Special screw corridors and imaging in pelvic ring trauma

Abstract

Adequate intraoperative visualization is mandatory for implant application in pelvic ring injuries. Several fluoroscopic X-ray views are in practical use. The gold standard primary X-ray is the anteroposterior view of the pelvis. In addition to this view, oblique views for pelvic ring instabilities and acetabular fractures are well defined. Combinations of these views allow better identification of osseous corridors for screw applications. These corridors are based on the 3-ring concept of the hemipelvis. For pelvic ring stabilization the main osseous corridors include the retrograde and antegrade superior ramus/anterior column corridor, the supraacetabular corridor and the gluteus medius pillar corridor. The radiographic anatomy of these corridors is described in detail for screw applications with definition of image intensifier angulations, risk zones and corridor parameters. This allows for intraoperative safe implant application.