Indication: nondisplaced or minimally displaced transverseand T type fractures
C-arm position for inlet-iliacoblique view of right acetabulum. Guide wire seen on inlet-iliacoblique view.C-arm position for outlet-obturator oblique view. Guide wire seen on outlet-obturator oblique view.·Path for antegrade anterior column screw. The startingpoint for antegrade placement of the anterior columnscrew is determined by a line drawn between the tip of the greater trochanter and the thick part of the iliaccrest (usually about 4 to 5 centimeters back from the anterior-superior iliac spine); In thin patients, the skin stab woundfor the guidewire is made just above the midpoint ofthis line. In heavy patients, the stab wound must be made closer to the iliaccrest.·The starting point for insertion of the antegrade anteriorcolumn screw is located slightly superior to the acetabulum in the pillar of the gluteusmedius , a thickening of the bone that extends from the acetabulum to the iliac crest. Cut-away pelvic model demonstrating the bony corridorof the anterior column of the acetabulum with a screw positioned in an idealtrajectory for fixation.·Avoiding damage to surrounding neurovascular structures and intraarticular penetration Theangles of Screw to the transverse, coronal and sagittal planes were 41.16◦ ± 4.59◦,18.18◦ ± 1.15◦ and 44.33◦ ± 4.31◦·The area A is the atriangle and the area was 1.98±0.85cm2, and the distance of the center of the triangle to the top of the acetabulum was 2.07 ±5.22cm.·Attias study that the mean maximum diameter of anterior column screws was 6.4mm (from 5 to 7.3mm). Chen found it was 8.16mm ( from 5.60 to 10.80 mm).But XiaoRengFeng study the maximum screw diameters of Screw (7.80–14.60mm) measured in all the 58 models (males andfemales) were larger than 7.3mm.References 1.[ AttiasN, Lindsey RW, Starr AJ, Borer D, Bridges K, HippJA (2005) The use of a virtual three-dimensional model to evaluate theintraosseousspaceavailableforpercutaneousscrewfixationofacetabular fractures. J Bone JtSurg Br 87:1520–1523 ]2 [ChenKN, WangG, CaoLG, Zhang MC Differences of percutaneous retrograde screw fixation of anterior column acetabular fractures betweenmale and female: a study of 164 virtual three dimensional models. Injury 40:1067–1072 ]3[XiaoRengFeng, JinTaoFang, ChaowenLin et al.Axialperspectiveto find the largest intraosseous space available for percutaneous screw fixation offractures of the acetabular anterior column. Internationaljournal of computer assisted radiology and surgery 2015 Aug;10(8):1347-53.]4.[Ye Peng, LihaiZhang, William Min, et al.Comparison of anterograde versus retrograde percutaneous screw fixation ofanterior column acetabular fractures. Internationaljournal of computer assisted radiology and surgery 2016 Apr;11(4):635-9]5.[João Antonio Matheus Guimarães, Murphy P. Martin III, Flávio Ribeiro da Silva, et al. The obturator oblique and iliac oblique/outlet views predict mostaccurately the adequate position of an anterior column acetabular screw. International orthopaedics 201905;43(5):1205-1213]6.[Philipp Lichte, HatemAlabdulrhaman, Miguel Pishnamaz, et al. PercutaneousscrewtechniquesforthepelvicringandacetabulumDerUnfallchirurg. 2019 May; 122 (5) :387-403. ]
