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With
significant improvement in pain and reduction in opioid use, percutaneous FICS
could be a treatment of choice for palliative pain management in patients with
pathologic pelvic fractures.
According to results of a retrospective analysis conducted by the investigators of Gustave Roussy Institute and the University of Paris-South, internal cemented screw (FICS) using the cone-beam CT needle and fluoroscopy supervision is an efficient and safe approach to fix pathologic pelvic fractures.
The single-centre study involved the retrospective analysis of 100 consecutive cancer patients with pathologic pelvic fractures managed with percutaneous FICS. Fluoroscopy and cone-beam CT needle guidance software were used for image guidance. Paired-sample t-test was applied to determine a comparison between pain palliative outcomes and opioid use following FICS.
A total of 141
pathologic fractures of 100 patients were palliated by performing 107
percutaneous FICS procedures from 2010 to 2017. One hundred and four processes
out of 107 were technically successful, with mean postprocedure hospitalisation
of 2 days ± 3. Fourteen patients found to have some complications like tumour
track seeding, hematoma, focal pain at the procedure site for longer than 48
hours, infection, screw displacement, and progressive fracture despite
fixation. The mean numeric rating scale pain score was improved considerably at
six weeks from 6.1 ± 2.5 to 2.1 ± 3.0 in the 88 patients who achieved early
follow-up. The use of opioids also reduced at six weeks. These outcomes explain
a significant role of fluoroscopy and cone-beam CT–guided fixation by the
internal cemented screw.
Radiology
Fluoroscopy and Cone-Beam CT–guided Fixation by Internal Cemented Screw for Pathologic Pelvic Fractures
Charles Roux et al.
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