scholarly journals Posterior pelvic ring fractures: Closed reduction and percutaneous CT-guided sacroiliac screw fixation

1997 ◽  
Vol 20 (4) ◽  
pp. 285-294 ◽  
Author(s):  
Augustinus Ludwig Jacob ◽  
Peter Messmer ◽  
Klaus-Wilhelm Stock ◽  
Norbert Suhm ◽  
Bernard Baumann ◽  
...  
2019 ◽  
Vol 22 (03n04) ◽  
pp. 1950007
Author(s):  
Florian Radetzki ◽  
Felix Goehre ◽  
Stefan Schwan ◽  
Andreas Wienke ◽  
Lars Jansch ◽  
...  

Sacroiliac screw fixation is the only minimally invasive technique for stabilizing unstable posterior pelvic ring fractures. X-ray/CT methods identify sacral shape variants, which influence screw fixation feasibility at sacral segment S1. As no reliability analysis was previously published, this study analyzed four X-ray/CT-based screw corridor evaluation methods. CT datasets of 80 human pelvises (♂[Formula: see text][Formula: see text], ♀[Formula: see text][Formula: see text], [Formula: see text] years, [Formula: see text][Formula: see text]cm, [Formula: see text][Formula: see text]kg) were used. CTs were post-processed using Amira 5.2 software to generate 3D models and analyzed for S1 transverse 7.3[Formula: see text]mm screw corridors using a C++ program. CT-slices and radiograph-like images were generated per each classification’s requirements. Five surgeons independently assessed sacral shape and transverse screw insertion feasibility. Sensitivity, specificity, and positive/negative predictive values were calculated. C++ analysis indicated feasible screw insertion in 66 cases (82%). Sensitivities were 86% (Mendel), 75% (Routt), 74% (Carlson), and 67% (Kim). Specificities were 73% (Mendel) and 79% (Kim). Mean positive predictive value spanned from 54.6% (Mendel) to 26.2% (Carlson); negative predictive value spanned from 94.5% (Kim) to 90.4% (Carlson). No significant differences existed between surgeons. Mendel’s classification provides reliable and reproducible assessment via the lateral sacral triangle, without additional CTs like Carlson or Routt or the subjectivity of Kim’s method.


Author(s):  
Christopher Alexander Becker ◽  
Adrian Cavalcanti Kussmaul ◽  
Eduardo Manuel Suero ◽  
Markus Regauer ◽  
Matthias Woiczinski ◽  
...  

Abstract Background Incomplete lateral compression fractures (including AO Type B2.1) are among the most common pelvic ring injuries. Although the treatment of choice remains controversial, sacroiliac (SI) screws are commonly used for the operative treatment of incomplete lateral compression fractures of the pelvic ring. However, the disadvantages of SI screws include the risk of nerve root or blood vessel injury. Recently, tape sutures have been found useful as stabilizing material for the treatment of injuries of the syndesmosis, the rotator cuff and knee ligaments. In this current study, we aimed to test the biomechanical feasibility of tape sutures to stabilize the pelvis in the setting of AO Type B2.1 injury. Methods Six human cadaveric pelvises underwent cyclic loading to compare the biomechanical stability of different osteosynthesis methods in a B2.1 fracture model. The methods tested in this experiment were a FiberTape® suture and the currently established SI screw. A 3D ultrasound tracking system was used to measure fracture fragment motion. Linear regression was used to model displacement and stiffness at the posterior and anterior pelvic ring. Results At the posterior fracture site, the FiberTape® demonstrated similar displacement (2.2 ± 0.8 mm) and stiffness (52.2 ± 18.0 N/mm) compared to the sacroiliac screw (displacement 2.1 ± 0.6 mm, P >  0.999; stiffness 50.8 ± 13.0 N/mm, P > 0.999). Considering the anterior fracture site, the FiberTape® again demonstrated similar displacement (3.8 ± 1.3 mm) and stiffness (29.5 ± 9.0 N/mm) compared to the sacroiliac screw (displacement 2.9 ± 0.8 mm, P = 0.2196; stiffness 37.5 ± 11.5 N/mm, P = 0.0711). Conclusion The newly presented osteosynthesis, the FiberTape®, shows promising results for the stabilization of the posterior pelvic ring in AO Type B2.1 lateral compression fractures compared to a sacroiliac screw osteosynthesis based on its minimal-invasiveness and the statistically similar biomechanical properties.


2018 ◽  
Vol 104 (7) ◽  
pp. 1063-1067 ◽  
Author(s):  
Simone Ghisla ◽  
Francesca Napoli ◽  
Gyozo Lehoczky ◽  
Marco Delcogliano ◽  
Nermine Habib ◽  
...  

2008 ◽  
Vol 19 (7) ◽  
pp. 1093-1098 ◽  
Author(s):  
Reto J. Bale ◽  
Peter Kovacs ◽  
Bahman Dolati ◽  
Christoph Hinterleithner ◽  
Ralf E. Rosenberger

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