Clinical efficacy analysis of anterior superior iliac spine 3D printed guide plate assisted sacroiliac screws in the treatment of pelvic fractures

Lin Chen¹Lan Luo²Xulin Zhang³Lei Li⁴Dong Liu^1*

• ¹Suining Central Hospital, Suining, China
• ²Gastroenterology Department, Suining Central Hospital, Suining, China
• ³Hand micrographic surgery, Suining Central Hospital, Suining, China
• ⁴Traumatic orthopedics, Suining Central Hospital, Suining, China

The aim of this study was to compare the clinical outcomes of percutaneous 3D-printed guides at the anterior anterior superior iliac spine site with traditional fluoroscopy-assisted sacroiliac screw implantation in the treatment of pelvic fractures. Methods: 40 patients with eligible pelvic fractures diagnosed and treated from December 2022 to May 2024 were collected and divided into 2 groups. The guide plate group used the anterior superior iliac spine 3D printed guide plate to assist the sacroiliac screws to fix the posterior pelvic ring fracture; the fluoroscopy group used fluoroscopic freehand placement of sacroiliac screws to fix the posterior pelvic ring fracture. The operative time, number of fluoroscopies, intraoperative bleeding, and length of incision for each screw implantation in the 2 groups were recorded. Fracture reduction was evaluated according to the Matta criteria, screw position was assessed by modified Gras classification, and statistical analysis was performed.Result: 40 patients were followed up for 6-12 months, with 23 sacroiliac screws implanted in 20 patients in the guide plate group and 25 sacroiliac screws implanted in 20 patients in the fluoroscopy group. The operative times were 50-75 (60.00±8.429) min and 50-90 (72.25±10.939) min (P<0.001) in the guide plate group and fluoroscopy group, respectively, the number of fluoroscopies was 7-18 (11.65±3.117) and 38-62 (48.05±7.258) (P< 0.001), and the intraoperative bleeding was 10-30 (16.60±5.642) mL and 5-20 (10.3±4.354) mL (P< 0.001).The Matta criteria scores for fracture repositioning in both groups were excellent and good (P=0.429). Modified Gras classification was used to assess screw positions: 19 in class I, 4 in class II, and 0 in class III in the guide plate group; 20 in class I, 4 in class II, and 1 in class III in the fluoroscopy group, and the difference between the 2 groups was not statistically significant (P=0.624). Conclusion: The anterior superior iliac spine 3D printing guide plate-assisted sacroiliac screw fixation of pelvic fracture compared with traditional fluoroscopy-assisted sacroiliac screw fixation of pelvic fracture can shorten the operation time, reduce the number of fluoroscopies, and improve the accuracy of implantation.