Anatomically correct reduction and fixation of a Tile C-1 type unilateral sacroiliac disruption using a rod and pedicle screw system between the S1 vertebra and the ilium: experimental and clinical case report |
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Authors: | Kunio Saiki Shigeru Hirabayashi Toshihiro Horie Nobuyuki Tsuzuki Kouichi Inokuchi Haruhiko Tsutsumi |
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Institution: | (1) Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical School, 1981 Kamoda-Tsujido, Kawagoe, Saitama 350-8550, Japan, JP;(2) Advanced Tertiary Emergency Medical Center, Saitama Medical Center, Saitama Medical School, Kawagoe, Japan, JP |
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Abstract: | We have developed a new surgical technique for the treatment of Tile C-1 type sacroiliac disruption. We tried this procedure
first in a cadaveric specimen and then applied it to a clinical case. We used the Texas Scottish Rite Hospital (TSRH) rod
and pedicle screw system to insert one screw into the S1 vertebra without using an image intensifier and the other screw into
the bone marrow of the ilium from the posterosuperior iliac spine. A straight rod was connected between the two screws by
using a manipulator to attempt to reduce and fix the sacroiliac disruption. The combined pubic symphysis diastasis could be
simultaneously reduced and fixed by using a plate through another incision, resulting in anatomically correct reconstruction
of the pelvic ring. In this procedure, the alignment of the sacroiliac joint can be reversibly and directly changed during
reduction and fixation. The sacroiliac joint can be strongly fixed because the screws can be freely inserted into the intact
portion of the pelvis and the adjacent lumbar spine, if necessary. Good reduction is obtained because direct compression force
is applied to the fracture site. The posterior and anterior procedures can be simultaneously performed under the same lateral
position.
Received: December 25, 2001 / Accepted: May 2, 2002 |
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Keywords: | Pelvic ring disruption Sacroiliac joint Tile classification Screw and rod fixation system |
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