Percutaneous screws CT guided to fix sacroiliac joint in tile C pelvic injury. Outcomes at 5 years of follow-up

Abstract

Introduction: The treatment of the sacroiliac joint (SIJ) vertical instability is a matter of current discussions and remains controversial. The aim of our study is the evaluation of the surgical management of SIJ vertical instability involving the use of cannulated screws introduced under CT guidance and local anesthesia.Materials and methods: In the set time frame of 7 years, 96 poly-trauma patients with Tile's type C fracture of the pelvis with vertical instability of the SIJ were treated. The average distance between the two stumps was 73.4 mm (range: 43–100 mm). All patients were treated with anterior stabilization and subsequent stabilization with cannulated screws (Asnis® Stryker® 6 mm, an average length of 70 mm; range from 55 to 85 mm) of the sacroiliac fracture. The clinical and radiological follow-up was performed with follow-up plain radiograph and Majeed score (from 1 to 60 months after injury).Results: The consolidation of pelvic fractures was obtained after an average of 63 days. The average Majeed score was as follows: 96 points at 1 month, 84 points at 3 months, 62 points at 6 months, 44 points at 12 months, 42 points at 24 months, 32 points at 36 months, 28 points at 48 months and 28 points at 60 months. Complications were as follows: not fatal deep vein thrombosis in five cases, skin infection at the entry point of the screws in six cases, screw breakage in one case and loosening of the screws in one case. Radiological evidence of fracture consolidation was achieved on average at 63 days. Forty-seven patients managed to get back to their pre-trauma employment at the end of the convalescence period.Conclusions: Our results suggest that the stabilization of SI Tile type C fracture/dislocations with CT-guided percutaneous cannulated screws is a valid and feasible management option and associated with a low complication rate.

Wound Infiltration with Levobupivacaine, Ketorolac, and Adrenaline for Postoperative Pain Control after Spinal Fusion Surgery

“…Patients' safety and experience, functional outcomes, and healthcare costs should always be considered. These key aspects further confirm that an appropriate pain control is warranted for our cohort of patients which could highlight the importance and relevance of our good results in terms of pain management, healthcare costs, and related safety of the intervention [18][19][20][21][22][23].…”

Safety, Effect and Feasibility of Percutaneous SI-Screw with and without Augmentation—A 15-Year Retrospective Analysis on over 640 Screws

“…For that reason, it is difficult to generally reject potential advantages of 3D navigation based on our results. However, our data contribute to the general judgement that percutaneous SI-screw osteosynthesis is considered to be safe in general, but technically demanding with specific risks [ 2 , 36 , 37 ].…”

Pelvic angiography is effective for emergency pediatric patients with pelvic fractures: a propensity-score-matching study with a nationwide trauma registry in Japan

“…Angiography allows the detection and simultaneous treatment of arterial bleeding, and its implementation would be more effective for children. Recently, CT-guided surgery was reported for tile type C pelvic injury [ 24 ]. As the blood flow in children is less than that in adults, bloodless treatments such as CT-guided surgery and embolization might be effective for pediatric patients with pelvic fracture.…”