title: Computed Tomography-Based Software Safely Guides Anterograde Percutaneous Anterior and Posterior Column Acetabular Screws.
abstract: The objective of this study was to develop three-dimensional (3-D) modeling software to generate the optimal individualized starting points and pathways for anterior and posterior column screws. In this cross-sectional study, 95 consecutive patients from a level I trauma center with noncontrast pelvis computed tomography (CT) images without displaced acetabular fractures were studied. A Java-based program was designed that generated a 3-D graph of pelvic bones and a list was compiled of every potential anterograde anterior and posterior column screw that exited distal to the acetabulum, eliminating screws that did not safely remain within the cortex. The longest safe screw pathway for each patient was determined for both 6.5-mm and 7.3-mm diameter screws. The program was able to identify safe screw pathways for the vast majority of patients (>96%). The study also found that males tolerated significantly longer screws in the anterior column (p < .05), but there was no posterior column difference regarding sex.
authors: Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas. smbanerjee@gmail.com.
authors: Soham
authors: S
authors: Banerjee
authors: Adam J
authors: AJ
authors: Starr
authors: Rahul
authors: R
authors: Banerjee
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D003430:Cross-Sectional Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012984:Software; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D055815:Young Adult