Osterhoff Georg, Noser Jonas, Sprengel Kai, Simmen Hans-Peter, Werner Clément M L
Department of Trauma, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
BMC Surg. 2019 Apr 15;19(1):39. doi: 10.1186/s12893-019-0501-0.
The indications for sacroiliac screw (SI) removal have been under debate. Data on complication rates of SI screw removal is missing in the current literature. The objective of this study was to compare the rate of intra- and perioperative problems and complications during SI screw removal to those with SI screw fixation.
A retrospective observational study with two interventions in the same cohort was performed. Consecutive patients who underwent both sacroiliac screw fixation for an isolated fracture of the pelvic ring and removal of the same implants between November 2008 and September 2015 (n = 19; age 57.3, SD 16.1 years) were included. Intraoperative technical problems, postoperative complications, duration of surgery, and radiation dose were analysed.
Intraoperative technical problems occurred in 1/19 patients (5%) during SI screw fixation and in 7/19 cases (37%) during SI screw removal (p = .021). Postoperative complications were seen in 3/19 patients after SI screw fixation and in 1/19 patients after SI screw removal (p = 0.128). The surgical time needed per screw was longer for screw removal than for implantation (p = .005). The amount of radiation used for the whole intervention (p = .845) and per screw (p = .845) did not differ among the two interventions.
Intraoperative technical problems were more frequent with SI screw removal than with SI screw fixation. Most of the intraoperative technical problems in this study were implant-related. They resulted in more surgical time needed per screw removed but similar radiation time.
骶髂螺钉取出的适应证一直存在争议。目前文献中缺少骶髂螺钉取出并发症发生率的数据。本研究的目的是比较骶髂螺钉取出术中及围手术期的问题和并发症发生率与骶髂螺钉固定术的情况。
对同一队列进行了两项干预措施的回顾性观察研究。纳入2008年11月至2015年9月期间连续接受骨盆环孤立骨折骶髂螺钉固定及相同植入物取出的患者（n = 19；年龄57.3岁，标准差16.1岁）。分析术中技术问题、术后并发症、手术时间和辐射剂量。
骶髂螺钉固定术中1/19例（5%）出现术中技术问题，骶髂螺钉取出术中7/（37%）出现术中技术问题（p = 0.021）。骶髂螺钉固定术后3/19例患者出现术后并发症，骶髂螺钉取出术后1/19例患者出现术后并发症（p = 0.128）。每枚螺钉取出所需的手术时间比植入时间长（p = 0.005）。两种干预措施在整个干预过程中（p = 0.845）和每枚螺钉（p = 0.845）所使用的辐射量没有差异。
骶髂螺钉取出术中的技术问题比骶髂螺钉固定术更常见。本研究中大多数术中技术问题与植入物有关。它们导致每枚取出的螺钉需要更多的手术时间，但辐射时间相似。
