Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Injury. 2021 Oct;52(10):2707-2711. doi: 10.1016/j.injury.2020.01.043. Epub 2020 Jan 30.
Percutaneous sacroiliac (SI) screw fixation is the standard operative treatment of traumatic disruptions to the posterior pelvic ring. The technique offers good outcomes and early postoperative mobilization, which is vital in elderly patients with fragility fractures of the pelvis. While a double-screw technique has been shown to provide optimal biomechanical stability compared to a single-screw construct, anatomic variations and patient-specific characteristics may prevent the safe insertion of two SI screws. We aimed to determine whether cement augmentation of a single SI screw would provide biomechanical stability comparable to that of the double-screw technique.
Three sacroiliac screw osteosynthesis configurations were tested on 10 human cadaveric pelvis specimens: a single cannulated screw; two cannulated screws; and a single, cement-augmented cannulated screw. Displacement and stiffness of the anterior and posterior pelvic ring after fixation with each technique were measured under axial load. Results where compared using linear regression and paired t-tests.
A single uncemented screw offered significantly worse stability in the anterior pelvis compared to a double-screw technique (P < 0.05) and to a single cement-augmented screw technique (P < 0.05). There was no significant difference in anterior pelvic ring stability between the single cement-augmented screw technique and the double-screw technique (P > 0.05). There was no significant difference in the stability of the posterior pelvic ring between the three techniques (P > 0.05).
A single cement-augmented cannulated sacroiliac screw provides biomechanical stability similar to that of a non-augmented double-screw technique in the treatment of posterior pelvic ring fractures.
经皮骶髂（SI）螺钉固定是治疗后骨盆环外伤性破裂的标准手术治疗方法。该技术提供了良好的结果和早期术后活动能力，这对于骨盆脆弱性骨折的老年患者至关重要。虽然双螺钉技术与单螺钉结构相比提供了最佳的生物力学稳定性，但解剖变异和患者特定特征可能会阻止安全插入两根 SI 螺钉。我们旨在确定水泥增强的单根 SI 螺钉是否会提供与双螺钉技术相当的生物力学稳定性。
在 10 个人体尸体骨盆标本上测试了三种骶髂螺钉骨合成配置：一根单腔钉；两根单腔钉；和一根水泥增强的单腔钉。在每种技术固定后，测量前骨盆环和后骨盆环的位移和刚度。使用线性回归和配对 t 检验比较结果。
与双螺钉技术（P<0.05）和单根水泥增强螺钉技术（P<0.05）相比，单根未固定螺钉在前骨盆中的稳定性明显较差。单根水泥增强螺钉技术和双螺钉技术在前骨盆环稳定性方面没有显著差异（P>0.05）。三种技术在后骨盆环稳定性方面没有显著差异（P>0.05）。
在治疗后骨盆环骨折时，单根水泥增强的骶髂螺钉提供的生物力学稳定性与未增强的双螺钉技术相似。
