Percutaneous Magic screw fixation for acetabular posterior column fracture: an imaging anatomical study#br#

CHEN Jian-Fei; GAO Shi-Chang

doi:10.16098/j.issn.0529-1356.2020.01.015

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Acta Anatomica Sinica ›› 2020, Vol. 51 ›› Issue (1) : 86-92. DOI: 10.16098/j.issn.0529-1356.2020.01.015

Anatomy

Percutaneous Magic screw fixation for acetabular posterior column fracture: an imaging anatomical study#br#

CHEN Jian-fei GAO Shi-chang* YU Ke-quan

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Abstract

Objective To investigate the entry point, direction and fixation range of Magic screw for acetabular posterior column fracture.

Methods The 3D models of 100 pelvis were reconstructed by Mimics 19.0 software based on CT data, and the virtual magic screw were placed in acetabular posterior column, then the screw’s entry point were determined, and the direction, length, diameter and safe range were measured respectively. Acetabular posterior column with magic screw was osteotomy modeling by Mimics 19.0 and imported the Geomagic Wrap 2017 software, after that anatomical parameters of the screw path were measured. Results The entry point of Magic screw on bone surface was located at (33.37±5.53)mm of the anterior inferior iliac spine moving posteriorly, and (13.40±3.70)mm of the apex of the upper margin of acetabular moving celphalad in male, which were (33.97±5.46)mm and (9.01±3.86)mm in female. The posterior inclination angle, interior inclination angle of magic screw and the angle between screw and iliac wing were (57.40±6.57)°, (52.09±5.65)°and (15.21±3.42)°in male, which were (55.64±8.01)°，(51.55±5.58)°and (9.85±3.68)°in female. The maximum diameter of male screw was (6.97±0.98) mm, which was (6.39±0.85) mm in female. The length of male screw was (76.73±9.20) mm, which was (63.64±8.37) mm in female. The safe range of posterior inclination and interior inclination of were (7.19±3.30)°and (9.41±3.95)°in male screw with 5.5 mm diameter, which were (8.37±2.82)°and (10.32±3.93)°in female screw with 5.2 mm diameter. In the direction of the screw, the length range of the posterior column which is fixed by screw was (56.87±7.60) mm，and the proportion of fractures fixed with screws which were located on the top of the acetabular was 20/50 in male, which were (41.71±7.97) mmand 8/50 in female. Conclusion Percutaneous Magic screw is a minimally invasive treatment for acetabular posterior column fracture, which is difficult to operate. The screw can fix the fracture which is located at the middle and upper part of the acetabular posterior column.

Key words

Acetabular posterior column / Magic screw / Imaging anatomy / Three-dimensional reconstruction / Human

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CHEN Jian-fei GAO Shi-chang YU Ke-quan. Percutaneous Magic screw fixation for acetabular posterior column fracture: an imaging anatomical study#br#[J]. Acta Anatomica Sinica. 2020, 51(1): 86-92 https://doi.org/10.16098/j.issn.0529-1356.2020.01.015

References

［1］ Giannoudis PV, Grotz MRW, Papakostidis C, et al. Operative treatment of displaced fractures of the acetabulum［J］. Bone Joint Surg Br, 2005, 87(1): 2-9.

［2］ Letournel E. The treatment of acetabular fractures through the ilioinguinal approach［J］. Clin Orthop Relat Res, 1993, (292): 62-76.

［3］ Wu XB, Zhang Q, Guo MK, et al. Model establishment of posterior column fracture of the acetabulum and biomechanical evaluation of the stability between plate and lag screw internal fixation［J］. Chinese Journal of Tissue Engineering Research, 2009, 13(52):10236-10240.(in Chinese)

吴啸波，张奇，郭明珂，等. 髋臼后柱骨折模型建立及髋臼后柱骨折钢板内固定和拉力螺钉内固定稳定性比较［J］. 中国组织工程研究与临床康复，2009，13(52)：10236-10240.

［4］ Mouhsine E, Garofalo R, Borens O, et al. Percutaneous retrograde screwing for stabilisation of acetabular fractures［J］. Injury, 2015, 36(11): 1330-1336.

［5］ Mu WD, Wang XQ, Jia TH, et al. Quantitative anatomic basis of antegrade lag screw placement in posterior column of acetabulum［J］. Arch Orthop Trauma Surg, 2009, 129(11): 1531-1537.

［6］ Starr AJ, Borer DS, Reinert CM. Technical aspects of limited open reduction and percutaneous screw fixation of fractures of the acetabulum ［J］. Operative Techniques Orthop, 2001, 11(3): 218-226.

［7］ Ruan Z, Luo CF, Zeng BF, et al. Percutaneous screw fixation for the acetabular fracture with quadrilateral plate involved by three-dimensional fluoroscopy navigation: surgical technique［J］. Injury, 2012, 43(4): 517-521.

［8］ Li J, Li Z, Wang X, et al. Establishment of fluoroscopy views and standardized procedure of percutaneous magic screw insertion for acetabulum fractures［J］. BMC Musculoskelet Disord, 2018, 19(1): 332.

［9］ Tang Y, Zhang YT, Zhang ChC, et al. Anatomic measurements and quantitative analysis of posterior acetabular wall［J］. China Journal of Orthopaedics and Traumatology, 2014, 27(12): 1024-1028.(in Chinese)

汤洋, 章云童, 张春才, 等. 髋臼后壁解剖学测量及定量分析［J］.中国骨伤,2014,27(12):1024-1028.

［10］Currin SS, Mirjalili SA, Meikle G, et al. Revisiting the surface anatomy of the sciatic nerve in the gluteal region［J］. Clin Anat, 2015, 28(1): 144-149.

［11］Florian-Ridriguez ME, Hare A, Chin K, et al. Inferior gluteal and other nerves associated with sacrospinous ligament: a cadaver study［J］. Am J Obstet Gynecol, 2016, 215(5): 641-646.

［12］Bilhim T, Pereira JA, Fernandes L, et al. Angiographic anatomy of the male pelvic arteries［J］. AJR Am J Roentgenol, 2014, 203(4): 373-382.

［13］Chang JK, Gill SS, Zura RD, et al. Comparative strength of three methods of fixation of transverse acetabular fractures［J］. Clin Orthop Relat Res, 2001,(392): 433-441.

［14］Yi C, Burns S, Hak DJ, et al. Intraoperative fluoroscopic evaluation of screw placement during pelvic and acetabular surgery ［J］. J Orthop Trauma, 2014, 28(1):48-56.

［15］Lai JQ, Cao ShL, Wang YR, et al. Anatomy and radiology of the back zone of acetabular posterior column［J］. Chinese Journal of Orthopaedic Trauma, 2015, (5): 369-373.(in Chinese)

赖剑强，曹生鲁，汪祎然，等. 髋臼后柱后区的解剖学和影像学研究［J］. 中华创伤骨科杂志，2015，(5)：369-373.

［16］ Wang G, Wang YR, Chen HF, et al. Treatment strategy of posterior column screw internal fixation for acetabular fracture［J］. Journal of Clinical Surgery, 2016, 24(5), 340-342.(in Chinese)

王钢，汪祎然，陈鸿奋，等. 髋臼骨折后柱螺钉内固定治疗策略［J］. 临床外科杂志，2016，24(5)：340-342.