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Minimally invasive percutaneous osteosynthesis

Stacoffe N, et al. Comment je fais une ostéosynthèse percutanée mini-invasive. Journal
d’imagerie diagnostique et interventionnelle (2022)


Percutaneous osteosynthesis is an interventional radiology technique that allows for the minimally invasive fixation of two bone fragments. This article outlines step-by-step the process of osteosynthesis through screwing, from indication to monitoring, enabling interventional radiologists to incorporate this practice into their stabilization procedures.

Key Messages
The decision-making process is collaborative, based on precise and recent clinical and imaging data. Patient consultation time is a fundamental validation step. Patient care pathways and anesthetic management should be standardized, with strict attention to procedural conditions and asepsis. Preparation for the procedure involves ensuring the availability of appropriate equipment, although screw length is often confirmed by intraoperative measurements, taking into account the screw head size. The technique relies on positioning an appropriately sized trocar through which the screw is inserted after passing the fracture line, followed by trocar removal and screw insertion. Ensuring stable screw placement involves anchoring the screw end through a cortical layer or passing through at least two cortices. Care must be taken to avoid bending or snagging the trocar at the initiation of passage through the distal cortex when removing it.

Percutaneous osteosynthesis is an accessible technique and can be safely performed under fluoroscopic and computed tomography guidance by interventional radiologists.

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