Ebraheim Nabil A, Ramineni Satheesh K, Alla Sreenivasa R, Ebraheim Molly
Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, Ohio, USA.
J Trauma. 2010 Nov;69(5):1226-9. doi: 10.1097/TA.0b013e3181e4f3f8.
Numerous studies have described screw fixation of sacroiliac (SI) joint, but there have been very few reports in the literature regarding long-term pain levels after SI joint fixation and their management. The objective of this study was to analyze the results of SI joint fusion with fibular bone graft in patients with persistent late pain after iliosacral screw fixation.
Eleven consecutive patients with persistent late pain following iliosacral screw fixation with failed conservative methods were managed with fibular bone grafting of the SI joint. The patients were followed up at 2, 6, 12, 24 weeks and every 3 months thereafter. They were clinically assessed for pain, infection, and ambulation.
The average duration of follow-up was 18 months. There were neither intraoperative complications nor postoperative wound infection. Eight patients were pain free and returned to their work. The remaining three patients were having persistent-localized pain, but they were able to manage their daily activities.
Fibular graft is feasible and apparently effective choice for SI joint fusion. This procedure avoids further metal work, which results in successful fusion and pain relief as well as stabilizing the SI joint.
众多研究已对骶髂关节螺钉固定进行了描述，但关于骶髂关节固定术后长期疼痛程度及其处理的文献报道却非常少。本研究的目的是分析在髂骶螺钉固定后仍存在持续性晚期疼痛的患者中，采用腓骨植骨进行骶髂关节融合的结果。
11例采用保守方法治疗失败、髂骶螺钉固定后仍存在持续性晚期疼痛的连续患者，接受了骶髂关节腓骨植骨治疗。在术后2周、6周、12周、24周以及此后每3个月对患者进行随访。对患者进行疼痛、感染及行走能力的临床评估。
平均随访时间为18个月。术中及术后均未出现并发症及伤口感染。8例患者疼痛消失并恢复工作。其余3例患者仍存在持续性局部疼痛，但能够进行日常活动。
腓骨植骨是骶髂关节融合可行且明显有效的选择。该手术避免了进一步的金属植入，实现了成功融合、缓解疼痛并稳定了骶髂关节。
