Percutaneous sacral screw fixation alone sufficient for mildly displaced U-type sacral fractures with preserved osseous fixation pathways.

Autor: Saiz AM Jr; Department of Orthopaedic Surgery, The University of California Davis, Sacramento, CA, USA. amsaiz@ucdavis.edu., Kellam PJ; Department of Orthopedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA., Amin A; Department of Orthopedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA., Arambula Z; Department of Orthopedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA., Rashiwala A; Department of Orthopedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA., Gary JL; Keck School of Medicine, Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA., Warner SJ; Department of Orthopedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA., Routt M; Department of Orthopedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA., Eastman JG; Department of Orthopedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Jazyk: angličtina
Zdroj: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie [Eur J Orthop Surg Traumatol] 2024 Oct; Vol. 34 (7), pp. 3523-3527. Date of Electronic Publication: 2023 Oct 24.
DOI: 10.1007/s00590-023-03661-4
Abstrakt: Purpose: To describe U-type sacral fracture characteristics amenable to percutaneous sacral screw fixation.
Methods: U-type sacral fractures were identified from a trauma registry at a level 1 trauma center from 2014 to 2020. Patient demographics, injury mechanism, fracture characteristics, and fixation construct were retrospectively retrieved. Associations between fracture pattern and surgical fixation were identified.
Results: 82 U-type sacral fractures were reviewed. Six treated with lumbopelvic fixation (LPF) and 76 were treated with percutaneous sacral screws (PSS) alone. Patients receiving LBF had greater sacral fracture displacement in coronal, sagittal, and axial planes compared to patients receiving PSS alone (P < 0.05), negating osseous fixation pathways. All patients went onto sacral union and there were no implant failures or unplanned reoperations for either group.
Conclusion: If osseous fixation pathways are present, U-type sacral fractures can be successfully treated with percutaneous sacral screws. LPF may be indicated in more displaced fractures with loss of spinopelvic alignment. Both techniques for U-type sacral fractures result in reliable fixation and healing without reoperations.
(© 2023. The Author(s).)
Databáze: MEDLINE
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