Percutaneous placement of iliosacral screws for unstable pelvic ring injuries: Comparison between one and two C-arm fluoroscopic techniques

Background: This study compares the efficacy and safety of percutaneous placement of iliosacral screws between one and two C-arm fluoroscope groups. Methods: This case series contains consecutive 18 unstable pelvic injuries, which were treated with percutaneous placement of iliosacral screws. A single orthopaedic surgeon (K.-T.P.) operated on all these patients. The patients were divided into two groups on the basis of the method of radiographic control. In group 1 (10 patients), iliosacral screws were introduced under the assistance of one C-arm fluoroscope. In group 2 (eight patients), percutaneous placements of iliosacral screws were performed under the control of two sets of fluoroscope. Results: There were neither clinical complications nor malpositioned screws in both groups. The median time from initial preparation to completion of the first screw insertion was 45.0 and 16.0 minutes for groups 1 and 2, respectively; the radiation exposure was 5.7 and 4.5 minutes, respectively. The differences between groups were statistically significant (p < 0.001). Conclusion: The use of two sets of fluoroscope provides a speedier method with less radiation exposure for percutaneous placement of iliosacral screws than the use of one set.