ArticleArchives of orthopaedic and trauma surgery2023
An evaluation of the inlet obturator oblique view for sacroiliac and transsacral screw placement.
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 3 citations in OpenAlex.
- Insufficient evaluation of S2 alar iliac screw malposition with the intraoperative inlet view: utility of the obturator inlet and iliac oblique views.Asian spine journal · 2026Article
- Article
- Safe surgical corridor for iliosacral screw placement in unstable pelvic fractures: a computed-tomography-guided validation study of the "triangulation method".Patient safety in surgery · 2023Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionBetween 2005 and 2017, the number of closed reduction and internal fixation of pelvic ring injuries increased by 1116%. Percutaneous fixation is currently the only minimally invasive technique that can stabilize the posterior elements of the pelvis. The purpose of this study was to investigate the utility of the inlet obturator oblique view (IOO) with the hypothesis that the IOO view will improve the accuracy of sacroiliac and transsacral screw placement in the S1 or S2 body and improve the accuracy of assessing whether the implant is fully seated against the outer cortex of the ilium. MATERIALS AND
methodsTen male pelvic training models were used. Thirty-six screw configurations were inserted by a fellowship trained orthopedic trauma surgeon in appropriately and inappropriately placed sacroiliac and transsacral screw configurations. These configurations were imaged using fluoroscopy in different planes and saved for survey.
resultsFourteen orthopedic professionals reviewed 313 fluoroscopic images. Interrater reliability demonstrated marked improvement in assessment of whether the screw head was seated against the outer cortex of the ilium with the IOO view (kappa = 0.841, without IOO kappa = 0.027). There was a statistically significant difference in overall accuracy (p value < 0.001, OR = 1.57, 95% CI = 1.35-1.84) and whether the screw head was seated (p value < 0.001, OR = 8.14, 95% CI = 5.52-11.99) when compared with and without the IOO view (accuracy with IOO view: 85%, accuracy without IOO view: 78.26%; screw seated with IOO view: 93.93%, screw seated without IOO view: 65.54%). There was no significant difference (p value 0.465, OR = 1.13, 95% CI = 0.82-1.55) determining if the screw was in a safe position (safe with IOO view: 84.64%, safe without IOO view: 83.04%).
conclusionsOur findings demonstrate that misinterpretation of sacroiliac and transsacral screw placement can occur with the standard fluoroscopic imaging. We suggest the addition of the IOO view increases the overall accuracy of screw placement and whether the screw head is fully seated against the outer table of the ilium. This in turn can improve fixation and potentially improve patient outcomes and decrease adverse events.
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