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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 11, 1520-1523.
doi: 10.1302/0301-620X.87B11.16614  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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The use of a virtual three-dimensional model to evaluate the intraosseous space available for percutaneous screw fixation of acetabular fractures

N. Attias, MD, Orthopaedic Surgeon, Instructor1; R. W. Lindsey, MD, Orthopaedic Surgeon, Professor2; A. J. Starr, MD, Orthopaedic Surgeon, Associate Professor3; D. Borer, MD, Orthopaedic Surgeon4; K. Bridges, MD, Internal Medicine5; and J. A. Hipp, PhD, Director2

1 Department of Orthopaedic Surgery, MIHS, Phoenix Orthopedic Residency Program, 2601 E. Roosevelt Street, Phoenix, Arizona 85008, USA.
2 Spine Research Laboratory, Department of Orthopaedic Surgery Baylor College of Medicine, 6620 Fannin, Houston, Texas 77030, USA.
3 Department of Orthopaedic Surgery, University of Texas, Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390, USA.
4 Austin Skeletal Trauma, Specialists Orthopaedic Surgery, P. O. Box 1847, Austin, Texas 78767, USA.
5 Department of Internal Medicine, King Drew Medical Center, 2021 South Wilmington Place, Los Angeles, California 90059, USA.

Correspondence should be sent to Dr N. Attias; e-mail: anaftaly{at}hotmail.com

We created virtual three-dimensional reconstruction models from computed tomography scans obtained from patients with acetabular fractures. Virtual cylindrical implants were placed intraosseously in the anterior column, the posterior column and across the dome of the acetabulum. The maximum diameter which was entirely contained within the bone was determined for each position of the screw. In the same model, the cross-sectional diameters of the columns were measured and compared to the maximum diameter of the corresponding virtual implant.

We found that the mean maximum diameter of virtual implant accommodated by the anterior columns was 6.4 mm and that the smallest diameter of the columns was larger than the maximum diameter of the equivalent virtual implant.

This study suggests that the size of the screw used for percutaneous fixation of acetabular fractures should not be based solely on the measurement of cross-sectional diameter and that virtual three-dimensional reconstructions might be useful in pre-operative planning.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General