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Iliosacral screwing under navigation control: Technical note.

Gilles Guerin1, Nadir Laghmouche1, Pierre Emmanuel Moreau1

  • 1Service de Chirurgie Orthopédique et Traumatologique, Groupe Hospitalier Paris Saint Joseph, 185, Rue Raymond Losserand, 75014 Paris, France.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|July 7, 2020
PubMed
Summary

This study standardizes percutaneous iliosacral screw fixation for pelvic fractures using navigated pedicular screw instruments. This navigation technique significantly improves accuracy and reduces errors in screw placement, enhancing patient outcomes.

Keywords:
CT-guided navigationIliosacral screw fixationPelvic fracturePelvic ringPercutaneous

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Area of Science:

  • Orthopedic Surgery
  • Surgical Navigation
  • Trauma Management

Background:

  • Percutaneous iliosacral screw fixation is crucial for pelvic fracture osteosynthesis.
  • Accurate screw placement is vital and traditionally relies on imaging guidance with variable error risks.
  • Existing navigation techniques using drill guides have limitations in precision due to projection-based guidance.

Purpose of the Study:

  • To propose and evaluate a standardized procedure for percutaneous iliosacral screw fixation.
  • To assess the efficacy of using navigated pedicular screw instruments for enhanced accuracy in pelvic fracture treatment.

Main Methods:

  • Standardization of percutaneous iliosacral screw fixation using navigated pedicular screw instruments.
  • The technique involves navigating the instrument directly, not a projection, for improved trajectory control.
  • A series of 90 screws were implanted in 62 patients.

Main Results:

  • Only one screw path required repetition based on intraoperative control.
  • Postoperative assessments revealed no instances of improperly positioned screws.
  • High accuracy and reliability were demonstrated in screw placement.

Conclusions:

  • Navigated pedicular screw instruments offer a standardized and highly accurate method for percutaneous iliosacral screw fixation.
  • This technique minimizes procedural errors and improves the reliability of osteosynthesis in pelvic fracture management.
  • The proposed method enhances surgical precision and patient safety in treating complex pelvic injuries.