Intraosseous correction of misdirected cannulated screws and fracture malalignment using a bent tip 2.0 mm guidewire: technique and indications

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Percutaneous pelvic screw placement is a technically demanding procedure. A precise intraosseous pathway must be prepared before screw placement into any osseous fixation pathway of the pelvis. Adjustments to a drill or guidewire become increasingly difficult as the instrument is advanced within the pelvis. We present a reliable and reproducible technique using a 2.0 mm guidewire that allows for correction of an initially misdirected drill within the pelvis. This technique also allows for manipulation and reduction of certain malaligned pelvic fractures prior to percutaneous cannulated screw placement. This technique does not substitute for poor surgical technique but is used to optimize the position of percutaneously placed pelvic screws.