Abstract
OBJECTIVES: We sought to determine whether inaccurate C-arm positioning could create images that lead to inaccurate interpretation of iliosacral screw positions. DESIGN: Cadaveric dissection study. SETTING: The learning institute of Zimmer Inc. in Warsaw, Indiana. METHODS: A laboratory investigation was performed using 3 nonpreserved cadaveric specimens. Several anatomic landmarks of the pelvis were outlined using radiographic markers and guide wires placed in several positions within the pelvis in each specimen. Using C-arm images we inserted the following: a "good" wire (GW), an out-the-front (OTF) wire, an out-the-back (OTB) wire placed into the sacral canal, an "in-out-in" (IOI) wire, and a wire in the S1 foramen (S1). The C-arm was then canted in 2-degree increments toward the head and then toward the feet starting from the optimum position. RESULTS: Properly positioned wires always appear to be contained within bone regardless of the amount of malrotation of the C-arm from the optimum inlet and outlet views. CONCLUSIONS: Improper malrotated fluoroscopic inlet and outlet views of the pelvis will distort the anatomic landmarks of the pelvis before improperly placed guide wires appear to be correctly placed. Properly placed guide wires will always appear correctly positioned regardless of the malrotation of the C-arm. "Malrotated" views, however, can be used to rule out certain incorrect screw positions.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 427-434 |
| Number of pages | 8 |
| Journal | Journal of Orthopaedic Trauma |
| Volume | 21 |
| Issue number | 7 |
| DOIs | |
| State | Published - Aug 2007 |
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Keywords
- Fluoroscopic guidance
- Pelvic ring
- Percutaneous fixation
- Sacral screw
ASJC Scopus subject areas
- Surgery
- Orthopedics and Sports Medicine
- Physical Therapy, Sports Therapy and Rehabilitation
Cite this
The effect of C-arm malrotation on iliosacral screw placement. / Wolinsky, Philip R; Lee, Mark A.
In: Journal of Orthopaedic Trauma, Vol. 21, No. 7, 08.2007, p. 427-434.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The effect of C-arm malrotation on iliosacral screw placement
AU - Wolinsky, Philip R
AU - Lee, Mark A
PY - 2007/8
Y1 - 2007/8
N2 - OBJECTIVES: We sought to determine whether inaccurate C-arm positioning could create images that lead to inaccurate interpretation of iliosacral screw positions. DESIGN: Cadaveric dissection study. SETTING: The learning institute of Zimmer Inc. in Warsaw, Indiana. METHODS: A laboratory investigation was performed using 3 nonpreserved cadaveric specimens. Several anatomic landmarks of the pelvis were outlined using radiographic markers and guide wires placed in several positions within the pelvis in each specimen. Using C-arm images we inserted the following: a "good" wire (GW), an out-the-front (OTF) wire, an out-the-back (OTB) wire placed into the sacral canal, an "in-out-in" (IOI) wire, and a wire in the S1 foramen (S1). The C-arm was then canted in 2-degree increments toward the head and then toward the feet starting from the optimum position. RESULTS: Properly positioned wires always appear to be contained within bone regardless of the amount of malrotation of the C-arm from the optimum inlet and outlet views. CONCLUSIONS: Improper malrotated fluoroscopic inlet and outlet views of the pelvis will distort the anatomic landmarks of the pelvis before improperly placed guide wires appear to be correctly placed. Properly placed guide wires will always appear correctly positioned regardless of the malrotation of the C-arm. "Malrotated" views, however, can be used to rule out certain incorrect screw positions.
AB - OBJECTIVES: We sought to determine whether inaccurate C-arm positioning could create images that lead to inaccurate interpretation of iliosacral screw positions. DESIGN: Cadaveric dissection study. SETTING: The learning institute of Zimmer Inc. in Warsaw, Indiana. METHODS: A laboratory investigation was performed using 3 nonpreserved cadaveric specimens. Several anatomic landmarks of the pelvis were outlined using radiographic markers and guide wires placed in several positions within the pelvis in each specimen. Using C-arm images we inserted the following: a "good" wire (GW), an out-the-front (OTF) wire, an out-the-back (OTB) wire placed into the sacral canal, an "in-out-in" (IOI) wire, and a wire in the S1 foramen (S1). The C-arm was then canted in 2-degree increments toward the head and then toward the feet starting from the optimum position. RESULTS: Properly positioned wires always appear to be contained within bone regardless of the amount of malrotation of the C-arm from the optimum inlet and outlet views. CONCLUSIONS: Improper malrotated fluoroscopic inlet and outlet views of the pelvis will distort the anatomic landmarks of the pelvis before improperly placed guide wires appear to be correctly placed. Properly placed guide wires will always appear correctly positioned regardless of the malrotation of the C-arm. "Malrotated" views, however, can be used to rule out certain incorrect screw positions.
KW - Fluoroscopic guidance
KW - Pelvic ring
KW - Percutaneous fixation
KW - Sacral screw
UR - http://www.scopus.com/inward/record.url?scp=34548379900&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34548379900&partnerID=8YFLogxK
U2 - 10.1097/BOT.0b013e318137948d
DO - 10.1097/BOT.0b013e318137948d
M3 - Article
C2 - 17762471
AN - SCOPUS:34548379900
VL - 21
SP - 427
EP - 434
JO - Journal of Orthopaedic Trauma
JF - Journal of Orthopaedic Trauma
SN - 0890-5339
IS - 7
ER -