Percutaneous iliosacral screw placement using a radiolucent drive

Area of Science:

• Orthopedic surgery
• Trauma management
• Skeletal fixation

Background:

• Percutaneous iliosacral screw placement is a crucial technique for stabilizing pelvic fractures.
• This procedure is technically demanding, requiring precise guidance for optimal outcomes.
• Existing guidance methods can be complex or require specialized equipment.

Purpose of the Study:

• To present a novel, simple, and effective fluoroscopy-guided technique for percutaneous iliosacral screw placement.
• To evaluate the accuracy and feasibility of this new technique in patients with pelvic fractures.

Main Methods:

• A fluoroscopy-guided technique utilizing a radiolucent drive, originally designed for intramedullary nail locking, was employed.
• The technique was applied to 27 screw insertions in 21 patients with pelvic fractures between January 2008 and December 2009.
• No highly specialized equipment beyond the described drive was required.

Main Results:

• The technique demonstrated precision in determining both screw entry points and drill tracks.
• An overall incorrect screw placement rate of 11% was observed across the study cohort.
• The method proved to be quick and simple to implement.

Conclusions:

• The described fluoroscopy-guided technique offers a precise and accessible method for percutaneous iliosacral screw placement.
• This approach simplifies the stabilization of pelvic fractures, potentially reducing operative complexity.
• Further studies may explore wider adoption and long-term outcomes of this technique.