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

World J Clin Cases. 2020 Jun 26;8(12):2464-2472. doi: 10.12998/wjcc.v8.i12.2464.

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.

Publication types

  • Review