ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025
Matched pair analysis of the accuracy and outcome of navigated screw fixation of the posterior pelvic ring.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Percutaneous fixation of posterior pelvic ring lesions in the elderly: current evidence and recent advances.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Review
- Bilateral ilio-sacral screw fixation of sacroiliac joint using a single guidewire: a technical case report.International journal of surgery case reports · 2026Article
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16 authors.
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Abstract
purposeNavigated sacroiliac screw fixation of the posterior pelvic ring has been introduced, providing the surgeon with an improved three-dimensional orientation of the anatomy. The primary aim of this study was to evaluate the influence of navigation on the surgical outcome. The secondary aim was to evaluate the relevance of sacral dysmorphism.
methodsA retrospective cohort study of patients from 2014 to 2022 admitted with acute traumatic pelvic ring injuries was performed. Patients aged ≥ 16 years treated electively with posterior pelvic ring screw fixation and at least 12 months follow up and informed consent were included. Patients were stratified according to treatment strategy (NAV: Navigated screws vs. CONV: Conventional screws) and compared regarding implant-related complications. Patients were automatically matched 1:1 according to age, gender and fracture stability.
resultsA total of 208 patients were included (NAV: n = 66, CONV: n = 142). After matching, 132 patients were finally included with 66 patients in each. Transsacral screws were used more often in the navigated group (69.7%; OR = 5.58, p < 0.0001). There were no significant differences regarding hardware complications. However, no malpositioning or foraminal breaching occurred in the navigated group. A back-analysis of the unmatched group with elevated power revealed that malpositioning rate in the navigated group was significantly lower (p = 0.033). The presence of sacral dysmorphism did not affect malpositioning rates yet those patients were less likely to receive a transsacral screw instrumentation.
conclusionNavigated screw fixation of the posterior pelvic ring resulted in optimal accuracy of screw placement in trauma patients. Sacral dysmorphism scores might support surgical decision-making regarding the choice of screws. Especially patients with poor bone quality might benefit from transsacral screws, which can be introduced more safely using navigation.
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