Modified triangular posterior osteosynthesis of unstable sacrum fracture.

Détails

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Etat: Public
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ID Serval
serval:BIB_C553FC93AF90
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Modified triangular posterior osteosynthesis of unstable sacrum fracture.
Périodique
European Spine Journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Auteur(s)
Mouhsine E., Wettstein M., Schizas C., Borens O., Blanc C.H., Leyvraz P.F., Theumann N., Garofalo R.
ISSN
0940-6719
Statut éditorial
Publié
Date de publication
06/2006
Peer-reviewed
Oui
Volume
15
Numéro
6
Pages
857-863
Langue
anglais
Notes
Publication types: Journal Article
Résumé
We report preliminary results for unstable sacral fractures treated with a modified posterior triangular osteosynthesis. Seven patients were admitted to our trauma center with an unstable sacral fracture. The average age was 31 years (22-41). There were four vertical shear lesions of the pelvis and three transverse fracture of the upper sacrum. The vertical shear injuries were initially treated with an anterior external fixator inserted at the time of admission. Definitive surgery was performed at a mean time of 9 days after trauma. The operation consisted in a posterior fixation combining a vertebropelvic distraction osteosynthesis with pedicle screws and a rod system, whereby the transverse fixation was obtained using a 6 mm rod as a cross-link between the two main rods. Late displacement of the posterior pelvis or fracture was measured on X-ray films according to the criteria of Henderson. The patients were followed-up for a minimum time of 12 months. Four patients who presented with a pre-operative perineal neurological impairment made a complete recovery. No iatrogenic nerve injury was reported. One case of deep infection was managed successfully with surgical debridement and local antibiotics. All patients complained of symptoms related to the prominence of the iliac screws. The metalwork was removed in all cases after healing of the fracture, at a mean time of 4.3 months after surgery. No loss of reduction of fracture was seen at final radiological follow-up. The preliminary results are promising. The fixation is sufficiently stable to allow an immediate progressive weight-bearing, and safe nursing care in polytrauma cases. The only problem seems to be related to prominent heads of the distal screws.
Mots-clé
Adult, Bone Screws, Female, Fracture Fixation, Internal/instrumentation, Fracture Fixation, Internal/methods, Humans, Male, Sacrum/injuries, Sacrum/radiography, Spinal Fractures/radiography, Spinal Fractures/surgery
Pubmed
Web of science
Open Access
Oui
Création de la notice
11/04/2008 13:00
Dernière modification de la notice
01/10/2019 7:19
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