ArticleWorld journal of orthopedics2025
Novel handheld pelvic alignment guide for hollow screw fixation in osteoporotic pelvic fragility fractures.
Article in World journal of orthopedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRetrograde pubic ramus screw placement is an effective technique but requires substantial surgical expertise and specialized equipment. The management of osteoporotic anterior pelvic ring injuries remains challenging due to technical difficulties and a high risk of complications.
aimTo introduce a novel and simplified surgical approach that utilizes a custom-designed handheld pelvic alignment guide (HPAG) in combination with a 6.0 mm hollow screw, aiming to enhance the accuracy, efficiency, and safety of retrograde pubic ramus screw fixation in osteoporotic pelvic fragility fractures.
methodsThe HPAG and 6.0 mm hollow screw were employed during surgical treatment. A 2.0-3.0 cm incision was made to expose the optimal screw entry point. Intraoperative pelvic inlet and obturator oblique views were used to monitor fracture reduction and guide screw insertion. Clinical outcomes and fracture reduction quality were evaluated using Matta, visual analog scale, and Majeed scores during follow-ups. A representative case is presented to demonstrate the surgical procedure in detail.
resultsNo perioperative complications were observed. The mean operative time was 35.2 ± 6.97 minutes, with a screw insertion time of 7.25 ± 1.86 minutes, an average incision length of 2.8 ± 0.67 cm, and mean blood loss of 43.25 ± 15.64 mL. At one-year follow-up, seven patients achieved excellent Majeed scores and three achieved good scores.
conclusionThe HPAG technique significantly shortens operative time, minimizes surgical trauma, and facilitates accurate screw placement. It presents a promising and efficient approach for managing fragility fractures of the pelvis, especially in osteoporotic patients.
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