Asanuma Kunihiro, Miyamura Gaku, Suzuki Yoshiaki, Makino Yoshinori, Takada Naoya, Satonaka Haruhiko, Yoshida Kakunoshin, Hagi Tomohito, Nakamura Tomoki, Sudo Akihiro
Department of Orthopedic Surgery, Mie University School of Medicine, Tsu, Japan.
Department of Orthopedic Surgery, Kainan Hospital, Yatomi, Japan.
J Surg Case Rep. 2023 Feb 27;2023(2):rjad073. doi: 10.1093/jscr/rjad073. eCollection 2023 Feb.
Management of the ischial fragment in acetabular fractures is a considerable problem. In this report, we presented how to drill or screw around the posterior column and ischium from the anterior approach using a novel 'sleeve guide technique' and the difficulty of plating. A sleeve, drill, depth gauge and driver from DepuySynthes were prepared. The portal was about 2-3 cm inside the anterior superior iliac spine opposite to the side of the fracture. The sleeve was inserted to the screw point around quadrilateral area through the retroperitoneal space. Drilling, measuring screw length by a depth gauge and the screwing were performed through the sleeve. Case 1 used a one-third plate and case 2 used a reconstruction plate. With this technique, the approach angles to the posterior column and ischium were inclined, and plating and screw insertion could be performed with a low risk of organ injury.
髋臼骨折坐骨碎片的处理是一个相当棘手的问题。在本报告中，我们介绍了如何使用一种新颖的“套筒导向技术”从前路在后柱和坐骨周围钻孔或拧入螺钉，以及钢板固定的难点。准备了来自DepuySynthes的套筒、钻头、深度测量仪和螺丝刀。切口位于与骨折侧相对的髂前上棘内侧约2 - 3厘米处。通过腹膜后间隙将套筒插入四边形区域周围的螺钉置入点。通过套筒进行钻孔、用深度测量仪测量螺钉长度以及拧入螺钉操作。病例1使用了三分之一管形钢板，病例2使用了重建钢板。采用该技术，后柱和坐骨的入路角度呈倾斜状，进行钢板固定和螺钉置入时器官损伤风险较低。
