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Review paper

Navigated percutaneous screw fixation of the pelvis with O-arm 2: two years’ experience

By
Gianluca Ciolli Orcid logo ,
Gianluca Ciolli
Contact Gianluca Ciolli

Department of Orthopaedics, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy

Daniele Caviglia ,
Daniele Caviglia

Department of Orthopaedics, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy

Carla Vitiello ,
Carla Vitiello

Department of Radiology, Ospedali Riuniti - Area Vesuviana - ASL Napoli 3 sud, Napoli, Italy

Salvatore Lucchesi ,
Salvatore Lucchesi

Department of Radiology, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy

Corrado Pinelli ,
Corrado Pinelli

Department of Orthopaedics, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy

Domenico De Mauro ,
Domenico De Mauro

Department of Orthopaedics, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy

Amarildo Smakaj ,
Amarildo Smakaj

Department of Orthopaedics, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy

Giuseppe Rovere ,
Giuseppe Rovere

Department of Orthopaedics, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy

Luigi Meccariello ,
Luigi Meccariello

Department of Orthopaedics and Traumatology, AORN San Pio, Benevento, Italy

Lawrence Camarda ,
Lawrence Camarda

Department of Orthopaedic Surgery, University of Palermo, Palermo, Italy

Giulio Maccauro ,
Giulio Maccauro

Department of Orthopaedics, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy

Francesco Liuzza
Francesco Liuzza
Contact Francesco Liuzza

Department of Orthopaedics, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy

Abstract

Aim
To evaluate the case series of the patients operated with percutaneous fixation by the navigation system based on 3D fluoroscopic images, to assess the precision of a surgical implant and functional outcome of patients.
Methods
A retrospective study of pelvic ring fractures in a 2-year period included those treated with the use of the O-Arm 2 in combination with the Stealth Station 8. Pelvic fractures were classified according to the Tile and the Young-Burgess classification. All patients were examined before surgery, with X-rays and CT scans, and three days after surgery with additional CT scan. The positioning of the screws was evaluated according to the Smith score, the outcome with the SF-36.
Results
Among 24 patients 18 were with B and six with C type fracture according to Tile, while eight were with APC, 10 LC, and
six with VS type according to Young-Burgess classification. All patients were treated in the supine position, except two. A total of 41 iliosacral or transsacral screws and five anterior pelvic ring screws were implanted. The medium surgical time per screw was 41 minutes. There was a perfect correspondence of screw scores value from post-operative CT and intraoperative fluoroscopy. The mean screw score value was 0.92. There were no cases of poor positioning. The median follow-up was 17.5 months. The patients were satisfied with their health condition on SF-36.
Conclusion
The use of the O-arm guarantees great precision in the positioning of the screws and reduced surgical times with excellent
clinical results in patients.

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