Vet Comp Orthop Traumatol 2019; 32(06): 467-474
DOI: 10.1055/s-0039-1693471
Original Research
Georg Thieme Verlag KG Stuttgart · New York

Evaluation of Fluoroscopic-Guided Closed Reduction versus Open Reduction of Sacroiliac Fracture-Luxations Stabilized with a Lag Screw

Amanda Rollins
1  VCA Animal Specialty and Emergency Center, Los Angeles, California, United States
2  Department of Surgery, The Animal Medical Center, New York, New York, United States
,
Raviv Balfour
1  VCA Animal Specialty and Emergency Center, Los Angeles, California, United States
,
David Szabo
1  VCA Animal Specialty and Emergency Center, Los Angeles, California, United States
,
Christina M. Chesvick
1  VCA Animal Specialty and Emergency Center, Los Angeles, California, United States
› Author Affiliations
Funding None.
Further Information

Publication History

16 October 2018

05 June 2019

Publication Date:
27 August 2019 (online)

Abstract

Objective The aim of this study was to compare radiographic outcomes of open reduction versus fluoroscopic-guided closed reduction (FGCR) of sacroiliac fracture-luxations stabilized with a lag screw, as well as peri- and postoperative complications.

Study Design Medical records (2010–2015) and radiographs of dogs and cats diagnosed with sacroiliac fracture-luxation that underwent open reduction without fluoroscopic guidance (n = 24) or FGCR (n = 17) were retrospectively reviewed to assess sacroiliac fracture-luxation reduction and lag screw placement, and lag screw loosening on follow-up radiographs (range, 1–8 weeks postoperatively) when available. Peri- and postoperative complications were also recorded.

Results Optimal screw depth to sacral body width ratio (>60%) was achieved in a significantly higher proportion of FGCR cases than openly reduced fracture-luxations. A significantly lower rate of lag screw loosening was found for FGCR cases. Few peri- and postoperative complications were noted across both groups. Four out of 17 FGCR cases requiring conversion to an open approach were excluded from data analysis; they had a longer duration from trauma to surgical repair than the median duration from trauma to surgical repair for cases successfully reduced in closed fashion.

Conclusion Fluoroscopic-guided closed reduction of sacroiliac fracture-luxations leads to consistently more optimal screw placement, as well as a lower incidence of lag screw loosening on follow-up radiographs. However, for cases with a longer duration from trauma to surgical repair, one should be prepared to convert to an open approach if a closed approach is not amenable to adequate reduction and lag screw placement.

Note

This manuscript is dedicated to the memory of Dr. Christina Chesvick, whose collaboration and impact on the veterinary field will be greatly missed.


Author Contribution

All author s contributed to conception of study, study design, acquisition of data and data analysis and interpretation. A. Rollins, R. Balfour and D. Szabo drafted, revised and approved the submitted manuscript.


Dr. Chesvick passed away while this manuscript was being drafted.


Supplementary Material