Skip to main content
Erschienen in: Die Unfallchirurgie 10/2016

22.09.2016 | Leitthema

Perkutane interne Fixation bei Beckenfrakturen

verfasst von: A. J. Stevenson, B. Swartman, A. T. Bucknill, MBBS, MSc (Dist), FRCS, FRACS

Erschienen in: Die Unfallchirurgie | Ausgabe 10/2016

Einloggen, um Zugang zu erhalten

Zusammenfassung

Hintergrund

Für die perkutane interne Fixation von Beckenfrakturen, die sich zunehmender Beliebtheit erfreut, werden verschiedene neue Techniken beschrieben.

Ziel der Arbeit

Im vorliegenden Beitrag werden die bildgebende Diagnostik, Indikation, Planung, apparative Ausstattung, chirurgische Technik und Komplikationen dieser Verfahren dargestellt.

Methoden

Neben einem Überblick über die Literatur werden die Techniken für die anteriore und posteriore Beckenstabilisierung erörtert.

Ergebnisse

Hochwertige präoperative Computertomographie(CT)-Aufnahmen sind für dieses Verfahren essenziell. Der anteriore Fixateur interne („InFix“) ist eine wirkungsvolle Technik zur Stabilisierung des vorderen Beckenrings und sollte gewöhnlich zusammen mit einer posterioren Fixation eingesetzt werden. Bei guter Technik lassen sich neurovaskuläre Verletzungen vermeiden, welche eine äußerst folgenreiche Komplikation darstellen können. Die „retrograde anterior column screw“ (RACS, retrograde anteriore Hüftbeinschraube) ist ein Verfahren, das bei den meisten Patienten angewendet werden kann; bei kleineren Patienten sind aber möglicherweise kleinere Schraubendurchmesser erforderlich. Die Insertion der Schraube erfolgt bei Frauen weiter lateral als bei Männern. Iliosakralschrauben (ISS) stellen eine wirkungsvolle Methode der posterioren Stabilisierung dar und können unter Verwendung der 2‑D- oder der 3‑D-Durchleuchtung, der Computer- oder CT-Navigation platziert werden.

Schlussfolgerung

Die perkutane Fixation von Beckenfrakturen erfordert eine Bildgebung hoher Qualität und kann durch Computernavigation unterstützt werden. Die sicheren Verfahren sind reproduzierbar; allerdings können nicht alle Patienten und Frakturmuster mit diesen Verfahren behandelt werden.
Literatur
1.
Zurück zum Zitat Gabbe BJ, de Steiger R, Esser M, Bucknill A, Russ MK, Cameron PA (2011) Predictors of mortality following severe pelvic ring fracture: Results of a population-based study. Injury 42(10):985–991PubMedCrossRef Gabbe BJ, de Steiger R, Esser M, Bucknill A, Russ MK, Cameron PA (2011) Predictors of mortality following severe pelvic ring fracture: Results of a population-based study. Injury 42(10):985–991PubMedCrossRef
3.
Zurück zum Zitat Balogh Z, King KL, Mackay P, McDougall D, Mackenzie S, Evans JA et al (2007) The epidemiology of pelvic ring fractures: a population-based study. J Trauma 63(5):1066–1073PubMedCrossRef Balogh Z, King KL, Mackay P, McDougall D, Mackenzie S, Evans JA et al (2007) The epidemiology of pelvic ring fractures: a population-based study. J Trauma 63(5):1066–1073PubMedCrossRef
4.
Zurück zum Zitat Kannus P, Palvanen M, Niemi S, Parkkari J, Järvinen M (2000) Epidemiology of osteoporotic pelvic fractures in elderly people in Finland: sharp increase in 1970–1997 and alarming projections for the new millennium. Osteoporos Int 11(5):443–448PubMedCrossRef Kannus P, Palvanen M, Niemi S, Parkkari J, Järvinen M (2000) Epidemiology of osteoporotic pelvic fractures in elderly people in Finland: sharp increase in 1970–1997 and alarming projections for the new millennium. Osteoporos Int 11(5):443–448PubMedCrossRef
5.
Zurück zum Zitat Kellam JF, McMurtry RY, Paley D, Tile M (1987) The unstable pelvic fracture. Operative treatment. Orthop Clin North Am 18(1):25–41PubMed Kellam JF, McMurtry RY, Paley D, Tile M (1987) The unstable pelvic fracture. Operative treatment. Orthop Clin North Am 18(1):25–41PubMed
6.
Zurück zum Zitat Dalal SA, Burgess AR, Siegel JH, Young JW, Brumback RJ, Poka A et al (1989) Pelvic fracture in multiple trauma: Classification by mechanism is key to pattern of organ injury, resuscitative requirements, and outcome. J Trauma 29(7):981–1000 (discussion1000–1002)PubMedCrossRef Dalal SA, Burgess AR, Siegel JH, Young JW, Brumback RJ, Poka A et al (1989) Pelvic fracture in multiple trauma: Classification by mechanism is key to pattern of organ injury, resuscitative requirements, and outcome. J Trauma 29(7):981–1000 (discussion1000–1002)PubMedCrossRef
7.
Zurück zum Zitat Gautier E, Rommens PM, Matta JM (1996) Late reconstruction after pelvic ring injuries. Injury 27(Supplement 2):39–46CrossRef Gautier E, Rommens PM, Matta JM (1996) Late reconstruction after pelvic ring injuries. Injury 27(Supplement 2):39–46CrossRef
8.
Zurück zum Zitat Giráldez-Sánchez MA, Lázaro-Gonzálvez Á, Martínez-Reina J, Serrano-Toledano D, Navarro-Robles A, Cano-Luis P et al (2015) Percutaneous iliosacral fixation in external rotational pelvic fractures. A biomechanical analysis. Injury 46(2):327–332PubMedCrossRef Giráldez-Sánchez MA, Lázaro-Gonzálvez Á, Martínez-Reina J, Serrano-Toledano D, Navarro-Robles A, Cano-Luis P et al (2015) Percutaneous iliosacral fixation in external rotational pelvic fractures. A biomechanical analysis. Injury 46(2):327–332PubMedCrossRef
9.
Zurück zum Zitat Wong JM-L, Bewsher S, Yew J, Bucknill A, de Steiger R (2015) Fluoroscopically assisted computer navigation enables accurate percutaneous screw placement for pelvic and acetabular fracture fixation. Injury 46(6):1064–1068PubMedCrossRef Wong JM-L, Bewsher S, Yew J, Bucknill A, de Steiger R (2015) Fluoroscopically assisted computer navigation enables accurate percutaneous screw placement for pelvic and acetabular fracture fixation. Injury 46(6):1064–1068PubMedCrossRef
10.
Zurück zum Zitat Routt ML, Simonian PT, Grujic L (1995) The retrograde medullary superior pubic ramus screw for the treatment of anterior pelvic ring disruptions: A new technique. J Orthop Trauma 9(1):35–44PubMedCrossRef Routt ML, Simonian PT, Grujic L (1995) The retrograde medullary superior pubic ramus screw for the treatment of anterior pelvic ring disruptions: A new technique. J Orthop Trauma 9(1):35–44PubMedCrossRef
11.
Zurück zum Zitat Ochs BG, Stuby FM, Ateschrang A, Stoeckle U, Gonser CE (2014) Retrograde lag screw placement in anterior acetabular column with regard to the anterior pelvic plane and midsagittal plane-Virtual mapping of 260 three-dimensional hemipelvises for quantitative anatomic analysis. Injury 45(10):1590–1598PubMedCrossRef Ochs BG, Stuby FM, Ateschrang A, Stoeckle U, Gonser CE (2014) Retrograde lag screw placement in anterior acetabular column with regard to the anterior pelvic plane and midsagittal plane-Virtual mapping of 260 three-dimensional hemipelvises for quantitative anatomic analysis. Injury 45(10):1590–1598PubMedCrossRef
12.
Zurück zum Zitat Chen KN, Wang G, Cao LG, Zhang MC (2009) Differences of percutaneous retrograde screw fixation of anterior column acetabular fractures between male and female: A study of 164 virtual three-dimensional models. Injury 40(10):1067–1072PubMedCrossRef Chen KN, Wang G, Cao LG, Zhang MC (2009) Differences of percutaneous retrograde screw fixation of anterior column acetabular fractures between male and female: A study of 164 virtual three-dimensional models. Injury 40(10):1067–1072PubMedCrossRef
13.
Zurück zum Zitat Kuttner M, Klaiber A, Lorenz T, Füchtmeier B, Neugebauer R (2009) The pelvic subcutaneous cross-over internal fixator. Unfallchirurg 112(7):661–669PubMedCrossRef Kuttner M, Klaiber A, Lorenz T, Füchtmeier B, Neugebauer R (2009) The pelvic subcutaneous cross-over internal fixator. Unfallchirurg 112(7):661–669PubMedCrossRef
14.
Zurück zum Zitat Vaidya R, Colen R, Vigdorchik J, Tonnos F, Sethi A (2012) Treatment of unstable pelvic ring injuries with an internal anterior fixator and posterior fixation: initial clinical series. J Orthop Trauma 26(1):1–8PubMedCrossRef Vaidya R, Colen R, Vigdorchik J, Tonnos F, Sethi A (2012) Treatment of unstable pelvic ring injuries with an internal anterior fixator and posterior fixation: initial clinical series. J Orthop Trauma 26(1):1–8PubMedCrossRef
15.
Zurück zum Zitat Cole PA, Gauger EM, Anavian J, Ly TV, Morgan RA, Heddings AA (2012) Anterior pelvic external fixator versus subcutaneous internal fixator in the treatment of anterior ring pelvic fractures. J Orthop Trauma 26(5):269–277PubMedCrossRef Cole PA, Gauger EM, Anavian J, Ly TV, Morgan RA, Heddings AA (2012) Anterior pelvic external fixator versus subcutaneous internal fixator in the treatment of anterior ring pelvic fractures. J Orthop Trauma 26(5):269–277PubMedCrossRef
16.
Zurück zum Zitat Gardner MJ, Mehta S, Mirza A, Ricci WM (2012) Anterior pelvic reduction and fixation using a subcutaneous internal fixator. J Orthop Trauma 26(5):314–321PubMedCrossRef Gardner MJ, Mehta S, Mirza A, Ricci WM (2012) Anterior pelvic reduction and fixation using a subcutaneous internal fixator. J Orthop Trauma 26(5):314–321PubMedCrossRef
17.
Zurück zum Zitat Hiesterman TG, Hill BW, Cole PA (2012) Surgical technique: A percutaneous method of subcutaneous fixation for the anterior pelvic ring: The pelvic bridge. Clin Orthop Relat Res 470(8):2116–2123PubMedPubMedCentralCrossRef Hiesterman TG, Hill BW, Cole PA (2012) Surgical technique: A percutaneous method of subcutaneous fixation for the anterior pelvic ring: The pelvic bridge. Clin Orthop Relat Res 470(8):2116–2123PubMedPubMedCentralCrossRef
18.
Zurück zum Zitat Cano-Luis P, Giráldez-Sanchez MA, Martínez-Reina J, Serrano-Escalante FJ, Galleguillos-Rioboo C, Lázaro-Gonzálvez A et al (2013) Biomechanical analysis of a new minimally invasive system for osteosynthesis of pubis symphysis disruption. Injury 43(S2):S20–S27 Cano-Luis P, Giráldez-Sanchez MA, Martínez-Reina J, Serrano-Escalante FJ, Galleguillos-Rioboo C, Lázaro-Gonzálvez A et al (2013) Biomechanical analysis of a new minimally invasive system for osteosynthesis of pubis symphysis disruption. Injury 43(S2):S20–S27
19.
Zurück zum Zitat Routt ML, Kregor PJ, Simonian PT, Mayo KA (1995) Early results of percutaneous iliosacral screws placed with the patient in the supine position. J Orthop Trauma 9(3):207–214PubMedCrossRef Routt ML, Kregor PJ, Simonian PT, Mayo KA (1995) Early results of percutaneous iliosacral screws placed with the patient in the supine position. J Orthop Trauma 9(3):207–214PubMedCrossRef
20.
Zurück zum Zitat Zhang L‑H, Zhang L‑C, Si Q‑H, Gao Y, Su X‑Y, Zhao Z et al (2016) Experimental study on treatment of acetabular anterior column fractures: Applyment of a minimally invasive percutaneous lag screw guide apparatus. BMC Musculoskeletal Disorders 17(1):1–7CrossRef Zhang L‑H, Zhang L‑C, Si Q‑H, Gao Y, Su X‑Y, Zhao Z et al (2016) Experimental study on treatment of acetabular anterior column fractures: Applyment of a minimally invasive percutaneous lag screw guide apparatus. BMC Musculoskeletal Disorders 17(1):1–7CrossRef
21.
Zurück zum Zitat Gras F, Gottschling H, Schröder M, Marintschev I, Reimers N, Burgkart R (2014) Sex-specific differences of the infraacetabular corridor: A biomorphometric CT-based analysis on a database of 523 pelves. Clin Orthop Relat Res 473(1):361–369PubMedPubMedCentralCrossRef Gras F, Gottschling H, Schröder M, Marintschev I, Reimers N, Burgkart R (2014) Sex-specific differences of the infraacetabular corridor: A biomorphometric CT-based analysis on a database of 523 pelves. Clin Orthop Relat Res 473(1):361–369PubMedPubMedCentralCrossRef
22.
Zurück zum Zitat Dienstknecht T, Müller M, Sellei R, Nerlich M, Müller FJ, Fuechtmeier B et al (2012) Screw placement in percutaneous acetabular surgery: Gender differences of anatomical landmarks in a cadaveric study. Int Orthop (SICOT) 37(4):673–679CrossRef Dienstknecht T, Müller M, Sellei R, Nerlich M, Müller FJ, Fuechtmeier B et al (2012) Screw placement in percutaneous acetabular surgery: Gender differences of anatomical landmarks in a cadaveric study. Int Orthop (SICOT) 37(4):673–679CrossRef
23.
Zurück zum Zitat Ochs BRG, Gonser C, Shiozawa T, Badke A, Weise K, Rolauffs B et al (2010) Computer-assisted periacetabular screw placement: Comparison of different fluoroscopy-based navigation procedures with conventional technique. Injury 41(12):1297–1305PubMedCrossRef Ochs BRG, Gonser C, Shiozawa T, Badke A, Weise K, Rolauffs B et al (2010) Computer-assisted periacetabular screw placement: Comparison of different fluoroscopy-based navigation procedures with conventional technique. Injury 41(12):1297–1305PubMedCrossRef
24.
Zurück zum Zitat Shahulhameed A, Roberts CS, Pomeroy CL, Acland RD, Giannoudis PV (2010) Mapping the columns of the acetabulum - implications for percutaneous fixation. Injury 41(4):339–342PubMedCrossRef Shahulhameed A, Roberts CS, Pomeroy CL, Acland RD, Giannoudis PV (2010) Mapping the columns of the acetabulum - implications for percutaneous fixation. Injury 41(4):339–342PubMedCrossRef
25.
Zurück zum Zitat Winkelhagen J, van den Bekerom MPJ, Bolhuis HW, Hogervorst M (2012) Preliminary results of cannulated screw fixation for isolated pubic ramus fractures. Strategies Trauma Limb Reconstr 7(2):87–91PubMedPubMedCentralCrossRef Winkelhagen J, van den Bekerom MPJ, Bolhuis HW, Hogervorst M (2012) Preliminary results of cannulated screw fixation for isolated pubic ramus fractures. Strategies Trauma Limb Reconstr 7(2):87–91PubMedPubMedCentralCrossRef
26.
Zurück zum Zitat Gänsslen A, Krettek C (2006) Retrograde transpubic screw fixation of transpubic instabilities. Oper Orthop Traumatol 18(4):330–340PubMedCrossRef Gänsslen A, Krettek C (2006) Retrograde transpubic screw fixation of transpubic instabilities. Oper Orthop Traumatol 18(4):330–340PubMedCrossRef
27.
Zurück zum Zitat Akagi M, Ikeda N, Fukiage K, Nakamura T (2002) A modification of the retrograde medullary screw for the treatment of bilateral pubic ramus nonunions: A case report. J Orthop Trauma 16(6):431–433PubMedCrossRef Akagi M, Ikeda N, Fukiage K, Nakamura T (2002) A modification of the retrograde medullary screw for the treatment of bilateral pubic ramus nonunions: A case report. J Orthop Trauma 16(6):431–433PubMedCrossRef
28.
Zurück zum Zitat Simonian PT, Routt MLC Jr, Harrington RM, Tencer AF (1994) Internal fixation of the unstable anterior pelvic ring: A biomechanical comparison of standard plating techniques and the retrograde medullary superior pubic ramus screw. J Orthop Trauma 8(6):476–482PubMedCrossRef Simonian PT, Routt MLC Jr, Harrington RM, Tencer AF (1994) Internal fixation of the unstable anterior pelvic ring: A biomechanical comparison of standard plating techniques and the retrograde medullary superior pubic ramus screw. J Orthop Trauma 8(6):476–482PubMedCrossRef
29.
Zurück zum Zitat Mosheiff R, Liebergall M (2002) Maneuvering the retrograde medullary screw in pubic ramus fractures. J Orthop Trauma 16(8):594–596PubMedCrossRef Mosheiff R, Liebergall M (2002) Maneuvering the retrograde medullary screw in pubic ramus fractures. J Orthop Trauma 16(8):594–596PubMedCrossRef
30.
Zurück zum Zitat Starr AJ, Reinert CM, Jones AL (1998) Percutaneous fixation of the columns of the acetabulum: A new technique. J Orthop Trauma 12(1):51–58PubMedCrossRef Starr AJ, Reinert CM, Jones AL (1998) Percutaneous fixation of the columns of the acetabulum: A new technique. J Orthop Trauma 12(1):51–58PubMedCrossRef
31.
Zurück zum Zitat Attias N, Lindsey RW, Starr AJ, Borer D (2005) The use of a virtual three-dimensional model to evaluate the intraosseous space available for percutaneous screw fixation of acetabular fractures. J Bone Joint Surg Br 87-B(11):1520–1523CrossRef Attias N, Lindsey RW, Starr AJ, Borer D (2005) The use of a virtual three-dimensional model to evaluate the intraosseous space available for percutaneous screw fixation of acetabular fractures. J Bone Joint Surg Br 87-B(11):1520–1523CrossRef
32.
Zurück zum Zitat Bucknill A, Yew J, Clifford J, de Steiger R (2012) Percutaneous pelvic screw placement in pelvic trauma using computer navigation. J Bone Joint Surg Br 94- B(Suppl. XXIII):196 Bucknill A, Yew J, Clifford J, de Steiger R (2012) Percutaneous pelvic screw placement in pelvic trauma using computer navigation. J Bone Joint Surg Br 94- B(Suppl. XXIII):196
33.
Zurück zum Zitat Firoozabadi R, Stafford P, Routt M (2015) Risk of spermatic cord injury during anterior pelvic ring andacetabular surgery: Ananatomical study. Arch Bone Jt Surg 3(4):269–273 Firoozabadi R, Stafford P, Routt M (2015) Risk of spermatic cord injury during anterior pelvic ring andacetabular surgery: Ananatomical study. Arch Bone Jt Surg 3(4):269–273
34.
Zurück zum Zitat Eagan M, Kim H, Manson TT, Gary JL, Russell JP, Hsieh AH et al (2015) Internal anterior fixators for pelvic ring injuries: Do monaxial pedicle screws provide more stiffness than polyaxial pedicle screws? Injury 46(6):996–1000PubMedCrossRef Eagan M, Kim H, Manson TT, Gary JL, Russell JP, Hsieh AH et al (2015) Internal anterior fixators for pelvic ring injuries: Do monaxial pedicle screws provide more stiffness than polyaxial pedicle screws? Injury 46(6):996–1000PubMedCrossRef
35.
Zurück zum Zitat Scheyerer MJ, Zimmermann SM, Osterhoff G, Tiziani S, Simmen H‑P, Wanner GA et al (2014) Anterior subcutaneous internal fixation for treatment of unstable pelvic fractures. BMC Res Notes 7(1):133PubMedPubMedCentralCrossRef Scheyerer MJ, Zimmermann SM, Osterhoff G, Tiziani S, Simmen H‑P, Wanner GA et al (2014) Anterior subcutaneous internal fixation for treatment of unstable pelvic fractures. BMC Res Notes 7(1):133PubMedPubMedCentralCrossRef
36.
Zurück zum Zitat Hesse D, Kandmir U, Solberg B, Stroh A, Osgood G, Sems SA et al (2015) Femoral nerve palsy after pelvic fracture treated with INFIX. J Orthop Trauma 29(3):138–143PubMedCrossRef Hesse D, Kandmir U, Solberg B, Stroh A, Osgood G, Sems SA et al (2015) Femoral nerve palsy after pelvic fracture treated with INFIX. J Orthop Trauma 29(3):138–143PubMedCrossRef
37.
Zurück zum Zitat Shuler TE, Boone DC, Gruen GS, Peitzman AB (1995) Percutaneous iliosacral screw fixation: Early treatment for unstable posterior pelvic ring disruptions. J Trauma 38(3):453–458PubMedCrossRef Shuler TE, Boone DC, Gruen GS, Peitzman AB (1995) Percutaneous iliosacral screw fixation: Early treatment for unstable posterior pelvic ring disruptions. J Trauma 38(3):453–458PubMedCrossRef
38.
Zurück zum Zitat Coste C, Asloum Y, Marcheix PS, Dijoux P, Charissoux JL, Mabit C (2013) Percutaneous iliosacral screw fixation in unstable pelvic ring lesions: The interest of O‑ARM CT-guided navigation. Orthop Traumatol Surg Res 99(4 Suppl):S273–S278PubMedCrossRef Coste C, Asloum Y, Marcheix PS, Dijoux P, Charissoux JL, Mabit C (2013) Percutaneous iliosacral screw fixation in unstable pelvic ring lesions: The interest of O‑ARM CT-guided navigation. Orthop Traumatol Surg Res 99(4 Suppl):S273–S278PubMedCrossRef
39.
Zurück zum Zitat El-Desouky II, Mohamed MM, Kandil AE (2016) Percutaneous iliosacral screw fixation in vertically unstable pelvic injuries, a refined conventional method. Acta Orthop Belg 82(1):52–59PubMed El-Desouky II, Mohamed MM, Kandil AE (2016) Percutaneous iliosacral screw fixation in vertically unstable pelvic injuries, a refined conventional method. Acta Orthop Belg 82(1):52–59PubMed
40.
Zurück zum Zitat Hopf JC, Krieglstein CF, Müller LP, Koslowsky TC (2015) Percutaneous iliosacral screw fixation after osteoporotic posterior ring fractures of the pelvis reduces pain significantly in elderly patients. Injury 46(8):1631–1636PubMedCrossRef Hopf JC, Krieglstein CF, Müller LP, Koslowsky TC (2015) Percutaneous iliosacral screw fixation after osteoporotic posterior ring fractures of the pelvis reduces pain significantly in elderly patients. Injury 46(8):1631–1636PubMedCrossRef
41.
Zurück zum Zitat Khaled SA, Soliman O, Wahed MA (2015) Functional outcome of unstable pelvic ring injuries after iliosacral screw fixation: Single versus two screw fixation. Eur J Trauma Emerg Surg 41(4):387–392PubMedCrossRef Khaled SA, Soliman O, Wahed MA (2015) Functional outcome of unstable pelvic ring injuries after iliosacral screw fixation: Single versus two screw fixation. Eur J Trauma Emerg Surg 41(4):387–392PubMedCrossRef
42.
Zurück zum Zitat Osterhoff G, Ossendorf C, Wanner GA, Simmen H‑P, Werner CML (2011) Posterior screw fixation in rotationally unstable pelvic ring injuries. Injury 42(10):992–996PubMedCrossRef Osterhoff G, Ossendorf C, Wanner GA, Simmen H‑P, Werner CML (2011) Posterior screw fixation in rotationally unstable pelvic ring injuries. Injury 42(10):992–996PubMedCrossRef
43.
Zurück zum Zitat Peng K‑T, Chen P‑H, Hsu W‑H, Huang T‑W, Huang T‑J, Li Y‑Y (2013) Outcome analysis of unstable posterior ring injury of the pelvis: Comparison between percutaneous iliosacral screw fixation and conservative treatment. Biomed J 36(6):289–286PubMedCrossRef Peng K‑T, Chen P‑H, Hsu W‑H, Huang T‑W, Huang T‑J, Li Y‑Y (2013) Outcome analysis of unstable posterior ring injury of the pelvis: Comparison between percutaneous iliosacral screw fixation and conservative treatment. Biomed J 36(6):289–286PubMedCrossRef
44.
Zurück zum Zitat Pieske O, Landersdorfer C, Trumm C, Greiner A, Wallmichrath J, Gottschalk O et al (2015) CT-guided sacroiliac percutaneous screw placement in unstable posterior pelvic ring injuries: Accuracy of screw position, injury reduction and complications in 71 patients with 136 screws. Injury 46(2):333–339PubMedCrossRef Pieske O, Landersdorfer C, Trumm C, Greiner A, Wallmichrath J, Gottschalk O et al (2015) CT-guided sacroiliac percutaneous screw placement in unstable posterior pelvic ring injuries: Accuracy of screw position, injury reduction and complications in 71 patients with 136 screws. Injury 46(2):333–339PubMedCrossRef
45.
Zurück zum Zitat Reuther G, Röhner U, Will T, Dehne I, Petereit U (2014) CT-guided screw fixation of vertical sacral fractures in local anaesthesia using a standard CT. Fortschr Röntgenstr 186(12):1134–1139CrossRef Reuther G, Röhner U, Will T, Dehne I, Petereit U (2014) CT-guided screw fixation of vertical sacral fractures in local anaesthesia using a standard CT. Fortschr Röntgenstr 186(12):1134–1139CrossRef
46.
Zurück zum Zitat Schweitzer D, Zylberberg A, Córdova M, Gonzalez J (2008) Closed reduction and iliosacral percutaneous fixation of unstable pelvic ring fractures. Injury 39(8):869–874PubMedCrossRef Schweitzer D, Zylberberg A, Córdova M, Gonzalez J (2008) Closed reduction and iliosacral percutaneous fixation of unstable pelvic ring fractures. Injury 39(8):869–874PubMedCrossRef
47.
Zurück zum Zitat Shui X, Ying X, Mao C, Feng Y, Chen L, Kong J et al (2015) Percutaneous screw fixation of crescent fracture-dislocation of the sacroiliac joint. Orthopedics 38(11):e976–e982PubMedCrossRef Shui X, Ying X, Mao C, Feng Y, Chen L, Kong J et al (2015) Percutaneous screw fixation of crescent fracture-dislocation of the sacroiliac joint. Orthopedics 38(11):e976–e982PubMedCrossRef
48.
Zurück zum Zitat Zwingmann J, Hauschild O, Bode G, Südkamp NP, Schmal H (2013) Malposition and revision rates of different imaging modalities for percutaneous iliosacral screw fixation following pelvic fractures: A systematic review and meta-analysis. Arch Orthop Trauma Surg 133(9):1257–1265PubMedCrossRef Zwingmann J, Hauschild O, Bode G, Südkamp NP, Schmal H (2013) Malposition and revision rates of different imaging modalities for percutaneous iliosacral screw fixation following pelvic fractures: A systematic review and meta-analysis. Arch Orthop Trauma Surg 133(9):1257–1265PubMedCrossRef
49.
Zurück zum Zitat Eastman JG, Routt MLC (2015) Correlating preoperative imaging with intraoperative fluoroscopy in iliosacral screw placement. J Orthop Traumatol 16(4):309–316PubMedPubMedCentralCrossRef Eastman JG, Routt MLC (2015) Correlating preoperative imaging with intraoperative fluoroscopy in iliosacral screw placement. J Orthop Traumatol 16(4):309–316PubMedPubMedCentralCrossRef
50.
Zurück zum Zitat Reilly MC, Bono CM, Litkouhi B, Sirkin M, Behrens FF (2003) The effect of sacral fracture malreduction on the safe placement of iliosacral screws. J Orthop Trauma 17(2):88–94PubMedCrossRef Reilly MC, Bono CM, Litkouhi B, Sirkin M, Behrens FF (2003) The effect of sacral fracture malreduction on the safe placement of iliosacral screws. J Orthop Trauma 17(2):88–94PubMedCrossRef
51.
Zurück zum Zitat Mendel T, Radetzki F, Wohlrab D, Stock K, Hofmann GO, Noser H (2013) CT-based 3‑D visualisation of secure bone corridors and optimal trajectories for sacroiliac screws. Injury 44(7):957–963PubMedCrossRef Mendel T, Radetzki F, Wohlrab D, Stock K, Hofmann GO, Noser H (2013) CT-based 3‑D visualisation of secure bone corridors and optimal trajectories for sacroiliac screws. Injury 44(7):957–963PubMedCrossRef
52.
Zurück zum Zitat Mendel T, Noser H, Kuervers J, Goehre F, Hofmann GO, Radetzki F (2013) The influence of sacral morphology on the existence of secure S1 and S2 transverse bone corridors for iliosacroiliac screw fixation. Injury 44(12):1773–1779PubMedCrossRef Mendel T, Noser H, Kuervers J, Goehre F, Hofmann GO, Radetzki F (2013) The influence of sacral morphology on the existence of secure S1 and S2 transverse bone corridors for iliosacroiliac screw fixation. Injury 44(12):1773–1779PubMedCrossRef
53.
Zurück zum Zitat Mendel T, Noser H, Wohlrab D, Stock K, Radetzki F (2011) The lateral sacral triangle – a decision support for secure transverse sacroiliac screw insertion. Injury 42(10):1164–1170PubMedCrossRef Mendel T, Noser H, Wohlrab D, Stock K, Radetzki F (2011) The lateral sacral triangle – a decision support for secure transverse sacroiliac screw insertion. Injury 42(10):1164–1170PubMedCrossRef
54.
Zurück zum Zitat Bastian JD, Jost J, Cullmann JL, Aghayev E, Keel MJB, Benneker LM (2015) Percutaneous screw fixation of the iliosacral joint: Optimal screw pathways are frequently not completely intraosseous. Injury 46(10):2003–2009PubMedCrossRef Bastian JD, Jost J, Cullmann JL, Aghayev E, Keel MJB, Benneker LM (2015) Percutaneous screw fixation of the iliosacral joint: Optimal screw pathways are frequently not completely intraosseous. Injury 46(10):2003–2009PubMedCrossRef
55.
Zurück zum Zitat Richter PH, Gebhard F, Dehner C, Scola A (2015) Accuracy of computer-assisted iliosacral screw placement using a hybrid operating room. Injury 47(2):402–407PubMedCrossRef Richter PH, Gebhard F, Dehner C, Scola A (2015) Accuracy of computer-assisted iliosacral screw placement using a hybrid operating room. Injury 47(2):402–407PubMedCrossRef
56.
Zurück zum Zitat Zwingmann J, Südkamp NP, König B, Culemann U, Pohlemann T, Aghayev E et al (2013) Intra- and postoperative complications of navigated and conventional techniques in percutaneous iliosacral screw fixation after pelvic fractures: Results from the German pelvic trauma registry. Injury 44(12):1765–1772 (Dez)PubMedCrossRef Zwingmann J, Südkamp NP, König B, Culemann U, Pohlemann T, Aghayev E et al (2013) Intra- and postoperative complications of navigated and conventional techniques in percutaneous iliosacral screw fixation after pelvic fractures: Results from the German pelvic trauma registry. Injury 44(12):1765–1772 (Dez)PubMedCrossRef
57.
Zurück zum Zitat Takao M, Nishii T, Sakai T, Sugano N (2013) CT-3D-fluoroscopy matching navigation can reduce the malposition rate of iliosacral screw insertion for less-experienced surgeons. J Orthop Trauma 27(12):716–721PubMedCrossRef Takao M, Nishii T, Sakai T, Sugano N (2013) CT-3D-fluoroscopy matching navigation can reduce the malposition rate of iliosacral screw insertion for less-experienced surgeons. J Orthop Trauma 27(12):716–721PubMedCrossRef
58.
Zurück zum Zitat Daffner RH, Sciulli RL (2013) CT-guided iliosacral screw placement. Semin Musculoskelet Radiol 17(4):407–415PubMedCrossRef Daffner RH, Sciulli RL (2013) CT-guided iliosacral screw placement. Semin Musculoskelet Radiol 17(4):407–415PubMedCrossRef
59.
Zurück zum Zitat Tonetti J, van Overschelde J, Sadok B, Vouaillat H, Eid A (2013) Percutaneous ilio-sacral screw insertion. Fluoroscopic techniques. Orthop Traumatol Surg Res 99(8):965–972PubMedCrossRef Tonetti J, van Overschelde J, Sadok B, Vouaillat H, Eid A (2013) Percutaneous ilio-sacral screw insertion. Fluoroscopic techniques. Orthop Traumatol Surg Res 99(8):965–972PubMedCrossRef
60.
Zurück zum Zitat Templeman D, Schmidt A, Freese J, Weisman I (1996) Proximity of iliosacral screws to neurovascular structures after internal fixation. Clin Orthop Relat Res 329:194–198PubMedCrossRef Templeman D, Schmidt A, Freese J, Weisman I (1996) Proximity of iliosacral screws to neurovascular structures after internal fixation. Clin Orthop Relat Res 329:194–198PubMedCrossRef
61.
Zurück zum Zitat Papathanasopoulos A, Tzioupis C, Giannoudis VP, Roberts C, Giannoudis PV (2010) Biomechanical aspects of pelvic ring reconstruction techniques: Evidence today. Injury 41(12):1220–1227PubMedCrossRef Papathanasopoulos A, Tzioupis C, Giannoudis VP, Roberts C, Giannoudis PV (2010) Biomechanical aspects of pelvic ring reconstruction techniques: Evidence today. Injury 41(12):1220–1227PubMedCrossRef
62.
Zurück zum Zitat Zhang L, Peng Y, Du C, Tang P (2014) Biomechanical study of four kinds of percutaneous screw fixation in two types of unilateral sacroiliac joint dislocation: A finite element analysis. Injury 45(12):2055–2059PubMedCrossRef Zhang L, Peng Y, Du C, Tang P (2014) Biomechanical study of four kinds of percutaneous screw fixation in two types of unilateral sacroiliac joint dislocation: A finite element analysis. Injury 45(12):2055–2059PubMedCrossRef
63.
Zurück zum Zitat Failinger MS, McGanity PL (1992) Unstable fractures of the pelvic ring. J Bone Joint Surg Am 74(5):781–791PubMed Failinger MS, McGanity PL (1992) Unstable fractures of the pelvic ring. J Bone Joint Surg Am 74(5):781–791PubMed
64.
Zurück zum Zitat Vigdorchik JM, Jin X, Sethi A, Herzog DT, Oliphant BW, Yang KH et al (2015) A biomechanical study of standard posterior pelvic ring fixation versus a posterior pedicle screw construct. Injury 46(8):1491–1496PubMedCrossRef Vigdorchik JM, Jin X, Sethi A, Herzog DT, Oliphant BW, Yang KH et al (2015) A biomechanical study of standard posterior pelvic ring fixation versus a posterior pedicle screw construct. Injury 46(8):1491–1496PubMedCrossRef
65.
Zurück zum Zitat Van Zwienen C, Van den Bosch EW (2004) Biomechanical comparison of sacroiliac screw techniques for unstable pelvic ring fractures. J Orthop Trauma 18(9):589–595PubMedCrossRef Van Zwienen C, Van den Bosch EW (2004) Biomechanical comparison of sacroiliac screw techniques for unstable pelvic ring fractures. J Orthop Trauma 18(9):589–595PubMedCrossRef
66.
Zurück zum Zitat Chen W, Hou Z, Su Y, Smith WR, Liporace FA, Zhang Y (2013) Treatment of posterior pelvic ring disruptions using a minimally invasive adjustable plate. Injury 44(7):975–980PubMedCrossRef Chen W, Hou Z, Su Y, Smith WR, Liporace FA, Zhang Y (2013) Treatment of posterior pelvic ring disruptions using a minimally invasive adjustable plate. Injury 44(7):975–980PubMedCrossRef
Metadaten
Titel
Perkutane interne Fixation bei Beckenfrakturen
verfasst von
A. J. Stevenson
B. Swartman
A. T. Bucknill, MBBS, MSc (Dist), FRCS, FRACS
Publikationsdatum
22.09.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Unfallchirurgie / Ausgabe 10/2016
Print ISSN: 2731-7021
Elektronische ISSN: 2731-703X
DOI
https://doi.org/10.1007/s00113-016-0242-9

Weitere Artikel der Ausgabe 10/2016

Die Unfallchirurgie 10/2016 Zur Ausgabe

Update Unfallchirurgie

Update Unfallchirurgie

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.