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


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.


CONCLUSIONS
CT fluoroscopy-guided placement of iliosacral screws is a safe and effective treatment in patients with unstable posterior pelvic fractures.
Iguchi
Toshihiro
T
Department of Radiology, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama, 721-8511, Japan, iguchi@ba2.so-net.ne.jp
Ogawa
Ken-Ichi
K
Doi
Takeshi
T
Miyasho
Koji
K
Munetomo
Kazuo
K
Hiraki
Takao
T
Ozaki
Toshifumi
T
Kanazawa
Susumu
S
D000328:Adult; D000368:Aged; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D007085:Ilium / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000000981:diagnostic imaging* / Q000601:surgery*; D019919:Prosthesis Implantation / Q000379:methods; D012447:Sacrum / Q000000981:diagnostic imaging / Q000601:surgery; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome