Geletaw TesemaBinyam Dagnaw2025-03-202025-03-202024-10-08https://etd.aau.edu.et/handle/123456789/5131Introduction: Unstable pelvic ring injuries present a high risk of morbidity and mortality, and early stabilization through percutaneous sacroiliac screw fixation (PSSF) offers pain relief and quicker mobilization. However, PSSF is technically challenging due to the complex pelvic anatomy and surrounding neurovascular structures, requiring precise fluoroscopic guidance. Issues such as poor visualization due to body habitus, bowel gas or fecal loading can prolong surgical time, increase radiation exposure, and increase the risk of nerve injury. This randomized controlled trial aimed to evaluate the effect of preoperative bowel preparation using a cleansing enema on fluoroscopic pelvic image quality and radiation exposure during PSSF. Method: In this study, 50 patients were randomized into two groups: the intervention group (n=25) received preoperative bowel preparation with cleansing enema, while the non intervention group (n=25) did not. Key outcomes assessed included fluoroscopic pelvic image quality score (FPIQS), radiation exposure (KAP), screw insertion time, number of irradiation events, postoperative reduction quality, and postoperative nerve injury. Data was analyzed using SPSS software, with significant results marked by a p-value of less than 0.05. Result: The intervention group showed significantly better outcomes compared to the non intervention group. The mean FPIQS was higher (25.16 vs. 16.96), radiation exposure was lower (4.88 Gycm² vs. 12.74 Gycm²), and screw insertion time was shorter (29.12 minutes vs. 49.28 minutes). Additionally, the intervention group had fewer irradiation events (86.92 vs. 151.8) and a higher rate of excellent postoperative reduction quality (56% vs. 20%). No cases of postoperative nerve injury were reported in either group. Conclusion: The study concludes that preoperative bowel preparation with a cleansing enema significantly improves fluoroscopic visualization, reduces radiation exposure, and improves surgical outcomes during PSSF. Based on the findings it is highly recommended to use the method before PSSF. It can also be extended to pelvic and acetabular procedures as well. Keywords: Unstable pelvic ring injury, percutaneous sacroiliac screw fixation (PSSF), fluoroscopic pelvic image quality score (FPIQS), radiation exposure (KAP), bowel preparation, cleansing enema, randomized controlled trial, screw insertion time, postoperative reduction quality, neurovascular injury.en-USUnstable pelvic ring injury percutaneous sacroiliac screw fixation (PSSF) fluoroscopic pelvic image quality score (FPIQS) radiation exposure (KAP) bowel preparation cleansing enema randomized controlled trial crew insertion time postoperative reduction quality neurovascular injury.Thesis