Coronal acetabular fractures: the anterior approach in computed tomography-navigated minimally invasive percutaneous fixation.
OBJECTIVE
To demonstrate the technical feasibility of the anterior approach to the coronal roof component of carefully selected acetabular fractures in computed tomography (CT)-navigated closed reduction and percutaneous fixation (CRPF).


METHODS
Four patients with nondisplaced or slightly displaced coronal fractures of the acetabular roof were treated with percutaneous screw fixation. Screws were implanted over guidepins placed under CT navigation. Mean clinical and radiological follow-up was 16 months.


RESULTS
All screws could be placed as intended. There were no peri- or postoperative complications. Radiological follow-up showed primary osseous union. Clinical results were excellent according to a median Merle-d'Aubigné score of 18.


CONCLUSIONS
Nondisplaced or slightly displaced coronally oriented fractures of the acetabular roof can be treated by minimally invasive percutaneous CT-navigated fixation through an anterior approach that does not endanger the sciatic nerve. Early clinical results are encouraging. Close cooperation between trauma surgeons and radiologists and careful selection of cases is mandatory.
Jacob
A L
AL
Institute of Diagnostic Radiology, University Hospital of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
Suhm
N
N
Kaim
A
A
Regazzoni
P
P
Steinbrich
W
W
Messmer
P
P
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries*; D000328:Adult; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome