3D image-guided surgery for fragility fractures of the sacrum.

3D image-guided surgery for fragility fractures of the sacrum. Oper Orthop Traumatol. 2019 Sep 12;: Authors: Balling H Abstract OBJECTIVE: Stabilizing sacral fragility fractures without radiation exposure to the surgical team. INDICATIONS: Non-displaced or minimally displaced unilateral or bilateral transalar, transforaminal or central sacral fractures in weak and osteoporotic bone. CONTRAINDICATIONS: Displaced or highly unstable sacral fractures. Patients under therapeutic anticoagulation. Patients needing fast track orthopedic surgery. SURGICAL TECHNIQUE: Prone position. Reference clamp installation on posterior iliac crest. Initial 3D scan of posterior pelvic ring. Image-guided virtual determination of 2-3 interforaminal iliosacroiliac trajectories in sacral vertebrae I and II. Lateral transgluteal mini-open approach. 3D image-guided insertion of 2-3 guide wires along planned trajectories. 3D-scan for controlling guide wire positions. Virtual determination of screw lengths. Cortical drilling and cannulated screw insertion along guide wires. Radiological documentation. FOLLOW-UP: Clinical and radiological follow-up after 12 weeks, 12 and 24 months including radiographs in anteroposterior, lateral, inlet and outlet views. RESULTS: From October 2011 until October 2016 a total of 124 sacral fracture sites (in sacral vertebrae I and II) were treated with 120 navigated sacral screws in 52...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research