Clinical Outcomes of Percutaneous Fixation with Buck’s Technique for Pars Articularis Fractures: A Case Series of 13 Patients

Background:Pars articularis fractures, particularly at the L5 level, are rare injuries that are often linked to repetitive trauma, particularly in athletes. Despite advancements in surgical techniques, evidence regarding the effectiveness of Buck's percutaneous fixation method remains limited. This study assesses the clinical outcomes of this technique in a group of 13 patients. Methods:A retrospective descriptive study was conducted on 13 patients (eight males, five females; mean age, 28 ± 5 years) with L5 pars fractures and no evidence of spondylolisthesis. All patients reported repetitive trauma as the cause, with sports such as football, CrossFit, volleyball, and ballet being common activities. A percutaneous fixation with 4.0 mm cannulated screws (KYC Ventures, FacetFuse) was performed using Buck's technique. Pain relief was assessed using the Visual Analog Scale (VAS) at baseline, six weeks, three months, one year, and two years. Fracture healing and hardware integrity were radiographically evaluated at six months. Results: Pain improved significantly at all follow-up intervals. Mean VAS scores decreased from 6.5 at baseline to 3.8 at six weeks, 2.0 at three months, and 1.08 at one year (p < 0.001). At the two-year follow-ups, 92.3% of patients were almost asymptomatic. Radiographic evaluations demonstrated complete healing without hardware complications. No intraoperative or postoperative adverse events were reported. Conclusion: Percutaneous fixation using Buck's technique delivers excellent clinical and radiographic outcomes for patients with L5 pars fractures resulting from repetitive trauma. This study underscores the safety, efficacy, and minimal invasiveness of this approach, thereby contributing to the limited literature on its application in these injuries.