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Review
. 2020 Jun 26;8(12):2464-2472.
doi: 10.12998/wjcc.v8.i12.2464.

Computer navigation-assisted minimally invasive percutaneous screw placement for pelvic fractures

Tong Yu  1 , Xue-Liang Cheng  1 , Yang Qu  1 , Rong-Peng Dong  1 , Ming-Yang Kang  1 , Jian-Wu Zhao  2
Affiliations
Review

Computer navigation-assisted minimally invasive percutaneous screw placement for pelvic fractures

Tong Yu et al. World J Clin Cases. .

Abstract

Pelvic fractures are often caused by high-energy injuries and accompanied by hemodynamic instability. Traditional open surgery has a large amount of bleeding, which is not suitable for patients with acute pelvic fracture. Navigation-guided, percutaneous puncture-screw implantation has gradually become a preferred procedure due to its advantages, which include less trauma, faster recovery times, and less bleeding. However, due to the complexity of pelvic anatomy, doctors often encounter some problems when using navigation to treat pelvic fractures. This article reviews the indications, contraindications, surgical procedures, and related complications of this procedure for the treatment of sacral fractures, sacroiliac joint injuries, pelvic ring injuries, and acetabular fractures. We also analyze the causes of inaccurate screw placement. Percutaneous screw placement under navigational guidance has the advantages of high accuracy, low incidence of complications and small soft-tissue damage, minimal blood loss, short hospital stays, and quick recovery. There is no difference in the incidence of complications between surgeries performed by new doctors and experienced ones. However, computer navigation technology requires extensive training, and attention should be given to avoid complications such as screw misplacement, intestinal injury, and serious blood vessel and nerve injuries caused by navigational drift.

Keywords: Acetabular fracture; Computer navigation; Iliac fracture; Pelvic fracture; Percutaneous puncture; Pubic fracture; Sacral fracture; Screw.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflict of interests for this article.

Figures

Figure 1
Figure 1
Procedure of sacral screw implantation. A: Navigation planning to design the length, diameter, and the best trajectory of screws; B: The user interface of the screw view mode of navigation, guiding the screw implantation. When the right lower corner of the image shows green (yellow arrow), it would be the best time to implant a guide wire.
Figure 2
Figure 2
Procedure of transpubic screw implantation. A: Navigation planning; B: The user interface of the screw view mode of navigation.
Figure 3
Figure 3
Procedure of periacetabular screw implantation. A: Navigation planning; B: The user interface of the screw view mode of navigation.
See this image and copyright information in PMC

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