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Fig. 2 | BMC Surgery

Fig. 2

From: Percutaneous screw fixation assisted by hollow pedicle finder for superior pubic ramus fractures

Fig. 2

Schematic diagram of retrograde pubic screw implantation for closed reduction of pubic ramus fracture assisted by hollow pedicle finder. When the pubic ramus fracture was obviously displaced, if the fracture was not reduction before, the guiding needle of screw will be easily to penetrate from the fracture site, so most of the fractures will be needed to open reduction and temporary fixation before inserting the guiding needle of screw. This traditional surgical method has the disadvantage that we need to open reduction the fracture before guiding needle inserting; B The following is the schematic diagram of our modified surgical method. Place the hollow pedicle finder and adjust the direction according to the hand feeling, stop when the tip was close to the fracture site; C Percutaneous reduction the displaced fracture by leverage with the hollow pedicle finder, it was not necessary to pursue the anatomical reduction of the fracture at this time; D Initial reduction of the fracture was achieved by hollow pedicle finder; E Continue drilling into the hollow pedicle finder after fracture reduction; F When the hollow pedicle finder was in good position verified by C-arm X-ray, place the guiding needle into the hollow channel of the hollow pedicle finder and hammer the guiding needle gently to make it fix firmly; G The fracture will slightly displaced again when removing hollow pedicle finder and leaving the guiding needle alone, but we can reduction the fracture by inserting a cannulated screw according to the intramedullary reduction effect; H The fracture will be well reduction and pressurized when cannulated screw was screwed in

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