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Purpose <p>To assess the feasibility, safety, and effectiveness of a retrograde technique for inserting a full-length ramus screw through an osseous starting site (OSS) at the anteromedial corner of the para-symphyseal bone, and to analyze the position and parameters of the ramus osseous fixation pathway (OFP) based on screw placement.</p> Methods <p>From August 2020 to December 2021, patients with fractures of the anterior acetabular column or the superior pubic ramus treated with a retrograde superior ramus screw were included in this study. The OSS was located at the anteromedial corner of the para-symphyseal bone. Perioperative and postoperative complications were recorded. The position and the parameters of the ramus OFP were established based on the postoperative CT images of the inserted full-length screws.</p> Results <p>Twenty-three (23/25) full-length large-diameter (≥ 7&#xa0;mm) ramus screws were successfully inserted in 19 (19/20) cases. Postoperative CT images showed that all full-length screws were positioned within a bony corridor, located anteriorly and cranially to the acetabular dome. The OFP measures 119.9 ± 7.6&#xa0;mm in length, with angle projection of 16.9 ± 6.3 degrees to the coronal plane and 38.6 ± 3.9 degrees to the horizontal plane. During follow-up, bone union was achieved in all cases, with no instances of bone delayed union or screw breakage observed.</p> Conclusions <p>Via the OSS at the anteromedial corner of the para-symphyseal bone, the inserted full-length large ramus screws were situated anteriorly and cranially to the acetabular dome. This retrograde technique has been demonstrated to be a feasible, safe, and effective surgical procedure.</p>

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Retrograde insertion of full-length ramus screws for the treatment of pelvic and/or acetabular fracture

  • 期刊论文

  • 发表日期：

    2026年5月7日

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  • Libin Zheng,
  • Chia-Jui Hu,
  • Xionghai Shen,
  • Jiangtao Hao,
  • Lai Yu,
  • Guanfei Zeng,
  • Guangming Yang,
  • Yongwei Pan

摘要

Purpose

To assess the feasibility, safety, and effectiveness of a retrograde technique for inserting a full-length ramus screw through an osseous starting site (OSS) at the anteromedial corner of the para-symphyseal bone, and to analyze the position and parameters of the ramus osseous fixation pathway (OFP) based on screw placement.

Methods

From August 2020 to December 2021, patients with fractures of the anterior acetabular column or the superior pubic ramus treated with a retrograde superior ramus screw were included in this study. The OSS was located at the anteromedial corner of the para-symphyseal bone. Perioperative and postoperative complications were recorded. The position and the parameters of the ramus OFP were established based on the postoperative CT images of the inserted full-length screws.

Results

Twenty-three (23/25) full-length large-diameter (≥ 7 mm) ramus screws were successfully inserted in 19 (19/20) cases. Postoperative CT images showed that all full-length screws were positioned within a bony corridor, located anteriorly and cranially to the acetabular dome. The OFP measures 119.9 ± 7.6 mm in length, with angle projection of 16.9 ± 6.3 degrees to the coronal plane and 38.6 ± 3.9 degrees to the horizontal plane. During follow-up, bone union was achieved in all cases, with no instances of bone delayed union or screw breakage observed.

Conclusions

Via the OSS at the anteromedial corner of the para-symphyseal bone, the inserted full-length large ramus screws were situated anteriorly and cranially to the acetabular dome. This retrograde technique has been demonstrated to be a feasible, safe, and effective surgical procedure.