title: Removal of an iliosacral screw entrapping the L5 nerve root after failed posterior pelvic ring fixation: a case report.
abstract: We present a case of a pelvic ring fracture that was originally treated with anterior symphyseal plating and a misplaced percutaneous iliosacral screw. The anterior extraosseus portion of the misplaced 7.3-mm cannulated screw irritated the L5 nerve root, resulting in a radiculopathy. Subsequent surgery involved and mandated removing the bent screw after open identification and protection of the L5 nerve root to avoid further nerve damage; the sacroiliac joint was subsequently debrided and fused. This case represents a complication of acute percutaneous iliosacral screw fixation of pelvic ring injuries and the subsequent strategy for successful salvage.
authors.affiliation: Orthopaedic Trauma Service, Hospital for Special Surgery, New York, New York 10021, USA. yoramweil@gmail.com
authors.forename: Yoram A
authors.initials: YA
authors.lastname: Weil
authors.forename: Markku T
authors.initials: MT
authors.lastname: Nousiainen
authors.forename: David L
authors.initials: DL
authors.lastname: Helfet
mesh_terms: D000328:Adult; D001863:Bone Screws; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D009408:Nerve Compression Syndromes / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011183:Postoperative Complications; D011843:Radiculopathy / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D012086:Reoperation; D012446:Sacroiliac Joint / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods; D013127:Spinal Nerves / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome