Retrograde posterior column acetabular screw: robotically assisted and CT-guided minimally invasive procedure.

OBJECTIVE OF THE SURGERY: The aim of this operation is to stabilise a T-type acetabular fracture against secondary dislocation and to restore the patient's preoperative functionality.

INDICATIONS: An 88-year-old patient with severe pain and immobility due to a T-type acetabular fracture (Letournel & Judet: associated fracture; AO: 62B2).

CONTRAINDICATIONS: General surgical contraindications.

SURGICAL TECHNIQUE: This surgery was performed in a 3D-Navigation Hybrid Operating Room, the Robotic Suite (Brainlab, Munich, Germany). The setup includes a navigation unit (Curve Navigation System) a movable robotic 3D cone beam computed tomography unit (Loop-X), a robotic arm (Cirq Arm System), 3D mixed reality glasses (for planning), and a wall monitor (Buzz). A step-by-step video is available online.

FOLLOW-UP: Immediate full weight-bearing, active and passive joint mobilisation through physiotherapy on the first postoperative day, pain medication as required.

EVIDENCE: Navigated surgeries of the pelvis (ring and acetabulum) have become standard practice, while robotic assistance is increasingly used, demonstrating very good outcomes and promising accuracy rates.