An Innovative Technique for Intraoperative Radiological Assessment of Pelvic and Spine Fractures in Austere Environment.

Abstract

Managing pelvic and spine fractures in the austere environment can be challenging even for skilled orthopedic surgeons, largely due to the difficulty of radiological visualization of bone structures. We present a simple alternative to the metallic operating table by placing the patient on a spinal board that will allow for a better radiological assessment of these fractures. A cross-sectional, descriptive, and retrospective study was carried out in the period between 2015 and 2020. The study population was all patients with pelvic o spine fractures, managed surgically using a spinal board in the Spanish Role 2 or in the Spanish Role 4. Seven patients underwent surgery in total using a spinal board, pelvic fracture being the the main diagnosis (n = 6; 85.71%). The distribution of surgical procedures was as follows: percutaneous pedicle screw fixation (one case), external fixation of the pelvis (two cases), percutaneous screw fixation of the pelvis (two cases), and open reduction and internal fixation of the pelvis (two cases). The mean duration of surgical interventions was 52 minutes, and a successful reduction and synthesis of the fracture was obtained in all the patients, with no complications reported. A spinal board can be a useful, simple, and effective device for the orthopedic surgeon in the deployed setting. The described technique is simple, fast, and efficient in getting a complete radiological assessment of complex regions such as the pelvis and the spine, facilitating the surgical management of these injuries.