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Clinical Trial
. 2018 Apr 10;13(1):77.
doi: 10.1186/s13018-018-0786-1.

A guideline for placement of an infra-acetabular screw based on anatomic landmarks via an intra-pelvic approach

Florian Baumann  1 , Paul Schmitz  2 , Daniel Mahr  2 , Maximilian Kerschbaum  2 , Axel Gänsslen  3 , Michael Nerlich  2 , Michael Worlicek  2
Affiliations
Clinical Trial

A guideline for placement of an infra-acetabular screw based on anatomic landmarks via an intra-pelvic approach

Florian Baumann et al. J Orthop Surg Res. .

Abstract

Background: Due to demographic changes, more and more fracture patterns involving anterior acetabular structures occur. The infra-acetabular screw is seen a useful tool to increase stability in fixation of the acetabular cup. However, the exact position of this screw in relation to anatomic landmarks which are intra-operatively palpable via an intra-pelvic approach has not yet been determined.

Methods: This biomorphometric experimental study references the ideal screw position of an infra-acetabular screw to anatomic landmarks palpable via an intra-pelvic approach. Therefore, we created a computer tomography-based 3D-model of 40 patients (20 women, 20 men) who received a computer tomography (CT) scan of the pelvis for any other reason than an acetabular fracture.

Results: The entry point of an ideal infra-acetabular was of high constancy. At mean, this point was 10.2 mm caudal and 10.4 mm medial of the ilio-pubic/ilio-pectineal eminence. This reference is independent of age, gender, or physical dimensions. However, we found gender-dependent differences for the angulation and the length of the screw.

Conclusions: This study provides a comprehensive guideline to determine the ideal entry point for an infra-acetabular screw via an intra-pelvic approach. The entry point is located 10.2 mm caudal and 10.4 mm medial of the ilio-pubic/ilio-pectineal eminence.

Trial registration: Clinical Trial Registry University of Regensburg Z-2017-0930-1 . Registered 04. Dec 2017.

Keywords: Acetabulum fracture; Anatomic landmarks; Entry point; Infra-acetabular screw; Intra-pelvic approach; Screw fixation.

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Conflict of interest statement

Ethics approval

The Ethics Committee at the University of Regensburg approved the study in January 2018 (Institutional Review Board Number 17-705649-180). The study is registered at the Clinical Trial Registry University of Regensburg Z-2017-0930-1. All procedures performed in studies were in accordance with the 1964 Helsinki declaration.

Consent for publication

We have obtained consent to publish from all participants to report patient data.

Competing interests

The authors declare that they have no competing interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Radiographs showing an ideal position of the infra-acetabular screw
Fig. 2
Fig. 2
Setting of the 3D-CT-based measurement of the infra-acetabular screw position
Fig. 3
Fig. 3
Boxplot of the distance of the ideal entry point to the ilio-pubic/ilio-pectineal eminence and the screw length
Fig. 4
Fig. 4
3D-CT virtual reality images illustrating the angle of the drill of left and right screw by lines in relation to the PIP
See this image and copyright information in PMC

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