[Percutaneous fixation of unstable pelvic ring disruption under CT guidance]. / Osteosíntesis percutánea bajo control de tomografía computarizada de la disrupción posterior del anillo pélvico.

CT-guided percutaneous osteosynthesis of posterior disruption of an unstable pelvic ring is an alternative to the fluoroscopically guided procedure or to open reduction and internal fixation (ORIF), which is the technique of choice for unstable pelvic fracture with disruption of the sacroiliac joint or fracture of the sacral wing. However, ORIF has a high rate of morbidity and mortality, and the CT-guided procedure involves less blood loss and has a lower rate of infectious and postoperative complications. CT guidance of the percutaneous technique also has significant advantages over fluoroscopic guidance. The critical point is the placement of the guidewire inside the sacral body through the external surface of the iliac wing and of the fracture line or sacroiliac diastasis. We describe and illustrate the procedure through three cases, two sacroiliac articular disruptions and a fracture of the sacral wing.

Osteosíntesis percutánea bajo control de tomografía computarizada de la disrupción posterior del anillo pélvico / Percutaneous fixation of unstable pelvic ring disruption under CT guidance

La osteosíntesis percutánea de la disrupción posterior inestable del anillo pélvico controlada con tomografía computarizada (TC) es una alternativa al procedimiento guiado por fluoroscopia y a la técnica de reducción abierta y fijación interna (RAFI); esta última es la técnica de elección en esta patología. La técnica consiste en la colocación de la aguja de guía bajo control de TC en el interior del cuerpo sacro a través de la superficie externa de la pala ilíaca y de la línea de fractura o diástasis sacroilíaca. El procedimiento TC-guiado presenta menor tasa de complicaciones postoperatorias, infecciosas y pérdida hemática que la RAFI, que tiene una alta morbilidad y mortalidad. Comunicamos 3 casos, 2 disrrupciones articulares sacroilíacas y 1 fractura de ala sacra, tratados bajo control de TC (AU)

CT-guided percutaneous osteosynthesis of posterior disruption of an unstable pelvic ring is an alternative to the fluoroscopically guided procedure or to open reduction and internal fixation (ORIF), which is the technique of choice for unstable pelvic fracture with disruption of the sacroiliac joint or fracture of the sacral wing. However, ORIF has a high rate of morbidity and mortality, and the CT-guided procedure involves less blood loss and has a lower rate of infectious and postoperative complications. CT guidance of the percutaneous technique also has significant advantages over fluoroscopic guidance. The critical point is the placement of the guidewire inside the sacral body through the external surface of the iliac wing and of the fracture line or sacroiliac diastasis. We describe and illustrate the procedure through three cases, two sacroiliac articular disruptions and a fracture of the sacral wing (AU)