Factors influencing the accuracy of iliosacral screw placement in trauma patients.

International Orthopaedics
Lars GrossterlindenD Briem

Abstract

Correct placement of iliosacral screws remains a surgical challenge. The aim of this retrospective study was to identify parameters which impact the accuracy of this technically demanding procedure. Eighty-two patients with vertically unstable pelvic injuries treated with a total of 147 iliosacral screws were included. Assessment of postoperative CT scans revealed screw misplacement in 13 cases (8%), of which six occurred following insertion of two unilateral screws into S1. Six screw misplacements occurred in patients with dislocation injuries of the posterior pelvis. Comparison of a navigated and the standard technique revealed a decreased screw misplacement rate in the navigated group (15% standard vs. 3% navigation, p < 0.05). In addition, the malposition rate was influenced by the surgeon's individual experience (20% for low vs. 3.9% for high volume surgeons, p < 0.05). Overall, the accuracy of iliosacral screw placement depends on the number of screws inserted into S1 and the extent of dislocation. In experienced hands, the use of navigation represents a helpful tool to improve the placement accuracy.

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Citations

Feb 11, 2014·Injury·Masaki TakaoNobuhiko Sugano
Oct 14, 2011·Computer Aided Surgery : Official Journal of the International Society for Computer Aided Surgery·Philip Catala-LehnenWolfgang Lehmann
Nov 10, 2013·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Masaki TakaoNobuhiko Sugano
Aug 12, 2015·International Orthopaedics·Miguel PishnamazHans-Christoph Pape
Jul 10, 2016·Clinical Orthopaedics and Related Research·Florian GrasRainer Burgkart
Oct 31, 2018·Archives of Orthopaedic and Trauma Surgery·Masaki TakaoNobuhiko Sugano
Dec 12, 2018·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Henry WendtFlorian Gras
Jan 27, 2018·Journal of Orthopaedic Trauma·Walid A ElnahalAnthony J Ward
Apr 17, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Pol Maria RommensMartin Hessmann
Feb 17, 2021·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·M F HoffmannT A Schildhauer
May 17, 2021·Journal of Orthopaedic Trauma·Benjamin F WatzigScott S Yang

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