Technical Report

Skeletal Radiology

, Volume 39, Issue 7, pp 701-705

First online:

Computed tomography fluoroscopy-guided placement of iliosacral screws in patients with unstable posterior pelvic fractures

  • Toshihiro IguchiAffiliated withDepartment of Radiology, Fukuyama City Hospital Email author 
  • , Ken-Ichi OgawaAffiliated withDivision of Orthopaedic Trauma, Fukuyama City Hospital Emergency Medical Center
  • , Takeshi DoiAffiliated withDivision of Orthopaedic Trauma, Fukuyama City Hospital Emergency Medical Center
  • , Koji MiyashoAffiliated withFukuyama City Hospital Emergency Medical Center
  • , Kazuo MunetomoAffiliated withDivision of Orthopaedic Trauma, Fukuyama City Hospital Emergency Medical Center
  • , Takao HirakiAffiliated withDepartment of Radiology, Okayama University Medical School
  • , Toshifumi OzakiAffiliated withDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
  • , Susumu KanazawaAffiliated withDepartment of Radiology, Okayama University Medical School

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Abstract

Objective

The purpose of this study was to evaluate retrospectively the safety and effectiveness of the computed tomography (CT) fluoroscopy-guided placement of iliosacral screws in patients with unstable posterior pelvic fractures.

Materials and methods

Six patients (four women and two men; mean age 55.8 years; range 35–77 years) with unstable posterior pelvic fractures underwent iliosacral screw placement under CT fluoroscopy guidance between November 2007 and August 2008. Unstable pelvic ring injury (AO types B and C) was the indication for this procedure.

Results

In all the six patients except one, CT fluoroscopy-guided placement had been technically successful. In one patient, a second screw had been inserted, with a tilt to the caudal site, and slightly advanced into the extrasacral body; afterward, it could be exchanged safely for a shorter screw. Five patients and one patient underwent placement of two screws and one screw, respectively. The mean duration of the procedure was 15.0 min (range 9–30 min) per screw; the duration was 12.3 min and 18.2 min for the first and second screws, respectively. No complications requiring treatment occurred during or after the procedure. The mean clinical and radiologic follow-up period was 14 months (range 6–21 months). All pelvic injuries had healed satisfactorily, without complication, and all patients are now doing well clinically and can walk.

Conclusion

CT fluoroscopy-guided placement of iliosacral screws is a safe and effective treatment in patients with unstable posterior pelvic fractures.

Keywords

Pelvis Fracture Screw fixation Computed tomography fluoroscopy