Department of Orthopaedic Surgery, 58934Guro Hospital, Korea University Medical Center, Seoul, Korea.
J Orthop Surg (Hong Kong). 2021 Jan-Apr;29(1):2309499021996838. doi: 10.1177/2309499021996838.
Proper placement of infra-acetabular screws is technically demanding; there is a limited safe zone for screw fixation because of the complexity of the bone anatomy around the hip joint and the vulnerability of the major neurovascular bundles in the pelvic cavity. We aimed to present the obturator hook technique as a surgical technique for infra-acetabular screw placement in acetabular and pelvic fractures and report its radiological outcomes.
Patients treated with infra-acetabular screw placement using the obturator hook technique between January 2015 and August 2020 were enrolled in this study. We collected data on demographics, surgical approach, reduction status, complications, and outcomes. The radiological outcomes of infra-acetabular screw placement based on computed tomography findings were evaluated as follows: success, articular penetration, or out of the bone.
Thirty-five patients underwent infra-acetabular screw placement (26 men, 9 women; mean age, 55 years; range, 27-90 years). One patient underwent bilateral infra-acetabular screw placement; therefore, 36 infra-acetabular screws were inserted in all patients. An ideal placement was achieved with 27 infra-acetabular screws (27/36, 75%). Seven infra-acetabular screws (7/36, 19%) showed articular penetration, and two infra-acetabular screws (2/36, 6%) were placed outside the bone. One patient with articular penetration and mechanical symptoms of the hip joint required screw replacement. No other complications, including obturator nerve and vascular injuries, were observed.
The obturator hook technique could be a favorable and individualized method for infra-acetabular screw placement in patients with acetabular and pelvic fractures.
IV, retrospective descriptive study.
髋臼下螺钉的正确放置技术要求较高；由于髋关节周围骨骼解剖结构复杂，盆腔内主要神经血管束脆弱，螺钉固定的安全范围有限。我们旨在介绍闭孔钩技术作为髋臼和骨盆骨折中髋臼下螺钉放置的一种手术技术，并报告其放射学结果。
本研究纳入了 2015 年 1 月至 2020 年 8 月期间采用闭孔钩技术行髋臼下螺钉放置的患者。我们收集了患者的人口统计学、手术入路、复位情况、并发症和结果等数据。根据 CT 检查结果评估髋臼下螺钉放置的放射学结果：成功、关节穿透或穿出骨。
35 例患者接受了髋臼下螺钉放置（26 例男性，9 例女性；平均年龄 55 岁；年龄范围 27-90 岁）。1 例患者行双侧髋臼下螺钉放置；因此，所有患者共置入 36 枚髋臼下螺钉。27 枚髋臼下螺钉（27/36，75%）达到理想位置。7 枚髋臼下螺钉（7/36，19%）出现关节穿透，2 枚髋臼下螺钉（2/36，6%）穿出骨外。1 例关节穿透且髋关节有机械症状的患者需要更换螺钉。未观察到其他并发症，包括闭孔神经和血管损伤。
闭孔钩技术可能是髋臼和骨盆骨折患者髋臼下螺钉放置的一种有利且个体化的方法。
IV，回顾性描述性研究。
