Injury - 2026-04-09 - Journal Article
CBCT-guided cement-augmented percutaneous pelvic fixation for fragility fractures: A single-center experience on procedural performance and early imaging-based safety.
Perez H, Chalamet B, Grange S, Gilbert T, Ben-Rejeb MI, Massy E, Pialat JB, Stacoffe N
Topics
Key Takeaway
CBCT-guided cement-augmented percutaneous pelvic screw fixation achieved 100% technical success in 51 fragility fracture patients with a mean operative time of 51.3 minutes, but 2 of 76 screws required reintervention for hardware-related adverse events.
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Summary
This single-center retrospective series evaluated procedural performance and early imaging-based safety of CBCT-guided cement-augmented percutaneous pelvic fixation for fragility fractures in 51 consecutive patients. Technical success was 100%; mean operative time was 51.3 ± 14.1 minutes, increasing with screw count (ρ=0.368) and entry sites (ρ=0.390). Median dose-area product was 64.45 Gy·cm², correlating with operative time (ρ=0.448) and BMI (ρ=0.480); two patients required reintervention for hardware failure (modified CIRSE grade 3).
Key Limitation
No patient-centered outcomes (pain, mobility, weight-bearing status, or quality of life) were collected, making it impossible to determine whether technical success translates to clinical benefit.
Original Abstract
PURPOSE
To report a single-center experience evaluating procedural performance and early imaging-based safety of CBCT-guided cement-augmented percutaneous pelvic fixation for fragility fractures.
MATERIALS AND METHODS
This retrospective cohort included 51 consecutive patients with pelvic fragility fractures who underwent CBCT-guided percutaneous screw fixation with cement augmentation between November 2023 and September 2025. Endpoints were technical success, operative time, radiation exposure, and adverse events. Exploratory analyses assessed associations between operative parameters and fracture classification, body mass index, number of entry sites, and number of screws.
RESULTS
A total of 76 screws were placed in 51 patients. Technical success was 100% (successful completion of planned screw placement). Mean operative time was 51.3 ± 14.1 min and increased with the number of screws (ρ = .368; adjusted P = .018) and the number of entry sites (ρ = .390; adjusted P = .015). Median DAP was 64.45 Gy·cm² (Q1-Q3, 50.35-103.85) and increased with operative time (ρ = .448; adjusted P = .004) and BMI (ρ = .480; adjusted P = .003). Two postoperative hardware-related adverse events required reintervention (modified CIRSE grade 3).
CONCLUSION
This retrospective single-center experience confirms reproducibility of CBCT-guided cement-augmented percutaneous pelvic fixation with 100% technical success. However, without patient-centered outcomes, comparative data, and systematic longer-term follow-up, clinical benefit cannot be assessed.
LEVELS OF EVIDENCE
This paper is Level IV / Level 4 of evidence.