Abstract
Background: The transiliac internal fixator (TIFI) is a novel minimally invasive surgical procedure to stabilize posterior pelvic ring fractures. Two bone corridors with different lengths, widths, and angulations are suitable to host screws in the posterior iliac wing. While the length and the width have been described previously, the angulation has not been determined yet. Methods: We created a computer tomography-based 3D-model of 40 patients (20 women, 20 men). The possible bone corridors to host the ilium screws for the TIFIcc (cranio-caudal) and the TIFIdv (dorso-ventral) procedure were identified. After reaching the optimal position, the angles in relation to the sagittal and axial plane were measured. The anterior pelvic plane was chosen as the reference plane. Results: The mean angle of the TIFIcc screws related to the axial plane was 63.4° (±1.8°) and to the sagittal plane was 12.3° (±1.5°). The mean angle of the TIFIdv screws related to the axial plane was 16.1° (±1.2°) and to the sagittal plane was 20.1° (±2.0°). In each group, a high constancy was apparent irrespective of the age or physical dimension of the patient, although a significant gender-dependent difference was observed”. Conclusions: Due to a high inter-individual constancy in length, width, and angulation, bone corridors in the posterior iliac wing are reliable to host screws for posterior pelvic ring fixation irrespective of each individual patient’s anatomy.
Highlights
Invasive surgery is requested in all surgical disciplines
The mean angle of the left side related to the axial plane was 64.6◦ (±2.0◦ ) and to the sagittal plane was 12.3◦ (±1.5◦ )
There was no significant difference to the right side with a mean angle of 63.3◦ (±1.7◦ ) (p = 0.557) related to the axial plane and 13.0◦ (±1.4◦ ) related to the sagittal plane (p = 0.053)
Summary
Invasive surgery is requested in all surgical disciplines. The aim of minimally invasive surgery is to reduce the local tissue damage. Reducing local tissue damage maintains tissue function as much as possible. The risk of surgical site infection is minimized. Importantly, it provides a cosmetic benefit for the patient. During the last decades in trauma surgery, approaches to the pelvis were developed from large incisions [1,2,3,4] to minimally invasive approaches [5,6,7,8]. The increasing amount of minimally invasive surgical techniques is based on the increasing knowledge of the anatomy and surgical procedures combined with the increasing amount of sophisticated implants
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