Abstract:
INTRODUCTION:The reference surgical treatment for unstable posterior pelvic fracture is percutaneous iliosacral screw fixation, isolated or in association with other techniques. As there is a risk of passage outside the bone when performing screw fixation under fluoroscopy, new image-guidance techniques have been developed: fluoronavigation, peroperative 3D navigation, CT-linked navigation, etc. Since September 2011, our department has performed iliosacral screw fixation under CT control linked to navigation so as to optimize screw positioning. This innovative technology has been used in neurosurgery in our center since 2007, for disc implants, spinal fracture, vertebral arthrodesis and intracerebral localization. MATERIAL AND METHODS:Six patients were treated by iliosacral screw fixation for posterior pelvic ring fracture lesion. The O-ARM (Medtronic(®)) computer-assisted surgical navigation system was used, combining surgical navigation and peroperative 3D imaging. This kind of osteosynthesis is suitable for non-displaced or prereduced fracture. A radiation dose report is drawn up at end of surgery. DISCUSSION:Postoperative course does not differ from other percutaneous osteosynthesis techniques, combing the advantages of a percutaneous approach (reduced infection and blood-loss rates, etc.) while optimizing iliosacral screw positioning. To date, no radiation overexposure has been found. CONCLUSION:The precision and safety of iliosacral screw fixation are now unequalled, meeting the basic computer-assisted surgery principles of reduced morbidity without overexposure to ionizing radiation. Indications for computer-assisted surgery should therefore be extended to iliosacral pathologies (arthritic, tumoral and inflammatory), non-displaced acetabular fracture, etc.
journal_name
Orthop Traumatol Surg Resjournal_title
Orthopaedics & traumatology, surgery & research : OTSRauthors
Coste C,Asloum Y,Marcheix PS,Dijoux P,Charissoux JL,Mabit Cdoi
10.1016/j.otsr.2013.03.002subject
Has Abstractpub_date
2013-06-01 00:00:00pages
S273-8issue
4 Supplissn
1877-0568pii
S1877-0568(13)00046-7journal_volume
99pub_type
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