title: Three-dimensionally-navigated cross-cannulated screw fixation for traumatic pubic symphysis diastasis: an anatomical study.
abstract: OBJECTIVE
  The aim of this study was to design and optimize the secure corridor of cross-cannulated screw implantation in pubic symphysis through Orbic 3D (Siemens Medical Solutions, Erlangen, Germany) computerized navigation and to provide an anatomic basis through the study of regional anatomy.
  
  
  METHODS
  Fifteen embalmed adult cadavers (8 males, 7 females) were used in this study. All pelvic specimens were placed in the supine position on a radiolucent carbon fiber table. The ideal angle of screw placement, appropriate screw diameter, and perfect attachment point were determined by the computerized navigation system. According to the above data, cross-cannulated screws 6.5 mm in diameter were implanted by the guide pins. Based on detailed local dissection, the entry-exit points of double screws were exposed in the pelvis. The distances were measured between the entry-exit points and the major structures. Radiographs and computed tomography (CT) scans of the pelvis were performed to reassess the position of screws.
  
  
  RESULTS
  The trajectory of the first screw originated from the trailing edge of the pubic tubercula to the anterior-lower corner of the contralateral pubic tubercula. The second screw was directed from the base of the pubic tubercula to the junctional zone between the pubic tubercula and inferior ramus of the pubis of the opposite side of the body. Both screws maintained a safe distance from the surrounding major structures. All screw corridors were found intact without any damage under X-ray and CT images.
  
  
  CONCLUSIONS
  The Orbic 3D computer navigation system is a reliable and new method of achieving a secure corridor for screw implantation in the pubic symphysis.
authors.affiliation: 1. Department of Traumatic Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China; 2. Department of Orthopaedics, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, China. muweidongdaoshi@126.com.
authors.forename: Guangchao
authors.initials: G
authors.lastname: Sun
authors.affiliation: Hand Surgery, The Third People Hospital of Jinan, Jinan, Shandong, China.
authors.forename: Chengguo
authors.initials: C
authors.lastname: Yin
authors.affiliation: Department of Traumatic Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Traumatic Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
authors.forename: Lubo
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Traumatic Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Mu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws / Q000592:standards*; D002102:Cadaver; D002681:China; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D010388:Pelvis / Q000000981:diagnostic imaging*; D011631:Pubic Symphysis / Q000601:surgery*; D046548:Pubic Symphysis Diastasis / Q000601:surgery*; D014057:Tomography, X-Ray Computed