Percutaneous Retrograde Screw Fixation of the Acetabulum: A Case Report

Abstract

Introduction: Percutaneous screw fixation techniques for pelvic fractures are mainly described in the management of posterior arch fractures. More recently, improved imaging technology and means for closed reduction have meant that percutaneous techniques have gained popularity in the treatment of acetabular fracture. The objective of this study is to evaluate the feasibility and interest of percutaneous screw fixation in minimally displaced acetabular fractures. Observation: We present the case of an 18-year-old female patient with a psychiatric history who was a victim of defenestration. The radiological exam revealed a fracture of the right sacral ala associated with a minimally displaced T fracture of the left acetabulum. The patient had a percutaneous right sacroiliac screwing and a percutaneous retrograde screw fixation of the left acetabular posterior column. A psychiatric follow-up was carried out. Touch-down weightbearing is allowed for the first three weeks with crutch. The postoperative course was simple. A postoperative CT scan confirmed the correct placement of the screw. Support was allowed after 45 days. No complications were observed at the last 12-month follow-up. Discussion:  Orthopedic treatment of minimally displaced or nondisplaced acetabular fractures provides good radiological results but does not allow early mobilization and rehabilitation and exposes to decubitus complications. Percutaneous retrograde screw fixation is a reliable and reproducible technique that allows rapid ambulation while avoiding the complications of conventional surgery, such as bleeding, vascular and nerve damage, and heterotopic ossifications. Conclusion: Percutaneous acetabular screw fixation is a safe and reliable technique for the management of non-displaced and minimally displaced acetabular fractures.