Study finds, Low Superior Pubic Ramus Screw Failure Rate wit
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A Study was conducted to determine whether fracture pattern, implant size, fixation direction, or the amount of posterior pelvic ring fixation influences superior ramus medullary screw fixation failure.

After excluding the patients who did not meet the exclusion criterion, 95 patients with 111 superior ramus fractures were included in the study, with a minimum follow-up of three months. Many of the patients had their pelvic rings fixed in the front and back.

Comparison was done of immediate postoperative radiographs and/or computer tomography scan with the latest postoperative image to calculate interval fracture displacement and implant position. Postoperative fracture displacement or implant position change greater than 1 cm were considered fixation failures.

Results:
--5 screws were defined as failures (4.5%), including 3 retrograde, 3 with bicortical fixation, 4 with a 4.5-mm screw, and 1 with a 7.0-mm screw.

--Fracture patterns included 2 oblique and 3 comminuted fractures.

--Based on the Nakatani classification, there were 3 zone II, 1 zone I, and 1 zone III.

--Failure modes included 3 with cut-out along the screw head and 1 cut-out and 1 cut-through at the screw tip.

Finally, 4.5% of superior pubic ramus intramedullary screw fixation failures were found. Failures also happen without a common failure indicator, even with anterior and posterior fixation and specific technique. An intramedullary implant is desirable to help reestablish global pelvic ring stability because of its percutaneous advantages and proven strength.

Source: https://journals.lww.com/jorthotrauma/Abstract/2021/04000/Low_Superior_Pubic_Ramus_Screw_Failure_Rate_With.3.aspx
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