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European Journal of Trauma and Emergency Surgery

Erschienen in:

20.07.2018 | Original Article

Accuracy of navigated and conventional iliosacral screw placement in B- and C-type pelvic ring fractures

verfasst von: Josephine Berger-Groch, Marie Lueers, Johannes Maria Rueger, Wolfgang Lehmann, Darius Thiesen, Jan Philipp Kolb, Maximilian Johannes Hartel, Lars Gerhard Grossterlinden

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 1/2020

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Abstract

Introduction

The objective of this study is to report the institutions experiences with standardized 2D computer-navigated percutaneous iliosacral screw placement (CNS), as well as the conventional fluoroscopically assisted screw placement method (CF) over a period of 10 years.

Patients and methods

A total of 604 patients with sacral fractures (OTA B and C) were treated at the institution. Cases with both, a preoperative and postoperative CT scan were included for further analysis. With this prerequisite, a total of 136 cases were included. The quality of screw positioning, length of operation and intraoperative radiation exposure were recorded and compared. Moreover, it was analyzed whether the presence of dysmorphic sacra influenced the precision of screw positioning.

Results

Two hundred and thirty-two screws were implanted in 136 patients (100 navigated, 36 conventional). The duration of the average procedure was similar in the two groups [49.8 min (p = 0.7) conventional group (CF) vs. 48.0 min computer-navigated (CNS) group]. With computer navigation, radiation exposure was significantly reduced by almost half [128.3 vs. 65.2 s (p = 0.023)]. Screw placement was more accurate in the navigation group (79.03% CF vs. 86.47% CNS). The presence of dysmorphic sacral foramina or an increased alar slope increased the incidence of screw malpositioning.

Conclusion

The conventional percutaneous method and a standardized 2D navigated method have similar rates of malpositioning. Dysmorphic upper sacral foramina and increased alar slope were identified as risk factors for screw malpositioning. Radiation exposure rates were reduced by half when using computer navigation. Therefore, computer navigation in iliosacral screw placement is recommended as method of choice.

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Titel: Accuracy of navigated and conventional iliosacral screw placement in B- and C-type pelvic ring fractures
verfasst von: Josephine Berger-Groch
Marie Lueers
Johannes Maria Rueger
Wolfgang Lehmann
Darius Thiesen
Jan Philipp Kolb
Maximilian Johannes Hartel
Lars Gerhard Grossterlinden
Publikationsdatum: 20.07.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 1/2020
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-018-0990-z

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Accuracy of navigated and conventional iliosacral screw placement in B- and C-type pelvic ring fractures

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Patients and methods

Results

Conclusion

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Results

Conclusion

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