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Guidance for dysmorphic sacrum fixation with upper sacroiliac screw based on imaging anatomy study: techniques and indications

OBJECTIVE: This study aimed to investigate the techniques and indications of upper sacroiliac screw fixation for the dysmorphic sacrum. METHODS: The dysmorphic sacra were selected from 267 three-dimensional pelvic models. The dysmorphic sacra which couldn’t accommodate a 7.3 mm upper trans ilio-sacr...

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Autores principales: Shan, Tan, Hanqing, Li, Qiuchi, Ai, Junchao, Xing, Meitao, Xu, Shichang, Gao, Tianyong, Hou
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10311822/
https://www.ncbi.nlm.nih.gov/pubmed/37386420
http://dx.doi.org/10.1186/s12891-023-06655-9
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author Shan, Tan
Hanqing, Li
Qiuchi, Ai
Junchao, Xing
Meitao, Xu
Shichang, Gao
Tianyong, Hou
author_facet Shan, Tan
Hanqing, Li
Qiuchi, Ai
Junchao, Xing
Meitao, Xu
Shichang, Gao
Tianyong, Hou
author_sort Shan, Tan
collection PubMed
description OBJECTIVE: This study aimed to investigate the techniques and indications of upper sacroiliac screw fixation for the dysmorphic sacrum. METHODS: The dysmorphic sacra were selected from 267 three-dimensional pelvic models. The dysmorphic sacra which couldn’t accommodate a 7.3 mm upper trans ilio-sacroiliac screw were classified as the main dysmorphic sacra. Then, the size of the bone corridor, the length of the screw in the corridor, and the orientation of the screw were measured. The insertion point on the sacrum was identified by two bone landmarks. RESULTS: totally, 30.3% of sacra were identified as the main dysmorphic sacra. The inclinations of the screw oriented from posterior to anterior were (21.80 ± 3.56)° for males and (19.97 ± 3.02)° for females (p < 0.001), and from caudal to cranial were (29.97 ± 5.38)° for males and (28.15 ± 6.21)° for females (p = 0.047). The min diameters of the corridor were (16.31 ± 2.40) mm for males and (15.07 ± 1.58) mm for females (p < 0.001). The lengths of the screw in the Denis III zone were (14.41 ± 4.40) mm for males and (14.09 ± 5.04) mm for females (p = 0.665), and in the Denis II+III zones were (36.25 ± 3.40) mm for males and (38.04 ± 4.60) mm for females (p = 0.005). The rates of LP-PSIS/LAIIS-PSIS were (0.36 ± 0.04) for males and (0.32 ± 0.03) for females (t = 4.943, p < 0.001). The lengths of LPM were (8.81 ± 5.88) for males and (-4.13 ± 6.33) for females (t = 13.434, p < 0.001). CONCLUSION: When the sacrum has the features of “sacrum not recessed” and/or “acute alar slope”, the conventional trans ilio-sacroiliac screw couldn’t be placed safely. The inclination oriented from posterior to anterior and from caudal to cranial are approximately 20° and 30°, respectively. The bone insertion point locates in the rear third of the anterior inferior iliac spine to the posterior superior iliac spine. The sacroiliac screw is not recommended to fix the fractures in Denis III zone.
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spelling pubmed-103118222023-07-01 Guidance for dysmorphic sacrum fixation with upper sacroiliac screw based on imaging anatomy study: techniques and indications Shan, Tan Hanqing, Li Qiuchi, Ai Junchao, Xing Meitao, Xu Shichang, Gao Tianyong, Hou BMC Musculoskelet Disord Research OBJECTIVE: This study aimed to investigate the techniques and indications of upper sacroiliac screw fixation for the dysmorphic sacrum. METHODS: The dysmorphic sacra were selected from 267 three-dimensional pelvic models. The dysmorphic sacra which couldn’t accommodate a 7.3 mm upper trans ilio-sacroiliac screw were classified as the main dysmorphic sacra. Then, the size of the bone corridor, the length of the screw in the corridor, and the orientation of the screw were measured. The insertion point on the sacrum was identified by two bone landmarks. RESULTS: totally, 30.3% of sacra were identified as the main dysmorphic sacra. The inclinations of the screw oriented from posterior to anterior were (21.80 ± 3.56)° for males and (19.97 ± 3.02)° for females (p < 0.001), and from caudal to cranial were (29.97 ± 5.38)° for males and (28.15 ± 6.21)° for females (p = 0.047). The min diameters of the corridor were (16.31 ± 2.40) mm for males and (15.07 ± 1.58) mm for females (p < 0.001). The lengths of the screw in the Denis III zone were (14.41 ± 4.40) mm for males and (14.09 ± 5.04) mm for females (p = 0.665), and in the Denis II+III zones were (36.25 ± 3.40) mm for males and (38.04 ± 4.60) mm for females (p = 0.005). The rates of LP-PSIS/LAIIS-PSIS were (0.36 ± 0.04) for males and (0.32 ± 0.03) for females (t = 4.943, p < 0.001). The lengths of LPM were (8.81 ± 5.88) for males and (-4.13 ± 6.33) for females (t = 13.434, p < 0.001). CONCLUSION: When the sacrum has the features of “sacrum not recessed” and/or “acute alar slope”, the conventional trans ilio-sacroiliac screw couldn’t be placed safely. The inclination oriented from posterior to anterior and from caudal to cranial are approximately 20° and 30°, respectively. The bone insertion point locates in the rear third of the anterior inferior iliac spine to the posterior superior iliac spine. The sacroiliac screw is not recommended to fix the fractures in Denis III zone. BioMed Central 2023-06-30 /pmc/articles/PMC10311822/ /pubmed/37386420 http://dx.doi.org/10.1186/s12891-023-06655-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Shan, Tan
Hanqing, Li
Qiuchi, Ai
Junchao, Xing
Meitao, Xu
Shichang, Gao
Tianyong, Hou
Guidance for dysmorphic sacrum fixation with upper sacroiliac screw based on imaging anatomy study: techniques and indications
title Guidance for dysmorphic sacrum fixation with upper sacroiliac screw based on imaging anatomy study: techniques and indications
title_full Guidance for dysmorphic sacrum fixation with upper sacroiliac screw based on imaging anatomy study: techniques and indications
title_fullStr Guidance for dysmorphic sacrum fixation with upper sacroiliac screw based on imaging anatomy study: techniques and indications
title_full_unstemmed Guidance for dysmorphic sacrum fixation with upper sacroiliac screw based on imaging anatomy study: techniques and indications
title_short Guidance for dysmorphic sacrum fixation with upper sacroiliac screw based on imaging anatomy study: techniques and indications
title_sort guidance for dysmorphic sacrum fixation with upper sacroiliac screw based on imaging anatomy study: techniques and indications
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10311822/
https://www.ncbi.nlm.nih.gov/pubmed/37386420
http://dx.doi.org/10.1186/s12891-023-06655-9
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