The crest-pillar-column method for percutaneous fixation of the posterior column using a curved intramedullary device: surgical technique.

Abstract

Treatment of posterior column fractures can be treated with open reduction internal fixation via plate osteosynthesis or with screw fixation. Due to common fracture planes and fixation trajectories, traditional anterograde posterior column screw fixation requires an open approach to access the starting point on the inner table. Retrograde posterior column implantation requires a start point in areas that are difficult to drape and access with familiar patient positioning and confident sterility. The advent of curved intramedullary implants allows implantation in nonlinear osseous fixation pathways. This technical paper describes a novel minimally invasive approach to placing a curved intramedullary implant within the posterior column from the readily identifiable iliac tubercle via the gluteal pillar ("Crest-Pillar-Column" technique).