Percutaneous ilio-sacral screw insertion. fluoroscopic techniques.

Unstable pelvic ring fractures raise treatment challenges in severely injured patients. Ilio-sacral screw fixation is an elegant option for stabilising the posterior lesion, which is a common source of residual pain. This technique provides secure fixation. The first description can be found in a 1913 treatise by Lambotte [1]. In 1978, Letournel reported the treatment of sacro-iliac joint dislocation by open ilio-sacral screw placement with the patient in the prone position and direct digital control [2]. A decade later, Matta et al. [3] extended the indications to sacral lesions by using the inlet, outlet, and antero-posterior views described by Pennal et al. [4]. Ebraheim et al. in 1987 then Routt et al. in 1993 described strictly percutaneous ilio-sacral screw insertion with the patient in the supine position [5,6] to allow the use of this technique in fragile multiply injured patients