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World J Clin Cases. Jun 26, 2020; 8(12): 2464-2472
Published online Jun 26, 2020. doi: 10.12998/wjcc.v8.i12.2464
Computer navigation-assisted minimally invasive percutaneous screw placement for pelvic fractures
Tong Yu, Xue-Liang Cheng, Yang Qu, Rong-Peng Dong, Ming-Yang Kang, Jian-Wu Zhao
Tong Yu, Xue-Liang Cheng, Yang Qu, Rong-Peng Dong, Ming-Yang Kang, Jian-Wu Zhao, Department of Orthopedics, the Second Hospital of Jilin University, Changchun 130014, Jilin Province, China
Author contributions: Yu T and Cheng XL equally contributed to this paper with regard to conceptualization, literature review and analysis, and manuscript drafting; Qu Y put forward suggestions for the article; Dong RP and Kang MY collected the relevant information; Zhao JW guided the writing of this paper and reviewed the manuscript. All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jian-Wu Zhao, PhD, Doctor, Surgeon, Department of Orthopaedics, The Second Hospital of Jilin University, #218 Ziqiang Street, Nanguan District, Changchun 130041, Jilin Province, China. jianwu@jlu.edu.cn
Received: February 10, 2020
Peer-review started: February 10, 2020
First decision: April 29, 2020
Revised: May 21, 2020
Accepted: May 26, 2020
Article in press: May 26, 2020
Published online: June 26, 2020
Abstract

Pelvic fractures are often caused by high-energy injuries and accompanied by hemodynamic instability. Traditional open surgery has a large amount of bleeding, which is not suitable for patients with acute pelvic fracture. Navigation-guided, percutaneous puncture-screw implantation has gradually become a preferred procedure due to its advantages, which include less trauma, faster recovery times, and less bleeding. However, due to the complexity of pelvic anatomy, doctors often encounter some problems when using navigation to treat pelvic fractures. This article reviews the indications, contraindications, surgical procedures, and related complications of this procedure for the treatment of sacral fractures, sacroiliac joint injuries, pelvic ring injuries, and acetabular fractures. We also analyze the causes of inaccurate screw placement. Percutaneous screw placement under navigational guidance has the advantages of high accuracy, low incidence of complications and small soft-tissue damage, minimal blood loss, short hospital stays, and quick recovery. There is no difference in the incidence of complications between surgeries performed by new doctors and experienced ones. However, computer navigation technology requires extensive training, and attention should be given to avoid complications such as screw misplacement, intestinal injury, and serious blood vessel and nerve injuries caused by navigational drift.

Keywords: Computer navigation, Percutaneous puncture, Screw, Pelvic fracture, Sacral fracture, Acetabular fracture, Iliac fracture, Pubic fracture

Core tip: Computer-assisted navigation is a technology used in minimally invasive spinal surgery. It provides advantages such as rapid recovery and minimal trauma. Here, we discuss the indications, contraindications, surgical procedures, and related complications during percutaneous screw fixation for the treatment of sacral fractures, sacroiliac-joint injuries, pelvic ring injuries, and acetabular fractures. The advantages of navigation in the treatment of pelvic fracture are clarified. At the same time, paying attention to navigational drift is also reminded.