CBCT-guided cement-augmented percutaneous pelvic fixation for fragility fractures: A single-center experience on procedural performance and early imaging-based safety.

Abstract

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. 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. 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). 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. This paper is Level IV / Level 4 of evidence.