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Percutaneous Iliosacral Screw Fixation

intermediate Level

Primary Indication

Posterior pelvic ring injury - sacral fractures, SI joint disruption

Danger Structures

  • undefined - Variable based on approach
  • undefined - Surrounding operative field
  • undefined - Bone surface
  • undefined - Joint surfaces if applicable

Visual Atlas

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We're currently sourcing high-quality anatomy diagrams for this procedure.

Step-by-Step Technique

1

Obtain inlet, outlet, and lateral sacral views

2

Identify safe corridor in S1 body

3

Start point on lateral ilium at level of S1

4

Use lateral view to confirm trajectory above S1 foramen

5

Inlet view ensures screw not breaching anterior cortex

6

Outlet view confirms trajectory above S1 foramen

7

Insert guide wire across SI joint into S1 body

8

Measure, drill, and insert 7.3mm cannulated screw

9

Washer to prevent screw head migration

10

Consider trans-sacral screw (S1-S1) for bilateral injuries

11

Second screw at S2 if needed