Lester Wilson1, Farhaan Altaf2, Philippa Tyler1. 1. Royal National Orthopaedic Hospital, Stanmore, London, UK. 2. Royal National Orthopaedic Hospital, Stanmore, London, UK. farhaanaltaf@hotmail.com.
Abstract
PURPOSE: A conventional midline posterior approach is used for most of the described surgical techniques. We describe a technique of percutaneous fixation of the pars interarticularis, augmented where necessary by grafting the defect, which minimises muscle injury. METHOD: A 4.5 mm partially threaded dynamic compression screw is placed over a wire inserted percutaneously across the pars interarticularis defect. Compression is achieved across the pars interarticularis defect on placement of the screw. The screw is locked in a compressed state. RESULTS: The patient is mobilised the same day with a corset for comfort and discharged the following day. Aerobic fitness is maintained for 3 months; then, focused rehabilitation performed until a CT scan confirms healing at 5-6 months, at which stage full (sports) activity is resumed. CONCLUSIONS: The minimal tissue injury and small incision used allow for the minimising of complications and for a rapid recovery and discharge from hospital. With adolescents, we have the opportunity to treat symptomatic pars interarticularis defects with minimal disruption to their academic and physical development.
PURPOSE: A conventional midline posterior approach is used for most of the described surgical techniques. We describe a technique of percutaneous fixation of the pars interarticularis, augmented where necessary by grafting the defect, which minimises muscle injury. METHOD: A 4.5 mm partially threaded dynamic compression screw is placed over a wire inserted percutaneously across the pars interarticularis defect. Compression is achieved across the pars interarticularis defect on placement of the screw. The screw is locked in a compressed state. RESULTS: The patient is mobilised the same day with a corset for comfort and discharged the following day. Aerobic fitness is maintained for 3 months; then, focused rehabilitation performed until a CT scan confirms healing at 5-6 months, at which stage full (sports) activity is resumed. CONCLUSIONS: The minimal tissue injury and small incision used allow for the minimising of complications and for a rapid recovery and discharge from hospital. With adolescents, we have the opportunity to treat symptomatic pars interarticularis defects with minimal disruption to their academic and physical development.