Evaluation of Closed Reduction and Screw Fixation in Lag Fashion of Sacroiliac Fracture‐Luxations

Abstract

Fluoroscopic-guided closed reduction and percutaneous screw fixation in lag fashion of sacroiliac fracture-luxations is a minimally invasive technique that restores and maintains pelvic canal dimensions and should be considered as an alternative to open reduction or nonsurgical management of sacroiliac fracture-luxations.

Evaluation of short- and long-term complications after endoscopically assisted gastropexy in dogs

“…[17][18][19][20][21][22] Although potentially challenging, these procedures are advantageous in humans in that they are associated with a decrease in incision size, decrease in the duration of hospitalization, decrease in morbidity, decrease in incisional complications, and improved cosmetic appearance, compared with results for conventional surgery. [22][23][24] Clearly, these advantages are magnified when performing a prophylactic procedure.…”

Minimally invasive lag screw fixation of sacroiliac luxation/fracture using a dedicated novel instrument system: Apparatus and technique description

“…Although localization of the sacral body and drill guide alignment are essential, adequate lag screw placement and bone purchase ultimately rely on being able to maintain accurate drill guide orientation during drilling. Currently established MIO techniques may still result in screw malalignment subsequent to human errors as the surgeon is attempting to manually maintain the initial position and orientation of the drill guide during drilling . Human error while drilling has been identified as a source of inaccuracy in orthopedic surgery and neurosurgery .…”

“…Currently established MIO techniques may still result in screw malalignment subsequent to human errors as the surgeon is attempting to manually maintain the initial position and orientation of the drill guide during drilling. 2,3,9 Human error while drilling has been identified as a source of inaccuracy in orthopedic surgery and neurosurgery. 20 Although they are not specific to a surgical procedure, drilling inaccuracies may be increasingly relevant in the case of SIL/F repair because of small size and dimensions of the safe sacral implantation corridor.…”

“…In human traumatology, MIO of SIL/F has become the standard of care because of numerous advantages including safer sacral screw positioning as well as decreased surgical time, intraoperative blood loss, hospitalization time, and postoperative pain . Similarly, despite a dearth of veterinary publications, clinical and experimental studies suggest that the MIO of SIL/F represents a valid alternative to ORIF . However, this technique is currently associated with several limitations including (1) difficulty of maintaining SIL/F reduction throughout surgery, (2) achieving precise and timely localization of the sacral body, (3) necessity of attaining accurate lag screw orientation in a narrow safe sacral implantation corridor, and (4) surgical team exposure to ionizing radiation during intraoperative imaging …”

“…[4][5][6][7][8] Similarly, despite a dearth of veterinary publications, clinical and experimental studies suggest that the MIO of SIL/F represents a valid alternative to ORIF. 3,[9][10][11] However, this technique is currently associated with several limitations including (1) difficulty of maintaining SIL/F reduction throughout surgery, (2) achieving precise and timely localization of the sacral body, (3) necessity of attaining accurate lag screw orientation in a narrow safe sacral implantation corridor, and (4) surgical team exposure to ionizing radiation during intraoperative imaging. [12][13][14] Currently, minimally invasive manual reduction of the sacroiliac luxation (SI) joint in small animals is typically accomplished by manipulation of the ischial tuberosity and/ or iliac wing by using bone reduction forceps or a Steinmann pin.…”