• Jan Verbeek, Erik Hermans, Arie van Vugt, and Jan Paul Frölke.
• *Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands; and †Department of Surgery, Medical Spectrum Twente, Enschede, the Netherlands.
• J Orthop Trauma. 2016 Jun 1; 30 (6): 331-5.

ObjectivesTo assess the correct positioning of iliosacral screw in patients with unstable traumatic pelvic ring injury by comparing fluoroscopically guided computer-navigated surgery (CNS) with conventional fluoroscopy (CF) through reviewing postoperative computed tomography (CT) and clinical indicators.DesignA comparative multicenter cohort study.SettingTwo level I Trauma Centers in the Netherlands.PatientsThe computer-navigated group (n = 56) and the CF group (n = 24) were comparable regarding age (mean, 43 years), sex (58%, male), body mass index (25 kg/m), injury severity score (27), injury-to-surgery interval (7 days), and Orthopaedic Trauma Association classification (40% 61-B, 60% 61-C).Main Outcome MeasurementsThe position of the iliosacral screws was evaluated on postoperative CT. In addition, clinical morbidity and reoperation were assessed.ResultsIn the CNS group, a total of 111 screws were placed (2.0 per patient), of which 83% were placed correctly. In the CF group, 39 screws (1.6 per patient) were placed, 82% of them correctly.Inadequate fixation included neural foramina hit [12 screws (11%) in the CNS group versus 3 screws (8%) in the CF group, P = 0.76] and extraosseous dislocation [7 screws (6%) vs. 4 screws (10%), respectively, P = 0.47]. Five patients required reoperation, all in the CNS group, P = 0.32. We observed more adequate positioning with increased surgical experience, P = 0.12.ConclusionsIn contrast to what has been suggested by previous studies, we found no benefit from computer-navigated iliosacral screw fixation compared with fluoroscopically guided surgery regarding the correct positioning of iliosacral screw on postoperative CT and related morbidity.Level Of EvidenceTherapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

38 keywords...

hide…