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. Particular attention must be given to the preoperative evaluation of both the iliosacral and transsacral corridors, as anatomical variations may restrict the available space for screw insertion. This review aims to highlight the essential aspects of sacroiliac osteosynthesis, with a focus on the critical role of thorough preoperative planning and its impact on achieving successful surgical outcomes.
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Iliosacral screw osteosynthesis - state of the art.
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 PDFComparison of spinopelvic fixation and iliosacral screw fixation for posterior pelvic ring injuries.
Ulus Travma Acil Cerrahi Derg
January 2025
Department of Orthopedics and Traumatology, Ankara Etlik City Hospital, Ankara-Türkiye.
Background: There is no consensus in the literature regarding the optimal treatment method for posterior pelvic ring injuries. This study aims to compare the radiologic and clinical outcomes, as well as complications of spinopelvic fixation (SPF) and iliosacral screw fixation (ISF) in patients with posterior pelvic ring injuries.
Methods: This retrospective study analyzed 54 patients (37 females, 17 males; mean age 38.
Treatment of Type IV Fragility Fractures of Pelvis With Robotic-Assisted Minimally Invasive Triangular Fixation.
Orthop Surg
December 2024
Department of Orthopaedic Trauma, Tianjin Hospital, Tianjin University, Tianjin, China.
Objective: Type IV fragility fractures of pelvis (FFP IV) are serious and complicated and the treatment is challengeable. Robotic-assisted minimally invasive triangular fixation (RoboTFX) is a new and advanced technique to treat this injury. The objective of this report is to evaluate the clinical outcomes of FFP IV treated with RoboTFX.
View Article and Find Full Text PDFAugmented ilio-sacral screws for the treatment of fragility pelvic fractures: review of literature, presentation of a novel low-cost technique, and clinical results of a case series.
Eur J Orthop Surg Traumatol
November 2024
Department of Orthopaedic Surgery, Pontificia Universidad Catolica de Chile, Santiago, Chile.
Article Synopsis
- Fragility pelvic fractures are becoming more common due to increased life expectancy, often requiring surgery with ilio-sacral screws for stabilization.* -
- This review discusses a novel, low-cost cement augmentation technique for ilio-sacral screws, designed for patients with poor bone quality and includes case examples from five patients treated between 2017 and 2024.* -
- The new surgical method is straightforward and uses readily available instruments, but further research is needed to prove its efficacy compared to traditional techniques without cement augmentation.*
New Minimally Invasive Method for Treating Posterior Pelvic Ring Fractures: Biomechanical Validation and Clinical Application of Sacroiliac Joint Locking Plate.
Orthop Surg
November 2024
Department of Orthopedic Surgery, Nanping First Hospital Affiliated to Fujian Medical University, Nanping, China.
Objective: Considering the high incidence and complexity of unstable posterior pelvic ring fractures, and the need for less invasive and more effective treatment options, this study aims to introduce a novel minimally invasive, safe, and simple internal fixation method for the treatment of unstable posterior pelvic ring fractures using the sacroiliac joint locking plate (SJP) system, and to provide biomechanical validation and clinical evaluation of this method.
Methods: Biomechanical research was conducted using standard pelvic bone models from Synbone, Switzerland, to create Denis II zone unstable posterior pelvic ring fracture models, and to assess the stability of the SJP under different loads compared with traditional fixation methods. A retrospective clinical study analyzed the clinical efficacy of SJP treatment in 62 patients (mean age of 51.
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