Analysis of trans‐sacral corridors in stabilization of fractures of the pelvic ring

Analysis of trans‐sacral corridors in stabilization of fractures of the pelvic ring

Percutaneous screw fixation combined with pelvic reduction is a surgical technique used to stabilize fractures of the posterior pelvic ring. This is the standard surgical treatment of unstable posterior pelvic ring injuries. The primary goal of this treatment is an anatomic reduction and stable fixa...

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Bibliographic Details
Published in:Journal of orthopaedic research Vol. 40; no. 5; pp. 1194 - 1202
Main Authors: Jäckle, Katharina, Paulisch, Matthias, Blüchel, Tobias, Meier, Marc‐Pascal, Seitz, Mark‐Tilmann, Acharya, Mehool R., Lehmann, Wolfgang, Spering, Christopher
Format: Journal Article
Language:English
Published: United States 01-05-2022
Subjects:
Bone Screws
dysmorphism
Fracture Fixation, Internal - methods
Fractures, Bone - surgery
Humans
Ilium - surgery
Pelvic Bones - injuries
Pelvic Bones - surgery
Pelvis
percutaneous screw fixation
S1/S2 screw corridor
Sacrum - injuries
Sacrum - surgery
screw length
trans‐sacral corridors
percutaneous screw fixation
dysmorphism
trans-sacral corridors
screw length
S1/S2 screw corridor
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Summary:Percutaneous screw fixation combined with pelvic reduction is a surgical technique used to stabilize fractures of the posterior pelvic ring. This is the standard surgical treatment of unstable posterior pelvic ring injuries. The primary goal of this treatment is an anatomic reduction and stable fixation. This has been shown to reduce pain and improve the patients' long‐term well‐being. The aim of this analysis was to determine the possible screw lengths and the positioning of the screws in the S1 and S2 sacral segments. A population of 697 pelvises from the Stryker Orthopaedic Modeling and Analytics database were analyzed. The dimensions of the S1 and S2 screw corridors were determined and after assessing for sacral dysmorphism, the correct screw placement was chosen to determine the necessary screw length for surgical treatment. The measurements of the screw lengths show a Gaussian distribution for the analyzed population. The percentage of dysmorphic pelvises for the S1 screw corridor was 31.3% and for the S2 corridor 8%. Average screw length for S1 was 163.8 ± 16.2 mm and for the S2 137.3 ± 9.5 mm. The results show that the S1/S2 axis cannot be used for a trans‐sacral screw placement in every patient. The study shows that intraosseous screw corridors are present in 68.7% of the patients in the S1 position and in 92% at the S2 level where an intended implant can be placed fully intraosseous.
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ISSN:0736-0266
1554-527X
DOI:10.1002/jor.25144