Sawada Ryohei, Ishikawa Tetsuhiro, Ota Mitsutoshi, Katsuragi Joe, Sasaki Yasuhito, Suzuki Masahiro, Umimura Tomotaka, Nagashima Yuki, Hashiba Daisuke, Yoshimoto Takuma, Yamoto Naoki, Ohtori Seiji
Department of Orthopaedic Surgery, Sanmu Medical Center, Chiba, Japan.
Department of Orthopedic Surgery, Seirei Yokohama Hospital, Kanagawa, Japan.
Surg Neurol Int. 2022 Sep 16;13:421. doi: 10.25259/SNI_301_2022. eCollection 2022.
Surgical indications for fragility fracture of the pelvis (FFP) have been reconsidered recently, and the indications to perform surgery have increased. However, the optimal surgical method to obtain sufficiently strong fixation in elderly patients with minimal invasiveness is not yet clear. In this report, we present the case of a patient with FFP who was treated with a novel posterior within ring fixation technique using a combination of iliac screws and an implant that locks the original iliosacral (IS) screw in the sacrum.
A 90-year-old man was diagnosed with FFP (Rommens classification: Type IIc) and hospitalized for conservative treatment. However, 6 weeks after the injury, pain reappeared in his right buttock and computed tomography showed additional fractures of the right subpubic branch and right sacrum (Rommens classification: Type IVb). The fracture was considered to have progressed from being stable to unstable, and surgical treatment was planned. To obtain strong fixation with minimal invasion, we performed posterior fixation using E.Spine Tanit (Euros, France) compact posterior thoracolumbar instrumentation, an implant that combines an IS screw with a sacral anchoring system. The patient started walking unaided 2 weeks after the surgery, suggesting a good outcome of this surgical approach to FFP.
We performed posterior fixation surgery for a patient with an unstable FFP that recurred and progressed after conservative treatment. We have achieved good results using a minimally invasive, strong, and within ring fixation technique.
骨盆脆性骨折（FFP）的手术指征最近已被重新审视，手术指征有所增加。然而，在老年患者中以最小的侵入性获得足够牢固固定的最佳手术方法尚不清楚。在本报告中，我们介绍了一例FFP患者的病例，该患者采用了一种新颖的后环内固定技术进行治疗，该技术结合了髂骨螺钉和一种将原始髂骶（IS）螺钉锁定在骶骨中的植入物。
一名90岁男性被诊断为FFP（罗曼斯分类：IIc型）并住院接受保守治疗。然而，受伤6周后，他的右臀部再次出现疼痛，计算机断层扫描显示右耻骨下支和右骶骨出现额外骨折（罗曼斯分类：IVb型）。骨折被认为已从稳定型发展为不稳定型，因此计划进行手术治疗。为了以最小的侵入性获得牢固的固定，我们使用E.Spine Tanit（法国Euros公司）紧凑型胸腰椎后路内固定器械进行了后路固定，该器械是一种将IS螺钉与骶骨锚固系统相结合的植入物。患者术后2周即可独立行走，表明这种FFP手术方法取得了良好的效果。
我们对一名保守治疗后复发并进展的不稳定FFP患者进行了后路固定手术。我们使用微创、牢固的后环内固定技术取得了良好的效果。
