Background: The transiliac internal fixator (TIFI) is a novel minimally invasive surgical procedure to stabilize posterior pelvic ring fractures. Two bone corridors with different lengths, widths, and angulations are suitable to host screws in the posterior iliac wing. While the length and the width have been described previously, the angulation has not been determined yet.
Methods: We created a computer tomography-based 3D-model of 40 patients (20 women, 20 men). The possible bone corridors to host the ilium screws for the TIFIcc (cranio-caudal) and the TIFIdv (dorso-ventral) procedure were identified. After reaching the optimal position, the angles in relation to the sagittal and axial plane were measured. The anterior pelvic plane was chosen as the reference plane.
Results: The mean angle of the TIFIcc screws related to the axial plane was 63.4° (±1.8°) and to the sagittal plane was 12.3° (±1.5°). The mean angle of the TIFIdv screws related to the axial plane was 16.1° (±1.2°) and to the sagittal plane was 20.1° (±2.0°). In each group, a high constancy was apparent irrespective of the age or physical dimension of the patient, although a significant gender-dependent difference was observed".
Conclusions: Due to a high inter-individual constancy in length, width, and angulation, bone corridors in the posterior iliac wing are reliable to host screws for posterior pelvic ring fixation irrespective of each individual patient's anatomy.
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http://dx.doi.org/10.3390/jcm10071500 | DOI Listing |
Arch Orthop Trauma Surg
January 2025
Department of Orthopedics and Traumatology, University Medical Center Mainz, Mainz, Germany.
Iliosacral screw osteosynthesis is a widely recognized technique for stabilizing unstable posterior pelvic ring injuries, offering notable advantages, including enhanced mechanical stability, minimal invasiveness, reduced blood loss, and lower infection rates. However, the procedure presents technical challenges due to the complex anatomy of the sacrum and the proximity of critical neurovascular structures. While conventional fluoroscopy remains the primary method for intraoperative guidance, precise preoperative planning using multiplanar reconstructions and three-dimensional volume rendering is crucial for ensuring accurate placement of iliosacral or transsacral screws.
View Article and Find Full Text PDFActa Neurochir (Wien)
January 2025
Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
Objective: The endoscopic endonasal approach (EEA), has become the preferred alternative to traditional open and transoral approaches to the ventral craniovertebral junction (CVJ) region. However, preoperative prediction of the limitations of caudal reach remains challenging. This cadaveric study aimed to quantify the CVJ area of exposure and access afforded by the EEA, evaluate the accuracy of previously described radiographic anthropometric lines, and identify the lowest limit of the EEA corridor.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
University Hospital Merkur, Zagreb, Croatia.
Adequate intraoperative visualization is mandatory for implant application in pelvic ring injuries. Several fluoroscopic X-ray views are in practical use. The gold standard primary X-ray is the anteroposterior view of the pelvis.
View Article and Find Full Text PDFEur J Orthop Surg Traumatol
December 2024
Department of Orthopedics and Traumatology, Hospital do Trabalhador, Curitiba, PR, Brazil.
Introduction: Pelvic ring fractures are rare in the pediatric population and can be treated using sacroiliac screws when needed. The aim of this study was to identify safe anatomical corridors for sacroiliac fixation in different pediatric age groups and also to determine the prevalence of sacral dysmorphism in the study sample.
Method: We measured the dimensions of the horizontal and oblique S1 corridors and the horizontal S2 corridor in pelvic computed tomography scans of 138 children aged 1 to 16 years.
J Neurosurg Case Lessons
December 2024
Departments of Neurological Surgery, University of Washington, Seattle, Washington.
Background: Treatment of pediatric craniopharyngioma requires a multidisciplinary approach to counsel patients and families on the spectrum of treatment options, including biopsy, radiation, and/or resection. Gross-total resection can avoid radiation and its long-term comorbidities. In very young patients, this is of particular importance but is especially challenging because of anatomical considerations.
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