One sacroiliac screw for posterior ring fixation in unstable pelvic fractures (original) (raw)
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Cardiovascular and Interventional Radiology, 1997
Purpose: To assess the midterm results of closed reduction and percutaneous fixation (CRPF) with computed tomography (CT)-guided sacroiliac screw fixation in longitudinal posterior pelvic ring fractures. To document radiographic and CT follow-up patterns. Methods: Thirteen patients with 15 fractures were treated. Eleven patients received a unilateral, two a bilateral, screw fixation. Twenty-seven screws were implanted. Continuous on-table traction was used in six cases. Mean radiological follow-up was 13 months. Results: Twenty-five (93%) screws were placed correctly. There was no impingement of screws on neurovascular structures. Union occurred in 12 (80%), delayed union in 2 (13%), and nonunion in 1 of 15 (7%) fractures. There was one screw breakage and two axial dislocations. Conclusion: Sacroiliac CRPF of longitudinal fractures of the posterior pelvic ring is technically simple, minimally invasive, well localized, and stable. It should be done by an interventional/surgical team. CT is an excellent guiding modality. Closed reduction may be a problem and succeeds best when performed as early as possible.
The use of pedicle screws in stabilizing posterior pelvic ring fractures
2019
Correspondence: Morad Omar, Orthopaedic department, faculty of medicine, Cairo University, Cairo. Egypt, Email: miro_mom@hotmail.com ABSTRACT Purpose: In this study, the clinical, functional and radiological outcomes of the patients were evaluated using a pedicle screw/rod system technique in stabilizing the posterior pelvic ring fractures. Methods: This was a prospective study during the period of April 2013–January 2016 in the level 1 trauma center, and thirty-eight (38) patients underwent internal fixation for pelvic ring fractures using pedicle screws and rod technique. Out of these, twenty-four (24) were posterior pelvic ring fractures with or without anterior pelvic failure (6 cases with posterior pelvic fixation only, 7 cases fixed with anterior and posterior pedicle rod system technique, 11 cases fixed with posterior pedicle rod system and any sort of anterior pelvic ring fixation EF and/or symphyseal plate). The study group was comprised of 13 men and 11 women, with a mean ...
Panacea Journal of Medical Sciences, 2023
Abstract Introduction: Percutaneous fixation of sacroiliac joint fractures and closed reduction gives advantages of limited blood loss, minimal invasion of compromised soft tissue, decreased infection rates and reduced operation time. The purpose of this study is to determine the outcome of sacroiliac percutaneous screw fixation of pelvic injuries in unstable fractures. Materials and Methods: This study was conducted at Tirunelveli medical college hospital from 2017 to 2019 in patients underwent sacro-iliac percutaneous screw fixation in unstable fractures of pelvic injuries. Functional assessment of patients with Pelvic fractures was assessed by Majeed Score Scale. Patients follow up was taken at 4, 8, 12 weeks, 6 months and 1 year. Results: The study included 22 patients with ages ranged from 16-70 years with the mean age range of 39 years with 16 males and 6 females. Mode of injury was a road traffic accident in 86.36% of cases and fall from height in 13.64%. As per the Majeed scoring system all patients were clinically evaluated. The overall Majeed score was excellent in 77.27%, while good in 13.63% and poor in 9.09% of cases. As per Matta and tornetta postoperative radiological evaluation was carried out. Conclusion: Percutaneous iliosacral screw fixation and anatomic reduction give better stability in unstable sacroiliac joint injuries allowing good functional outcomes and early mobility. For sacral fracture and sacroiliac, joint injury with C arm guidance percutaneous iliosacral screw fixation is a minimally invasive and safe technique. Keywords: Sacroiliac Joint Disruption, Pelvic Ring Injuries, Iliosacral screw, Percutaneous fixation
Pelvic Fracture - Results of Early External Fixation
2016
Background: The behavior of pelvic ring fracture following surgical fixation has been very sparsely studied. Pelvic ring injuries, depending on their severity had been treated by variety of closed method. The purpose of the study is to assess the short-term functional outcome of pelvic ring fracture following surgical fixation. Method: Present prospective study consists of 62 patients of pelvic fracture admitted in department of orthopedics, NSCB medical college and hospital Jabalpur (M.P) during the period of Oct. 2010 to Sep. 2011. All patient of type A (stable) fracture treated by conservative method. Out of 40 patients of unstable pelvic fracture (involving pelvic ring) 14 were treated by surgical method. Out of 14 patients 4 were treated by external fixation, 8 by internal fixation, and 2 by combined external and internal fixation. Functional outcome assessment was done by Majeed Scoring System [1]. Results: Functional outcome score in surgically treated patient is excellent in...
Journal of Clinical Medicine, 2021
Background: Incidence of pelvic ring fractures has increased over the past four decades, especially after low-impact trauma—classified as fragility fractures of the pelvis (FFP). To date, there is a lack of biomechanical evidence for the superiority of one existing fixation technique over another. An FFP type IIc was simulated in 50 artificial pelvises, assigned to 5 study groups: Sacroiliac (SI) screw, SI screw plus supra-acetabular external fixator, SI screw plus plate, SI screw plus retrograde transpubic screw, or S1/S2 ala–ilium screws. The specimens were tested under progressively increasing cyclic loading. Axial stiffness and cycles to failure were analysed. Displacement at the fracture sites was evaluated, having been continuously captured via motion tracking. Results: Fixation with SI screw plus plate and SI screw plus retrograde transpubic screw led to higher stability than the other tested techniques. The S1/S2 ala–ilium screws were more stable than the SI screw or the SI ...
Functional outcome of internal fixation for pelvic ring fractures
The Journal of trauma, 1999
Evaluation of the functional outcome after unstable pelvic ring fractures stabilized with internal fixation. Between January 1, 1990, and September 1, 1997, 37 patients were treated with internal fixation for unstable pelvic fracture. Demographic data, type of accident, Hospital Trauma Index-Injury Severity Score, and fracture type according to Tile classification were scored. One patient died the day after the accident from neurologic injury. A Short Form-36 health questionnaire and a form regarding functional result after pelvic trauma, adapted from Majeed et al., were returned by 31 of 36 patients (86%). Twenty-eight patients (78%) were seen for physical and radiologic examination. Twenty-six men and 11 women, with an average age of 34.7 years (range, 15-66 years) were included. The mean Injury Severity Score reached 30.4 (range, 16-66). According to the Tile classification, there were 16 type B fractures and 21 type C fractures. Seven patients were treated with open reduction an...
Today’s Role of External Fixation in Unstable and Complex Pelvic Fractures
European Journal of Trauma and Emergency Surgery, 2010
Introduction: The treatment of pelvic fractures has undergone a change over the past few years. As there seems to be a trend away from external towards internal fixation, the goal of this study was to investigate whether the use of an external fixator is still a standard procedure for the initial as well as -if necessary -for the definitive treatment of complex and unstable pelvic injuries. Methods: During a period of five years at the Level I Trauma Center, an external fixator was applied in 28 (11%) out of 236 pelvic ring fracture cases. The common indications were open fractures, complex fractures and multiple injuries with hemodynamic instability. Hemorrhage control, fracture stabilization and infection prophylaxis in cases of open fracture were achieved by variable placement and fixation of Schanz screws. In some cases, the assembly of a hybrid combined with internal osteosynthesis was used to increase stability. Results: Of the 28 patients, 20 survived, while eight (28.6%) died in the course of treatment due to fatal hemorrhage, craniocerebral trauma, multi-organ failure and sepsis. A satisfactory result (anatomical and functional outcome) was achieved in 16 of the 20 cases (80%). The remaining four (20%) suffered from serious complications, the majority of them caused by the initial type of injury. Conclusions: The use of the external fixator for the initial and in some cases for the definitive fixation of unstable and complex pelvic injuries with hemodynamic instability is still a successful treatment of multiply injured patients.
Journal of Orthopedics & Bone Disorders
Object: Sacroiliac dislocation frequently poses a complex problem for the surgical management and stabilization because of the anatomical and biomechanical factors of this transition zone between the spine and pelvis. The authors had used a modification of the Galveston technique, originally described by Allen and Ferguson in the treatment of scoliosis, to achieve rigid spinal-pelvic fixation in patient's sacroiliac dislocation with vertical and rotational shear. Methods: Twelve patients who had required spinal-pelvic fixation secondary to sacroiliac dislocation and instability fixation was achieved by intraoperative placement of S1 pedicle screws and contoured titanium rods bilaterally into the ilium. Results: During the follow-up period of18 to 36 months (average 26 months), Postoperative posterior fracture reduction was excellent in 9 patients (75%), good in 2 (17%) and fair in 1 patient (8%) (7). Conclusion: The combined use of S1 pedicle screws and the Galveston technique provided immediate stability and sufficient reduction of sacroiliac dislocation.