Robot-assisted versus conventional percutaneous sacroiliac screw fixation for posterior pelvic ring injuries: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Abdulrahman Al-Naseem ◽  
Abdelrahman Sallam ◽  
Ahmed Gonnah ◽  
Omar Masoud ◽  
Muhammad M. Abd-El-Barr ◽  
...  
Keyword(s):  
Systematic Review ◽  
Screw Fixation ◽  
Pelvic Ring ◽  
Meta Analysis ◽  
Robot Assisted ◽  
Posterior Pelvic Ring ◽  
Sacroiliac Screw ◽  
Pelvic Ring Injuries ◽  
Sacroiliac Screw Fixation

COMPARISON OF X-RAY AND CT METHODS FOR ASSESSING SACRAL SHAPE VARIANTS AND IDENTIFYING A SECURE SACROILIAC SCREW FIXATION CORRIDOR

2019 ◽  
Vol 22 (03n04) ◽  
pp. 1950007
Author(s):  
Florian Radetzki ◽  
Felix Goehre ◽  
Stefan Schwan ◽  
Andreas Wienke ◽  
Lars Jansch ◽  
...  
Keyword(s):  
Predictive Value ◽  
Screw Fixation ◽  
Pelvic Ring ◽  
Invasive Technique ◽  
Posterior Pelvic Ring ◽  
Predictive Values ◽  
X Ray ◽  
Sacroiliac Screw ◽  
Screw Insertion ◽  
Sacroiliac Screw Fixation

Sacroiliac screw fixation is the only minimally invasive technique for stabilizing unstable posterior pelvic ring fractures. X-ray/CT methods identify sacral shape variants, which influence screw fixation feasibility at sacral segment S1. As no reliability analysis was previously published, this study analyzed four X-ray/CT-based screw corridor evaluation methods. CT datasets of 80 human pelvises (♂[Formula: see text][Formula: see text], ♀[Formula: see text][Formula: see text], [Formula: see text] years, [Formula: see text][Formula: see text]cm, [Formula: see text][Formula: see text]kg) were used. CTs were post-processed using Amira 5.2 software to generate 3D models and analyzed for S1 transverse 7.3[Formula: see text]mm screw corridors using a C++ program. CT-slices and radiograph-like images were generated per each classification’s requirements. Five surgeons independently assessed sacral shape and transverse screw insertion feasibility. Sensitivity, specificity, and positive/negative predictive values were calculated. C++ analysis indicated feasible screw insertion in 66 cases (82%). Sensitivities were 86% (Mendel), 75% (Routt), 74% (Carlson), and 67% (Kim). Specificities were 73% (Mendel) and 79% (Kim). Mean positive predictive value spanned from 54.6% (Mendel) to 26.2% (Carlson); negative predictive value spanned from 94.5% (Kim) to 90.4% (Carlson). No significant differences existed between surgeons. Mendel’s classification provides reliable and reproducible assessment via the lateral sacral triangle, without additional CTs like Carlson or Routt or the subjectivity of Kim’s method.

scholarly journals Posterior pelvic ring fractures: Closed reduction and percutaneous CT-guided sacroiliac screw fixation

1997 ◽  
Vol 20 (4) ◽  
pp. 285-294 ◽  
Author(s):  
Augustinus Ludwig Jacob ◽  
Peter Messmer ◽  
Klaus-Wilhelm Stock ◽  
Norbert Suhm ◽  
Bernard Baumann ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Screw Fixation ◽  
Pelvic Ring ◽  
Posterior Pelvic Ring ◽  
Ct Guided ◽  
Sacroiliac Screw ◽  
Pelvic Ring Fractures ◽  
Sacroiliac Screw Fixation

Robot-assisted S2 screw fixation for posterior pelvic ring injury

Injury ◽  
2020 ◽  
Author(s):  
Junqiang Wang ◽  
Teng Zhang ◽  
Wei Han ◽  
KeHan Hua ◽  
Xinbao Wu
Keyword(s):  
Screw Fixation ◽  
Pelvic Ring ◽  
Pelvic Ring Injury ◽  
Robot Assisted ◽  
Posterior Pelvic Ring ◽  
Posterior Pelvic Ring Injury

scholarly journals Complications associated with the use of ilio-sacral screw fixation in posterior pelvic ring injuries

Injury Extra ◽  
2010 ◽  
Vol 41 (12) ◽  
pp. 151
Author(s):  
A.J.B. Tasker ◽  
A. Odutola ◽  
R. Fox ◽  
C. Morrey ◽  
A.J. Ward ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Pelvic Ring ◽  
Posterior Pelvic Ring ◽  
Pelvic Ring Injuries

scholarly journals Comparison of Lumbopelvic Fixation and Iliosacral Screw Fixation for the Treatment of Bilateral Sacral Fractures

2021 ◽  
Author(s):  
Katharina E. Wenning ◽  
Emre Yilmaz ◽  
Thomas A. Schildhauer ◽  
Martin F. Hoffmann
Keyword(s):  
Operative Time ◽  
Screw Fixation ◽  
Pelvic Ring ◽  
Weight Bearing ◽  
Iliosacral Screw ◽  
Posterior Pelvic Ring ◽  
Sacral Fractures ◽  
Lumbopelvic Fixation ◽  
Pelvic Ring Injuries ◽  
Iliosacral Screw Fixation

Abstract Background: Bilateral sacral fractures result in traumatic disruption of the posterior pelvic ring. Treatment for unstable posterior pelvic ring fractures should aim for fracture reduction and rigid fixation to facilitate early mobilization. Iliosacral screw fixation (ISF) and lumbopelvic fixation (LPF) were recommended for the treatment of these injuries. No algorithm or gold standard exists for surgery of these fractures. Purpose: The purpose of this study was to evaluate the differences between ISF and LPF in bilateral sacral fractures regarding intraoperative procedures, complications, and postoperative mobilization. The secondary aim was to determine if demographics influence surgical treatment.Methods: Over a 4-year period (2016-2019) 188 consecutive patients with pelvic ring injuries were treated at one academic level-1 trauma center and retrospectively identified. Fractures were classified according to the AO/OTA classification system. 77 patients were treated with LPF or ISF in combination with internal fixation of pubic rami fractures and could be included in this study. Comparisons were made between demographic and perioperative data. Infection, hematoma, and hardware malpositioning were used as complication variables. Mobilization with unrestricted weight-bearing was used as outcome variable. Follow-up was at least 6 months postoperatively.Results: Operative stabilization of bilateral posterior pelvic ring injuries was performed in 77 patients. Thereof, 29 patients (females 59%) underwent LPF whereas 48 patients (females 83%) had bilateral ISF. The ISF group was older (76 yrs.) compared to the LPF group (62 yrs.) (p=0.001), but no differences regarding BMI or comorbidities were detected. Time for surgery was reduced for patients who were treated with ISF compared to lumbopelvic fixation (165 min vs. 73 min; respectively, p<0.001). But this did not result in reduced fluoroscopic time or radiation exposure. Overall complication rate was not different between the groups. Patients with LPF had a greater length of stay (p=0.008) but were all weight-bearing as tolerated when discharged (p<0.001). Conclusion: Bilateral posterior pelvic ring injuries of the sacrum can be sufficiently treated by LPF or ISF. LPF allows immediate weight-bearing which may benefit younger patients and patients with an elevated risk for pneumonia or other pulmonary complications. Treatment with ISF reduces operative time, length of stay and postoperative wound infection. Elderly patients may be better suited for treatment with ISF if there is concern that the patient may not tolerate the increased operative time.

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