Ventral abdominal approach for screw fixation of sacroiliac luxation in cadavers of cats and dogs.

摘要

Objective-To investigate a technique for repair of sacroiliac luxation with positional screw insertion from the ventral surface of the sacral wing via a ventral abdominal approach. Sample Population-Hemipelvis specimens from cadavers of 5 small- to large-breed dogs and 9 European shorthair cats. Procedures-An optimal entry point and a safe drill corridor for implant placement were determined (4 hemipelvis specimens). Anatomic landmarks were identified, and the surgical technique for a ventral abdominal approach was described. Single positional screw placement was performed across the sacroiliac joint in 23 hemipelvis specimens. Screws were aimed at 25 degrees (n = 2), 35 degrees (2), and 45 degrees (19) angles to the vertical axis in a transverse plane (alpha angles) and at a 90 degrees angle to the longitudinal axis in a dorsal plane (beta angle). Implant placement was assessed by radiographic evaluation of the cadavers and of the hemipelvis specimens devoid of soft tissue. Results-By use of alpha angles of 35 degrees and 45 degrees , 20 of 21 implants were placed adequately; screws crossed the sacroiliac joint and penetrated the wing of the ilium without damaging adjacent nerves. The measured median alpha angle was 38 degrees , and the median beta angle was 88 degrees . One complication was recorded. Conclusions and Clinical Relevance-Cortical positional screw placement from the ventral aspect of the sacral wing by use of a ventral abdominal approach could be an alternative to conventional techniques. This novel technique may be useful for repair of bilateral sacroiliac luxation, treatment of concomitant soft tissue injuries of the caudal portion of the abdominal cavity or abdominal wall, and repair of pelvic floor fractures in a single approach.