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CardioVascular and Interventional Radiology

, Volume 39, Issue 9, pp 1332–1338 | Cite as

Percutaneous CT and Fluoroscopy-Guided Screw Fixation of Pathological Fractures in the Shoulder Girdle: Technical Report of 3 Cases

  • Julien Garnon
  • Guillaume Koch
  • Nitin Ramamurthy
  • Jean Caudrelier
  • Pramod Rao
  • Georgia Tsoumakidou
  • Roberto Luigi Cazzato
  • Afshin Gangi
Technical Note

Abstract

Objective

To review our initial experience with percutaneous CT and fluoroscopy-guided screw fixation of pathological shoulder-girdle fractures.

Materials and Methods

Between May 2014 and June 2015, three consecutive oncologic patients (mean age 65 years; range 57–75 years) with symptomatic pathological shoulder-girdle fractures unsuitable for surgery and radiotherapy underwent percutaneous image-guided screw fixation. Fractures occurred through metastases (n = 2) or a post-ablation cavity (n = 1). Mechanical properties of osteosynthesis were adjudged superior to stand-alone cementoplasty in each case. Cannulated screws were placed under combined CT and fluoroscopic guidance with complementary radiofrequency ablation or cementoplasty to optimise local palliation and secure screw fixation, respectively, in two cases. Follow-up was undertaken every few weeks until mortality or most recent appointment.

Results

Four pathological fractures were treated in three patients (2 acromion, 1 clavicular, 1 coracoid). Mean size of associated lesion was 2.6 cm (range 1–4.5 cm). Technical success was achieved in all cases (100 %), without complications. Good palliation and restoration of mobility were observed in two cases at 2–3 months; one case could not be followed due to early post-procedural oncologic mortality.

Conclusion

Percutaneous image-guided shoulder-girdle osteosynthesis appears technically feasible with good short-term efficacy in this complex patient subset. Further studies are warranted to confirm these promising initial results.

Keywords

Percutaneous osteosynthesis Screw fixation Pathological fracture Shoulder girdle 

Notes

Acknowledgments

No grant.

Compliance with Ethical Standards

Conflict of interest

The authors declare no conflict of interest or relevant disclosures.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2016

Authors and Affiliations

  • Julien Garnon
    • 1
  • Guillaume Koch
    • 1
  • Nitin Ramamurthy
    • 2
  • Jean Caudrelier
    • 1
  • Pramod Rao
    • 3
  • Georgia Tsoumakidou
    • 1
  • Roberto Luigi Cazzato
    • 1
  • Afshin Gangi
    • 1
  1. 1.Department of Interventional RadiologyUniversity Hospital of StrasbourgStrasbourgFrance
  2. 2.Department of RadiologyNorfolk and Norwich University HospitalNorwichUK
  3. 3.ICubeUniversity of StrasbourgStrasbourgFrance

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