- See:
Classification and Column Theory
- Percutaneous Screw Placement:
- anterior column screws can be placed either antegrade (from cephalad to caudad) or retrograde (vice versa);
- implant: 7.3 or 8.0 mm cannulated screws;
- C-arm is placed perpendicular to the superior pubic ramus;
- inlet iliac view: helps to avoid guide wire penetration of the inner cortex of the superior ramus;
- outlet-obturator oblique view: helps to avoid guide wire penetration of the hip joint;
- antegrade insertion:
- used when the patient is in the lateral or supine position;
- starting
point is 4-5 cm back from the ASIS;
- guide pin is driven down into the superior ramus using the inlet-iliac oblique (to ensure that the guide wire does not penetrate
the inner pubic ramus cortex) and the inlet-obturator oblique view ( to ensure that the guide pin does not penetrate into the hip);
- retrograde insertion:
- only used when the patient is in the supine position;
- difficult insertion when the patient is obese;
- use a 3 cm mini Pfannenstiel incision;
- guide pin is directed into the affected side pubic tubercle;
- guide pin is directed to a point posterior and inferior to the ASIS;
- guide pin is directed up into the superior ramus using the inlet-iliac oblique (to ensure that the guide wire does not penetrate the inner pubic
ramus cortex) and the inlet-obturator oblique view ( to ensure that the guide pin does not penetrate into the hip);
Anterior column fractures of the acetabulum.
Anatomic Considerations of Plate Screw Fixation of the Anterior Column of the Acetabulum;
J.A. Benedetti, N.A. Ebraheim, R. Xu, and R.A. Yeasting.
J. Orthop Trauma, Vol 10. No. 4. 1996.
Acetabular fracture fixation via a modified Stoppa limited intrapelvic approach. Description of operative technique and preliminary treatment results.
Technical Tricks. Percutaneous Fixation of the Columns of the Acetabulum. A New Technique.
AJ Starr et al.
J. of Orthopaedic Trauma. Vol 12. No 1. p 51-58.
- PreOp Planning: 
