Fluoroscopic Views for a More Accurate Placement of Iliosacral Screws

Abstract

Our findings highlight that misperception can occur using standard inlet and outlet views. We suggest using 2 variations of the inlet views and 3 variations of the outlet views to avoid misperception in clinical practice.

A novel patient-specific three-dimensional-printed external template to guide iliosacral screw insertion: a retrospective study

“…Use of our novel external template to guide K-wire insertion, and subsequent IS screw placement, provided high accuracy, with a shorter operative time and lower radiation exposure than the conventional fluoroscopy-guided technique. Moreover, despite the conventional use of inlet, outlet and lateral fluoroscopy views to guide percutaneous IS insertion, violation of the cortex remains an inherent problem of IS screw implantation [ 18 – 20 ], with additional fluoroscopic views often required intra-operatively to further improve accuracy. Ozmeric et al [ 19 ] advised that two different inlet views should be used to evaluate the anterior and posterior borders of the sacral body, separately.…”

“…Ozmeric et al [ 19 ] advised that two different inlet views should be used to evaluate the anterior and posterior borders of the sacral body, separately. Kim et al [ 18 ] even suggested using two inlet views (at 25° and 55° from the vertical) and three outlet views (at 25°, 35° and 55° from the vertical) to avoid misperception of the local anatomy. However, any adjustment in the position of the guide wire required in one view should necessarily be reconfirmed on all fluoroscopic views.…”

Percutaneous posterior transiliac plate versus iliosacral screw fixation for posterior fixation of Tile C-type pelvic fractures: a retrospective comparative study

“…In this study, the incidence of iatrogenic nerve injuries was 4.8%. More caution should be applied, and careful examination of fluoroscopic images must be performed [ 32 ]. The use of navigation techniques for guidewire placement and intraoperative 3D-image control of the guidewire position are helpful in reducing this complication [ 33 , 34 ].…”

Percutaneous posterior transiliac plate versus iliosacral screw fixation for posterior fixation of Tile C-type pelvic fractures

“…In this study, the incidence of iatrogenic nerve injuries was 4.8%. More caution should be applied, and careful examination of uoroscopic images must be performed 26 . The use of navigation techniques for guidewire placement and intraoperative 3D-image control of the guidewire position are helpful in reducing this complication 27,28 .…”