Complications of percutaneous image-guided screw fixation: An analysis of 94 consecutive patients - 26/05/21
, Julien Garnon a, Grégory Bertucci a, Danoob Dalili b, c, Pierre De Marini a, Pierre Auloge a, Guillaume Koch a, Jean Caudrelier a, Julia Weiss a, Roberto L. Cazzato a, Afshin Gangi a
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Graphical abstract |
Highlights |
• | Percutaneous image-guided screw fixation (PIGSF) is an easy to perform procedure for insufficiency, impending or pathological fractures, with a low rate of per-procedural and early (within 24 hours) complications. |
• | Most of the complications of PIGSF appear after 24 hours, are asymptomatic and can be managed conservatively. |
• | Imaging guidance plays a key-role for the excellent safety profile of PIGSF, which is expected to develop in many centers in the future. |
Abstract |
Purpose |
The purpose of this study was to retrospectively assess the safety profile of percutaneous image-guided screw fixation (PIGSF) for insufficiency, impending or pathological fractures.
Materials and methods |
From July 2012 to April 2020, all consecutive patients who underwent PIGSF were retrospectively included in the study. Patient characteristics, fracture type, procedural data and complications were analyzed. Complications were divided into per-procedural, early (<24hours) and delayed (>24hours) and classified into minor (grade 1-2) and major complications (grade 3-5) according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0.
Results |
A total of 110 fractures (40 insufficiency [36%], 53 pathological [48.5%] and 17 impending [15.5%] fractures) in 94 patients (48 women, 46 men; mean age, 62.7±12.7 [SD] years; age range: 32–88 years) were treated with PIGSF during 95 procedures. Twenty-four-hours follow-up was available for all patients, and>24-hours follow-up was available for 79 (79/110; 71.8%) fractures in 69 (69/94; 73.4%) patients. Per-procedural complications occurred in 3/110 fractures (2.7%, all minor). Early complications were reported in 4/110 fractures (3.6%, 1 major and 3 minor) and delayed ones in 14/79 fractures (17.7%, 5 major and 9 minor). The most frequent major delayed complication was infection (3/79; 3.8%).
Conclusion |
The rate of per-procedural and early (within 24hours) complications following PIGSF is extremely low with most complications being minor, with major complications being delayed ones (>24hours).
Le texte complet de cet article est disponible en PDF.Keywords : Bone screws, Cementoplasty, Osteoporotic fracture, Pathological fracture, Complications
Abbreviations : CBCT, CT, CTCAE, IF, ImF, MRI, OR, PCR, PET-CT, PF, PIGSF, PMMA
Plan
Vol 102 - N° 6
P. 347-353 - juin 2021 Retour au numéro
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