Comerlatto Leonardo, Concatto Natália Henz, Crestani Marcus Vinícius, Silva Tauã Brum, Galia Carlos Roberto, Telöken Marco Aurélio
Serviço de Ortopedia e Traumatologia, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil.
Serviço de Radiologia, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil.
Rev Bras Ortop (Sao Paulo). 2025 Apr 28;60(1):1-9. doi: 10.1055/s-0044-1800947. eCollection 2025 Feb.
Brazilian orthopedic surgeons experience the unavailability of long screws allowing percutaneous fixation of the posterior pelvic ring in transiliac-transsacral (TI-TS) configuration. The objective of the present study is to measure the lenght of the osseous fixation pathways available for TI-TS fixation in a population sample to infer the required implant length. We retrospectively assessed patients undergoing computed tomography (CT), initially identifying the existence of a potential osseous fixation pathway (POFP) in S1, S2 and S3. Each POFP was measured from the external cortex of the iliac bone to the external cortex of the contralateral iliac bone on axial CT images. The analysis comprised a sample of 180 cases. A POFP was identified in S1 in 116 (64.4%) cases, in S2 in 178 (98.9%) cases, and in S3 in 16 (8.9%) cases. The median (interquartile range - IQR) POFP measurement in S1 was 153 (148-161) mm, ranging from 135 mm to 179 mm. In S2, the median (IQR) POFP measurement was 136 (131-144) mm, ranging from 114 to 160 mm. In S3, the median (IQR) POFP measurement was 120.5 (115-126) mm, ranging from 110 to 131 mm. We demonstrated that the maximum lengths of the osseous fixation pathways identified in our sample would require screws up to 180 mm in length, with a clear dissociation between the values measured and the longer screws currently commercialized in our setting.
巴西骨科医生面临无法获得长螺钉的问题，这种长螺钉可用于经髂骨-经骶骨（TI-TS）构型的骨盆后环经皮固定。本研究的目的是测量人群样本中可用于TI-TS固定的骨固定路径长度，以推断所需植入物的长度。
我们回顾性评估了接受计算机断层扫描（CT）的患者，首先确定S1、S2和S3中潜在骨固定路径（POFP）的存在。在轴向CT图像上，从髂骨外皮质到对侧髂骨外皮质测量每个POFP。
分析包括180例样本。在116例（64.4%）中在S1发现POFP，在178例（98.9%）中在S2发现POFP，在16例（8.9%）中在S3发现POFP。S1中POFP测量的中位数（四分位间距-IQR）为153（148-161）mm，范围为135mm至179mm。在S2中，POFP测量的中位数（IQR）为136（131-144）mm，范围为114至160mm。在S3中，POFP测量的中位数（IQR）为120.5（115-126）mm，范围为110至131mm。
我们证明，在我们的样本中确定的骨固定路径的最大长度将需要长度达180mm的螺钉，所测值与我们所在地区目前商业化的较长螺钉之间存在明显差异。
