Application of three-dimensional lfuoroscopic navigation in percutaneous iliosacral screw ifxation for posterior pelvic ring injuries

JIA Shuai-jun; CAO Zheng; Lü Shang-jun; HE Li-jun; LIU Jian

doi:10.3969/j.issn.2095-252X.2014.07.010

Abstract：Objective To explore the safety and treatment outcomes of the application of three-dimensional ( 3D ) lfuoroscopic navigation in percutaneous iliosacral screw ifxation for posterior pelvic ring injuries.Methods From March 2009 to December 2012, 18 patients with posterior pelvic ring injuries underwent percutaneous iliosacral screw ifxation using an optoelectronic 3D lfuoroscopic based navigation system. There were 13 males and 5 females, whose average age was 40.2 years old ( range: 23-61 years ). Fractures were caused by trafifc accidents in 12 cases, high falling injuries in 5 cases and collapsed building in 1 case. The interval from injury to hospitalization was 25 hours on average ( range: 3 hours-5 days ). According to AO classiifcation, there were 3 cases of type B 1.2, 2 cases of type B 2.2, 7 cases of type C 1.2, 5 cases of type C 1.3 and 1 case of type C 2.3.Results A total of 40 iliosacral screws were inserted during the operation, which took a mean period of ( 29.12±3.00 ) min per screw ( range: 20-38 min ). The mean lfuoroscopy time was ( 4.55±0.80 ) min per screw ( 3.5-5.2 min ), and the blood loss ranged from 10 ml to 20 ml per screw. The screw position was satisfactory in all the patients, without breaking into the sclerotin or entering the articular cavity or the sacral canal. No wound infections or obvious neurological complications were found. Based on the Matta scoring system, excellent results were seen in 12 patients, good results in 5 patients and a fair result in 1 patient, and the overall excellent and good rate was 94%. According to the Majeed functional scoring, the results were excellent in 11 cases and good in 7 cases, with the overall excellent and good rate of 100%.Conclusions The technique of 3D lfuoroscopic navigation is safe and effective in percutaneous iliosacral screw ifxation for posterior pelvic ring injuries.