Does increased acetabular depth affect safe infra-acetabular screw placement in acetabular fracture fixation?

Bastian, Johannes Dominik; Näf, David Riccardo; Cullmann, Jennifer Larissa; Keel, Marius Johann; Giannoudis, Peter V. (2021). Does increased acetabular depth affect safe infra-acetabular screw placement in acetabular fracture fixation? European journal of trauma and emergency surgery, 47(5), pp. 1319-1326. Springer-Medizin-Verlag 10.1007/s00068-020-01455-5

Preview

Text Does_Cullmann.pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (1MB) | Preview

BACKGROUND

Infra-acetabular screws enhance the fixation strength in acetabular fractures with separation of both columns. Placement without iatrogenic femoral head violation is challenging.

PURPOSE

To assess the impact of the acetabular configuration, the patients' age and gender on safe infra-acetabulum screw insertion.

METHODS

In 112 patients (69 females; mean age: 34 years, range 17-88; n = 200 hips), the lateral center-edge angle (LCE) was measured on radiographs. Using corresponding axial CT scans the residual distance from (the lateral border) of the screw to (the medial border of) the femoral head ("Screw-to-Femoral Head distance"; "RD_SFH") was determined. Statistical analysis was carried out using linear regression, multiple linear regression and normal distribution estimation.

RESULTS

The mean (range) LCE angle was 30° (7°-51°) and the mean (range) "RD_SFH" was 5 mm (1-14 mm). The linear regression model shows a significant linear relation between LCE and "RD_SFH" with a slope parameter of - 0.15 (p value < 0.0001), the Pearson correlation between LCE and "RD_SFH" is - 0.56 (CI [- 0.71, [- 0.40]). Age did not have a significant impact on the relation between LCE and "RD_SFH" (p value 0.85). Compared to male patients, in females, the intercept is 4.62 mm (p value 0.0005) less, the slope parameter is 0.09 (p value 0.029) larger.

CONCLUSION

The virtual possibility to place an infra-acetabular screw was given in all patients. An increasing depth of the acetabulum correlated with a decrease in residual distances. As hip joint cartilage thickness was not considered in measurements, intraoperative rule-out of screw mispositioning especially in deep acetabular sockets and females is still of utmost importance.

Interest & Impact

Downloads

168 since deposited on 31 Jul 2020
23 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item