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Clinical outcomes in prone positioning for percutaneous fixation of posterior column acetabular fractures

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Percutaneous retrograde fixation of posterior column acetabular fractures is becoming a commonly practiced technique. Prone positioning provides reliably reproducible intraoperative fluoroscopic images necessary for precise preparation of the osseous fixation corridor necessary for accurate and safe implant placement. Additionally, the prone position facilitates an open posterior approach if an open reduction is necessary. The purpose of this study was to analyze the radiographic and clinical outcomes of retrograde posterior column fixation utilizing the prone position.

Methods

From 2017 to 2020, 41 patients were included in the retrospective study. Clinical outcomes were collected for a minimum of 6 months. Implant placement was assessed on post-operative pelvic computed tomography (CT) scans and fracture union was assessed on routine follow-up radiographs.

Results

All (100%) cases achieved union by 4 months, with an average time to union of 3.2 months. Every post-operative CT scan demonstrated screw placement contained throughout the posterior column with no intrusion into the hip joint or sciatic notch. Clinically, one patient reported pain with sitting. No patients required additional surgical intervention.

Conclusion

Prone positioning is a versatile and effective approach for retrograde percutaneous fixation of posterior column acetabular fractures. This study is the first to report clinical outcomes utilizing this technique and contributes to a growing body of the literature supporting the value and safety of percutaneous fixation of acetabular fractures appropriate for this fixation strategy.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Code availability

All data acquisition and analysis was performed using publicly available software from Microsoft Excel (Microsoft, Redmond, WA). Image acquisition from Philips PACS (Koninklijke Philips N.V., Andover, MA).

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Funding

No funding was received to assist with the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedics, Orlando Health, Orlando Health Orthopaedic Institute, 1222 South Orange Avenue, MP 43, Orlando, FL, 32806, USA

    Samantha Levin

  2. Florida State University College of Medicine, 1115 West Call Street, Tallahassee, FL, 32306, USA

    Ryan Krumins

  3. Level One Orthopedics, Orlando Health, Orlando Health Orthopaedic Institute, 1222 South Orange Avenue, MP 43, Orlando, FL, 32806, USA

    M. Kareem Shaath & Frank R. Avilucea

Authors
  1. Samantha Levin
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  2. Ryan Krumins
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  3. M. Kareem Shaath
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  4. Frank R. Avilucea
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Contributions

All authors contributed to the study conception and design, material preparation, data collection and analysis. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Samantha Levin.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical approval

Ethical approval was waived by the local Ethics Committee of Orlando Health in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

Informed consent to participate

Consent to participate was waived by the Institutional Review Board of Orlando Health in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

Informed consent for publication

Consent for publication was waived by the Institutional Review Board of Orlando Health in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

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Levin, S., Krumins, R., Shaath, M.K. et al. Clinical outcomes in prone positioning for percutaneous fixation of posterior column acetabular fractures. Eur J Trauma Emerg Surg 48, 3721–3727 (2022). https://doi.org/10.1007/s00068-021-01636-w

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  • DOI: https://doi.org/10.1007/s00068-021-01636-w

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