title: Biomorphometric analysis of ilio-sacro-iliacal corridors for an intra-osseous implant to fix posterior pelvic ring fractures.
abstract: It is hypothesized that ilio-sacro-iliacal corridors for a new envisioned pelvic ring implant (trans-sacral nail with two iliacal bolts = ISI-nail: ilio-sacro-iliacal nail) exists on the level of S1- or S2-vertebra in each patient. The corridors of 84 healthy human pelves (42x ♂; 42x ♀, 18-85 years) were measured in high resolution CT scans using the Merlin Diagnostic Workcenter Software. Trans-sacral corridors (≥ 9 mm diameter) on the level of S1 and S2 were found in 62% and 54% of pelves with a mean length [mm ± SD] of 164 ± 12.9 and 142 ± 10.2. Corresponding iliac corridors were present in all specimens in caudally tilted axial planes of 37.8 ± 0.67° and 53.7 ± 0.94° in relation to the operating table plane and divergent angulations of 69.0 ± 0.49° and 70.1 ± 0.32° in relation to the sagittal midline plane. Sacral dysmorphism, with compensatory larger S2 corridors were prevalent in 24% of pelves; ilio-sacro-iliacal osseous corridors for the envisioned implant were found in 88% of pelves on the level of S1 or S2. In the remaining 12% with too narrow corridors for any trans-sacral implant (screws, bars, ISI nail) alternative fixation methods have to be considered. Expected advantages of the envisioned ISI nail compared to available fixation devices are discussed.
authors.affiliation: Department of Trauma-, Hand- and Reconstructive Surgery, Friedrich-Schiller University Jena, Erlanger Allee 101, Jena, 07740, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Gras
authors.forename: Sophia
authors.initials: S
authors.lastname: Hillmann
authors.forename: Sascha
authors.initials: S
authors.lastname: Rausch
authors.forename: Kajetan
authors.initials: K
authors.lastname: Klos
authors.forename: Gunther O
authors.initials: GO
authors.lastname: Hofmann
authors.forename: Ivan
authors.initials: I
authors.lastname: Marintschev
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000886:Anthropometry; D005260:Female; D005592:Fracture Fixation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000000981:diagnostic imaging*; D011859:Radiography; D012016:Reference Values; D012447:Sacrum / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: ISI nail; iliac corridor; iliosacral screw; pelvic ring fracture; transsacral corridor