Upper sacral segment fixation with converging iliosacral screws: A technical trick for preoperative planning and case series

Abstract

Introduction: There are some situations where pelvic surgeons may want to place iliosacral screws with differing trajectories (Sacroiliac and Sacral styles) but may not be able to because of overlapping trajectories.

Hypothesis: Sacroiliac and Sacral style screws can be placed in S1 in select patients by using a preoperative planning technique off the 3D reconstructed surface rendered preoperative CT scan.

Materials/methods: Retrospective review of all patients receiving iliosacral screws using the described technique.

Results: Six patients received iliosacral screws using the described technique. When the preoperative planning technique demonstrated feasibility, all screws were able to be safely placed.

Discussion: Placing Sacroiliac and Sacral style screws within S1 may be ideal in some injury patterns. The described technique allows pelvic surgeons facile in iliosacral screw techniques to preoperatively plan for this construct.

Level of evidence: VI; Retrospective case series.

Keywords: Iliosacral screws; Osseous fixation pathway; Pelvic fracture; Preoperative planning; Sacral fracture; Sacroiliac disruption.