column).

Main Results:

  • PPS provides fixation for various pelvic ring fractures and tumor lesions, applicable to young and older patients.
  • Results are comparable to open surgery with significantly reduced morbidity.
  • Common complications include malpositioning and fixation failure.

Conclusions:

  • Rigorous preoperative planning is essential for successful PPS.
  • Innovations like 3D printing, navigation, and robotic surgery are shaping the future of PPS.
  • Intraoperative imaging and navigation can enhance safety and reduce pitfalls.