{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:10:49Z","timestamp":1790035849503,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sacral fractures are posterior pelvic ring injuries which mechanisms range from high\u2010energy trauma to low\u2010energy falls in osteoporotic patients. In surgical treatment, percutaneous approaches have demonstrated significant shorter operation time and less soft tissue damage. In this study, we present a method of iliosacral (SI) screw insertion in prone position, with modified pedicle\u2010guided technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The present study is a retrospective case series of 22 patients for SI screw fixation from February 2019 to September 2023 under our method. Surgical technique was described in detail with images. Perioperative clinical parameters were analyzed. Activity status, complications, data of 10\u2010point visual analogue scale (VAS) for pain and further functional outcomes using the Majeed Pelvic Score (MPS) were recorded. In addition, computed tomography (CT) was routinely performed at 6\u2009months postsurgery to inspect the quality of screws position.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Excellence rate of screw position was 97% upon CT. Two patients had screws partially contacting the cortical bone but not violating sacral foramen, and no neurological symptoms were noted. All screws were secure from possible iatrogenic nerve injuries. VAS scores improved significantly over time and most patients recorded excellent functional recovery. One untoward complication occurred involving unexpected cement extravasation after sacroplasty. No associated neurologic compromise, or clinical evidence of venous emboli thrombosis was reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our method aims at reducing operation time and radiation exposure to surgeons as conventional two\u2010dimensional fluoroscopy was enough to identify safe insertion corridors in SI screw placement. Performing SI fixation in prone position is also advantageous when dealing with obese patients and concomitant spinal injuries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70439","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:50:45Z","timestamp":1790034645000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Iliosacral Screw Fixation for Treating Sacral Fractures: A Modified Pedicle\u2010Guided Fixation Technique in Prone Position"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5578-9274","authenticated-orcid":false,"given":"Ben\u2010Mao","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Shuang Ho Hospital Taipei Medical University  New Taipei City Taiwan"},{"name":"Department of Biomedical Engineering, College of Medicine and College of Engineering National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Hsin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Shuang Ho Hospital Taipei Medical University  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting\u2010Shuo","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Shuang Ho Hospital Taipei Medical University  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Shuang Ho Hospital Taipei Medical University  New Taipei City Taiwan"},{"name":"Department of Orthopaedics, School of Medicine, College of Medicine Taipei Medical University  Taipei Taiwan"},{"name":"School of Biomedical Engineering Taipei Medical University  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2269-8337","authenticated-orcid":false,"given":"Chang\u2010Jung","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Shuang Ho Hospital Taipei Medical University  New Taipei City Taiwan"},{"name":"Department of Orthopaedics, School of Medicine, College of Medicine Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6743-4717","authenticated-orcid":false,"given":"Yueh\u2010Ying","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Shuang Ho Hospital Taipei Medical University  New Taipei City Taiwan"},{"name":"Department of Orthopaedics, School of Medicine, College of Medicine Taipei Medical University  Taipei Taiwan"},{"name":"Department of Orthopedics, Hsin Kuo Min Hospital Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"issue":"5","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1302\/2058-5241.5.190064","article-title":"Sacral Fractures: Issues, Challenges, Solutions","volume":"5","author":"Santolini E.","year":"2020","journal-title":"EFORT Open Reviews"},{"issue":"2","key":"e_1_2_12_3_1","first-page":"e1008","article-title":"Sacral Insufficiency Fractures: Recognition and Treatment in Patients With Concurrent Lumbar Vertebral Compression Fractures","volume":"9","author":"Hatgis J.","year":"2017","journal-title":"Cureus"},{"issue":"2","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"201","DOI":"10.3174\/ajnr.A1666","article-title":"Imaging and Treatment of Sacral Insufficiency Fractures","volume":"31","author":"Lyders E. M.","year":"2010","journal-title":"AJNR. American Journal of Neuroradiology"},{"issue":"9","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"e318","DOI":"10.1097\/BOT.0000000000000559","article-title":"Percutaneous Lumbopelvic Fixation for Reduction and Stabilization of Sacral Fractures With Spinopelvic Dissociation Patterns","volume":"30","author":"Williams S. K.","year":"2016","journal-title":"Journal of Orthopaedic Trauma"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.ocl.2015.06.005","article-title":"Percutaneous Sacroiliac Screw Fixation of the Posterior Pelvic Ring","volume":"46","author":"Iorio J. A.","year":"2015","journal-title":"Orthopedic Clinics of North America"},{"issue":"2","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1177\/15563316221129607","article-title":"Sacral Fractures: A Review","volume":"19","author":"Barber L. A.","year":"2023","journal-title":"HSS Journal"},{"issue":"8","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1097\/00005131-199711000-00007","article-title":"Iliosacral Screw Fixation: Early Complications of the Percutaneous Technique","volume":"11","author":"Routt M. L.","year":"1997","journal-title":"Journal of Orthopaedic Trauma"},{"issue":"2","key":"e_1_2_12_9_1","first-page":"304","article-title":"Grading the Outcome of Pelvic Fractures","volume":"71","author":"Majeed S. A.","year":"1989","journal-title":"Journal of Bone and Joint Surgery. British Volume"},{"key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1186\/1471-2474-11-153","article-title":"2D\u2010Fluoroscopic Navigated Percutaneous Screw Fixation of Pelvic Ring Injuries\u2014A Case Series","volume":"11","author":"Gras F.","year":"2010","journal-title":"BMC Musculoskeletal Disorders"},{"key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"455","DOI":"10.25259\/SNI_616_2022","article-title":"Percutaneous Iliosacral Screw Insertion With Only Outlet and Inlet Fluoroscopic View for Unstable Pelvic Ring Injuries: Clinical and Radiological Outcomes","volume":"13","author":"Zarei M.","year":"2022","journal-title":"Surgical Neurology International"},{"key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1007\/s00402-013-1788-4","article-title":"Malposition and Revision Rates of Different Imaging Modalities for Percutaneous Iliosacral Screw Fixation Following Pelvic Fractures: A Systematic Review and Meta\u2010Analysis","volume":"133","author":"Zwingmann J.","year":"2013","journal-title":"Archives of Orthopaedic and Trauma Surgery"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.23396"},{"issue":"6","key":"e_1_2_12_14_1","first-page":"1501","article-title":"Percutaneous Iliosacral Screw Insertion: Malpositioning and Revision Rate of Screws With Regards to Application Technique (Navigated vs. Conventional)","volume":"69","author":"Zwingmann J.","year":"2010","journal-title":"Journal of Trauma"},{"issue":"8","key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"2660","DOI":"10.3390\/jcm9082660","article-title":"Safety, Effect and Feasibility of Percutaneous SI\u2010Screw With and Without Augmentation\u2010A 15\u2010Year Retrospective Analysis on Over 640 Screws","volume":"9","author":"Hartensuer R.","year":"2020","journal-title":"Journal of Clinical Medicine"},{"issue":"1","key":"e_1_2_12_16_1","first-page":"309","article-title":"Navigated Percutaneous Screw Fixation of the Pelvis With O\u2010Arm 2: Two Years' Experience","volume":"18","author":"Ciolli G.","year":"2021","journal-title":"Med Glas"},{"key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1051\/sicotj\/2018047","article-title":"Percutaneous Screws CT Guided to Fix Sacroiliac Joint in Tile C Pelvic Injury. Outcomes at 5\u2009Years of Follow\u2010Up","volume":"4","author":"Falzarano G.","year":"2018","journal-title":"SICOT Journal"},{"issue":"9","key":"e_1_2_12_18_1","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1016\/j.spinee.2017.06.022","article-title":"Percutaneous Pedicle Screw Placement Under Single Dimensional Fluoroscopy With a Designed Pedicle Finder\u2010a Technical Note and Case Series","volume":"17","author":"Tsuang F. Y.","year":"2017","journal-title":"Spine Journal"},{"issue":"9","key":"e_1_2_12_19_1","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1007\/s00264-010-1092-7","article-title":"Factors Influencing the Accuracy of Iliosacral Screw Placement in Trauma Patients","volume":"35","author":"Grossterlinden L.","year":"2011","journal-title":"International Orthopaedics"},{"issue":"3","key":"e_1_2_12_20_1","first-page":"e2023153","article-title":"Outcomes at 2\u2009Years Follow\u2010Up of Sacral Fractures Associated With Unstable Vertical Pelvic Ring Injuries in Obese Patients: A Multicentric Retrospective Study","volume":"94","author":"Liuzza F.","year":"2023","journal-title":"Acta Bio\u2010Medica: Atenei Parmensis"},{"issue":"1","key":"e_1_2_12_21_1","first-page":"299","article-title":"A New Prognostic Pelvic Injury Outcome Score","volume":"18","author":"Meccariello L.","year":"2021","journal-title":"Med Glas"},{"issue":"1","key":"e_1_2_12_22_1","first-page":"273","article-title":"Radiographic and Functional Outcome of Complex Acetabular Fractures: Implications of Open Reduction in Spinopelvic Balance, Gait and Quality of Life","volume":"18","author":"Muzii V. F.","year":"2021","journal-title":"Med Glas"},{"issue":"8","key":"e_1_2_12_23_1","first-page":"3457","article-title":"Preliminary Data on the Neurophysiological Evaluation of Male Sexual Dysfunction in Patients With Pelvic Ring Fractures: A Multicenter Retrospective Study","volume":"27","author":"Rovere G.","year":"2023","journal-title":"European Review for Medical and Pharmacological Sciences"},{"issue":"6","key":"e_1_2_12_24_1","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1007\/s00264-023-05767-0","article-title":"Correlation Between Traumatic Pelvic Ring Injuries and Sexual Dysfunctions: A Multicentric Retrospective Study","volume":"47","author":"Rovere G.","year":"2023","journal-title":"International Orthopaedics"},{"issue":"10","key":"e_1_2_12_25_1","doi-asserted-by":"crossref","first-page":"2687","DOI":"10.1007\/s00264-021-05153-8","article-title":"Epidemiology and Aetiology of Male and Female Sexual Dysfunctions Related to Pelvic Ring Injuries: A Systematic Review","volume":"45","author":"Rovere G.","year":"2021","journal-title":"International Orthopaedics"},{"issue":"7","key":"e_1_2_12_26_1","first-page":"e41745","article-title":"A Systematic Review of Sacral Insufficiency Fractures: Treatment Modalities and Outcomes","volume":"15","author":"Briggs P.","year":"2023","journal-title":"Cureus"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70439","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.70439","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70439","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:50:49Z","timestamp":1790034649000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.70439"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":25,"alternative-id":["10.1111\/os.70439"],"URL":"https:\/\/doi.org\/10.1111\/os.70439","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"assertion":[{"value":"2026-07-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"os.70439"}}