Zhanle Zheng1, Wenjuan Wu2, Xian Yu3, Jinshe Pan1, Mahrukh Latif2, Zhiyong Hou1, Yingze Zhang4. 1. Orthopedics Trauma Center, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 86-050051, China. 2. Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, 86-050051, China. 3. Department of Endocrinology, The General Hospital of Hebei Province, Hebei Medical University, Shijiazhuang, 86-050051, China. 4. Orthopedics Trauma Center, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 86-050051, China. lancelotzzl@163.com.
Abstract
INTRODUCTION: To search for a new radiographic view/projection of the acetabular anterior column to provide a safe guide for percutaneous screw placement for acetabular fractures. MATERIALS AND METHODS: Eight pelvic specimens taken from normal adult cadavers were positioned in a supine position on the operating table. First, the ipsilateral ilium-oblique view of the observed side was obtained on C-arm fluoroscopy by tilting the C-arm approximately 35° toward the contralateral hip joint. Then, the tilting angle of the C-arm was changed gradually until an oval track image (acetabular anterior column axial view) appeared. The oval shadow was clear only in one position as the angle of the C-arm was changed toward the caudal side of the operating table. A guide pin was put on the skin of the cadaver, and the location and tilting direction of the guide pin were adjusted under C-arm fluoroscopy until the pin's shadow became a point in the center of the oval track. Then, the guide pin was inserted into the bone using a battery-powered drill. The degree of inclination of the guide pin in the cadaver in the frontal and sagittal planes was measured using computed tomography (CT). RESULTS: Axial views of the anterior column were found successfully in all of the pelvic specimens, and the guide pins were inserted accurately into the acetabular anterior column under C-arm fluoroscopic guidance. On the CT-reconstructed image, the average degree of angle between the guide pin and the sagittal plane was 33.6° (range 29.6°-36.5°). The average angle between the guide pin and the transverse plane was 59.1° (range 56.4°-63.2°). CONCLUSION: This axial view of the acetabular anterior column is a novel X-ray projection which provides an optimal method for guiding percutaneous insertion of anterior column screws for acetabular fractures.
INTRODUCTION: To search for a new radiographic view/projection of the acetabular anterior column to provide a safe guide for percutaneous screw placement for acetabular fractures. MATERIALS AND METHODS: Eight pelvic specimens taken from normal adult cadavers were positioned in a supine position on the operating table. First, the ipsilateral ilium-oblique view of the observed side was obtained on C-arm fluoroscopy by tilting the C-arm approximately 35° toward the contralateral hip joint. Then, the tilting angle of the C-arm was changed gradually until an oval track image (acetabular anterior column axial view) appeared. The oval shadow was clear only in one position as the angle of the C-arm was changed toward the caudal side of the operating table. A guide pin was put on the skin of the cadaver, and the location and tilting direction of the guide pin were adjusted under C-arm fluoroscopy until the pin's shadow became a point in the center of the oval track. Then, the guide pin was inserted into the bone using a battery-powered drill. The degree of inclination of the guide pin in the cadaver in the frontal and sagittal planes was measured using computed tomography (CT). RESULTS: Axial views of the anterior column were found successfully in all of the pelvic specimens, and the guide pins were inserted accurately into the acetabular anterior column under C-arm fluoroscopic guidance. On the CT-reconstructed image, the average degree of angle between the guide pin and the sagittal plane was 33.6° (range 29.6°-36.5°). The average angle between the guide pin and the transverse plane was 59.1° (range 56.4°-63.2°). CONCLUSION: This axial view of the acetabular anterior column is a novel X-ray projection which provides an optimal method for guiding percutaneous insertion of anterior column screws for acetabular fractures.