Sar Cüneyt, Kilicoglu Onder
Department of Orthopaedics and Trauma, Ustanbul University, Instanbul Medical Faculty, Turkey.
J Orthop Trauma. 2003 Apr;17(4):262-70. doi: 10.1097/00005131-200304000-00004.
A new technique for posterior sacroiliac fixation is described and compared with conventional techniques.
PATIENTS/MATERIAL AND METHODS: A patient with sacral alar fracture (zone 1) and another one with sacroiliac joint instability due to tuberculous infection underwent fixation using screws placed in the S1 pedicle and the iliac bone. Vertical stability of the new technique also was investigated using polyurethane pelvic bone analogs and compared with anterior double plating (group P) and iliosacral screw fixation (group ISS) techniques.
Healing was obtained and reduction was maintained in both patients on the final follow-up examination at 2 years postoperatively. Vertical loading tests revealed that failure loads within the first 10 mm of displacement of the new pediculoiliac screw fixation technique (group PIS) was higher than plating (P = 0.03) and lower than ISS techniques (P = 0.002). Ultimate failure load of the PIS technique was slightly higher than plating (P = 0.277) and lower than ISS techniques (P = 0.003). With the addition of an iliosacral screw to the pediculoiliac screw construction (PIS+ISS), the PIS technique became more stable in early (P = 0.110) and ultimate failure loads (P = 0.003).
Pediculoiliac screw fixation for sacroiliac joint disruptions and zone I sacrum fractures using iliac and S1 pedicle screws is a new and effective alternative for obtaining and maintaining anatomic reduction.
描述一种骶髂关节后方固定的新技术，并与传统技术进行比较。
患者/材料与方法：一名患有骶骨翼骨折（1区）的患者和另一名因结核感染导致骶髂关节不稳定的患者接受了通过将螺钉置入S1椎弓根和髂骨的固定。还使用聚氨酯骨盆骨模拟物研究了新技术的垂直稳定性，并与前路双钢板固定（P组）和髂骶螺钉固定（ISS组）技术进行了比较。
两名患者术后2年的最终随访检查均实现愈合且复位得以维持。垂直载荷试验显示，新型椎弓根髂骨螺钉固定技术（PIS组）在位移最初10毫米内的失效载荷高于钢板固定（P = 0.03），低于ISS技术（P = 0.002）。PIS技术的极限失效载荷略高于钢板固定（P = 0.277），低于ISS技术（P = 0.003）。在椎弓根髂骨螺钉结构中增加一枚髂骶螺钉（PIS+ISS）后，PIS技术在早期（P = 0.110）和极限失效载荷方面（P = 0.003）变得更加稳定。
使用髂骨和S1椎弓根螺钉对骶髂关节脱位和I区骶骨骨折进行椎弓根髂骨螺钉固定是实现和维持解剖复位的一种新的有效替代方法。
