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Analysis of computed tomography-based infra-acetabular morphometry to assess the feasibility of infra-acetabular screws

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The number of pelvic fractures based on osteoporosis has been increasing. The infra-acetabular screw (IAS), which connected both osseous columns, is a safe method of screw placement going through the infra-acetabular corridor (IAC). However, the specifics of the anatomy of IAC have been far from completely understood, especially in the Asian population. The purpose of our study was to reveal the details of the IAC using computed tomography (CT) data.

Materials and methods

Traumatized in-patients having pelvic CT scans from 2014 to 2016 were enrolled. Pediatric and adult patients with pelvic fractures and hip prostheses were excluded. The male/female ratio and distribution of patients' age were equalized manually; 40 male and 40 female patients were included. The IAC was measured on the plane of the inlet view (25° caudal) in multi-planar reconstructed CT images. Measurements: infra-acetabular diameter (IAD), anterior–posterior length of the IAC (APL), length from the starting point of the IAC to the medial edge of the pelvis (LME), length from the starting point of the IAC to the top of the pubic symphysis (LPS), and tilting on inlet plate (TIP).

Results

Age was 59 ± 22 (mean ± SD). Height was 159 ± 11 cm, and body mass index (BMI) was 22.9 ± 4.1. IAD, APL, LME, LPS, and TIP was 4.0 ± 1.3 mm, 89.5 ± 7.1 mm, 8.7 ± 3.6 mm, 57.8 ± 4.8 mm, and 4.7 ± 5.2°, respectively. Over 20% of corridors (35 of 160) were not feasible for IAS placement, because of inadequate width (less than 3.0 mm). Nine corridors (5.6%) had curvature in IAC, which meant technically demanding to insert IAS. There was no difference in IAD between male and female patients, while APL, LME, LPS, and TIP had sex-related differences.

Conclusions

Surgeons should pay attention to the fact that over 20% of IACs are not feasible for infra-acetabular screw placement even with the perfect reduction of fragments when treating acetabular fractures.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita, 879-5593, Japan

    Shozo Kanezaki, Masashi Miyazaki, Naoki Notani, Toshinobu Ishihara, Tomonori Sakamoto, Tetsutaro Abe & Hiroshi Tsumura

  2. Advanced Trauma, Emergency, and Critical Care Center, Oita University Hospital, Oita, Japan

    Shozo Kanezaki, Naoki Notani & Tomonori Sakamoto

  3. Physical Therapy Course of Study, Faculty of Welfare and Health Sciences, Oita University, Oita, Japan

    Masashi Kataoka

Authors
  1. Shozo Kanezaki
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  2. Masashi Miyazaki
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  3. Naoki Notani
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  4. Toshinobu Ishihara
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  5. Tomonori Sakamoto
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  6. Tetsutaro Abe
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  7. Masashi Kataoka
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  8. Hiroshi Tsumura
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Correspondence to Masashi Miyazaki.

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Kanezaki, S., Miyazaki, M., Notani, N. et al. Analysis of computed tomography-based infra-acetabular morphometry to assess the feasibility of infra-acetabular screws. Arch Orthop Trauma Surg 140, 359–364 (2020). https://doi.org/10.1007/s00402-019-03280-x

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  • DOI: https://doi.org/10.1007/s00402-019-03280-x

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