AI Summary & Key Takeaways
AI InsightConclusion: Percutaneous iliosacral screw fixation is an effective way to obtain early pelvic stability and decreasing morbidity in sacral fracture cases with additional organ injuries and fractures.
📌 3 Key Takeaways
Abstract
Objective: The purpose of the study was to determine the effectiveness of percutaneous iliosacral screw for sacral fractures that cause pelvic instability. Materials and methods: 10 patients with sacral fractures were retrospectively assessed. The study consists of 7 males and 3 females, the mean age was 29.1 ± 6.6. Neurologic injury was assessed according to Gibbons classification; fractures were classified according to Denis, Young and Burgess Classification. Clinical (Majeed score) and radiologic (Nelson ve Duwelius criteria) were used to analyze the patients. Results: Mean follow-up time was 14.3 ± 6.3 months. 2 patients had U-type sacral fractures, two patients had A2 fractures whereas other patients had A1, A3, B3 and C fractures. Totally sixteen screws were inserted including 6 bilaterally and 4 unilaterally inserted screws. One case received sacral laminectomy. The mean postoperative Majeed score was 73.6 ± 21.7, the mean radiographic displacement was found less than 5 mm in 90 % of patients and was found 5-10 mm in 10 % of patients. The mean vertical reduction was found less than 5mm. The mean Gibbons score was decreased from 2 ± 1.3 to 1.75 ± 1.4 after the operation. There was no iatrogenic nerve injury. Conclusion: Percutaneous iliosacral screw fixation is an effective way to obtain early pelvic stability and decreasing morbidity in sacral fracture cases with additional organ injuries and fractures.
Özet
Amaç: Pelvik instabiliteye yol açan sakrum kırıklarını tespit için yapılan perkütanöz iliosakral vidanın etkinliğinin değerlendirilmesi. Materyal ve metod: 2009-2010 yılları arasında sakrum kırıklı 10 hasta retrospektif olarak değerlendirildi. Olguların yedisi erkek, üçü kadın, ortalama yaşları 29.1 ± 6.6 idi. Nörolojik yaralanma Gibbons sınıflamasına göre, kırıklar Denis, Young ve Burgess sınıflamasına göre sınıflandırıldı. Hastalar ameliyat sonrası klinik olarak Majeed skoru ile radyografik olarak Nelson ve Duwelius kriterlerine göre değerlendirildi. Sonuçlar: Takip süresi ortalama 14.3 ± 6.3 aydı. İki hastada U tip sakral kırık, iki hastada A2 tip kırık varken, diğer hastalarda A1, A3, B3 ve C kırıklar mevcuttu. Altı olguya bilateral, altı olguya unilateral olmak üzere toplam 16 vida konuldu. Bir olguya sakral laminektomi yapıldı. Ameliyat sonrası Majeed skoru ortalama 73.6 ± 21.7 olurken, radyografik olarak ortalama deplasman % 90.0 hastada 5 mmʼin altında, % 10.0 hastada 5-10 mm, ve vertikal redüksiyon tüm hastalarda 5 mmʼden az olarak bulundu. Ameliyat öncesi ortalama 2 ± 1.3 olan Gibbons skoru ameliyat sonrası 1.75 ± 1.4ʼe geriledi. İyatrojenik nörolojik yaralanma görülmedi. Çıkarımlar: Perkütan iliosakral vida ek organ yaralanması ve diğer kırıkları olan sakrum kırıklı olgularda, ameliyat morbiditesini azaltan, pelvis stabilitesini erken dönem sağlayan etkin bir yöntemdir.