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Axial perspective to find the largest intraosseous space available for percutaneous screw fixation of fractures of the acetabular anterior column

  • XiaoReng Feng
  • JinTao Fang
  • Chaowen Lin
  • Sheng Zhang
  • WenXiong Lei
  • YuanHui Li
  • SanYuan Tang
  • Bin ChenEmail author
Original Article

Abstract

Objective

To find the largest screw path in the acetabular anterior column using a novel method of axial perspective and test the clinical feasibility of the anterior column axial view projection.

Methods

3D models with the inner triangular patches deleted were created from the pelvic CT scan data of 58 normal pelvises. The transparency of each 3D model was downgraded at the axial perspective (the view perpendicular to the cross section of the anterior column axis) so that a translucent area was seen clearly. The orientations of each 3D model were adjusted until a triangle-like translucent area that could accommodate the largest virtual screw (Screw I) was present and then an ellipse-like translucent area that could accommodate the two largest virtual screws (Screw II) was present. The maximum diameter, direction of Screw I and the maximum diameter Screw II were measured. Clinical feasibility of the axial view projection was next tested in five cadaveric specimens.

Results

The mean maximum diameters of Screw I and Screw II were \(11.20\,\pm \,1.73\) (7.80–14.60 mm) and \(8.71\,\pm \,0.91\) (6.60–10.60 mm), respectively. The angles of Screw I to the transverse, coronal and sagittal planes were \(41.16^{\circ }\,\pm \,4.59^{\circ }, 18.18^{\circ }\,\pm \,1.15^{\circ }\) and \(44.33^{\circ }\,\pm \,4.31^{\circ }\), respectively. Translucent areas were successfully observed in all the cadaveric hemi-pelves and guide pins were successfully inserted in all the cadaveric hemi-pelves with the assistance of the anterior column axial view projection without cortex penetration or joint violation.

Conclusions

The acetabular anterior column could safely accommodate not only one 7.3-mm screw, but also two 6.5-mm screws. The anterior column axial projection may be clinically feasible.

Keywords

Acetabular anterior column Percutaneous screw fixation Axial perspective Anterior column axial view projection 

Notes

Acknowledgments

The authors thank Professor Ping Allen Liang for his great contribution to the writing and revising this manuscript. This project was supported by the Natural Science Foundation of China (No. 81401777).

Conflict of interest

None.

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Copyright information

© CARS 2015

Authors and Affiliations

  • XiaoReng Feng
    • 1
  • JinTao Fang
    • 1
  • Chaowen Lin
    • 1
  • Sheng Zhang
    • 1
  • WenXiong Lei
    • 2
  • YuanHui Li
    • 3
  • SanYuan Tang
    • 3
  • Bin Chen
    • 1
    Email author
  1. 1.Department of Orthopedic Trauma, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
  2. 2.Emergency Department, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
  3. 3.Department of Orthopaedics and TraumatologyThe People’s Hospital of Zhuhai The Third Hospital Affiliated to Jinan UniversityZhuhaiChina

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