Educational Corner

Educational Insights on Acetabular Percutaneous Screw Fixation: Posterior and Anterior Column Management in Prone Position

Abstract

Background: Open reduction and internal fixation (ORIF) of acetabular fractures, while effective, carries significant morbidity.
Percutaneous techniques offer reduced soft-tissue damage and blood loss, but require precise radiographic guidance. This study
explores the safety and efficacy of prone positioning for percutaneous fixation of both acetabular columns, addressing the lack of
data on this approach.
Case Report: A 59-year-old man with a transverse acetabular fracture, classified by Letournel-Judet, underwent percutaneous fixation
in the prone position. The procedure involved retrograde posterior column screw placement and antegrade anterior column screw
placement. Fluoroscopic imaging was crucial for accurate guide pin and screw insertion, with specific attention to anatomical
landmarks and neurovascular structures. The surgical technique details the steps for each screw placement, including fluoroscopic
views and potential complications.
Conclusion: Prone positioning for percutaneous acetabular fracture fixation provides excellent surgical access and reliable imaging,
and facilitates conversion to open surgery if needed. While prone positioning has limitations, including potential cardiovascular
and pulmonary effects, this minimally-invasive technique demonstrated safety and reliability for treating specific acetabular
fracture patterns. Preoperative planning and intraoperative imaging are critical for successful outcomes.

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Files
IssueVol 11 No 2 (2025) QRcode
SectionEducational Corner
Keywords
Acetabular Fracture; Percutaneous Screw Fixation; Posterior Column; Anterior Column; Prone Position; Orthopedic Surgery; Minimally Invasive Technique; Fluoroscopic Guidance; Surgical Planning; Column Stabilization
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How to Cite
1.
Heidari S, Hosseinaei N, Choobdar Omrani M, Kalantar SH. Educational Insights on Acetabular Percutaneous Screw Fixation: Posterior and Anterior Column Management in Prone Position. J Orthop Spine Trauma. 2025;11(2):69-72.