Department of Orthopaedic Surgery, The University of California Davis, Sacramento, CA, USA.
Department of Orthopedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Eur J Orthop Surg Traumatol. 2024 Oct;34(7):3523-3527. doi: 10.1007/s00590-023-03661-4. Epub 2023 Oct 24.
To describe U-type sacral fracture characteristics amenable to percutaneous sacral screw fixation.
U-type sacral fractures were identified from a trauma registry at a level 1 trauma center from 2014 to 2020. Patient demographics, injury mechanism, fracture characteristics, and fixation construct were retrospectively retrieved. Associations between fracture pattern and surgical fixation were identified.
82 U-type sacral fractures were reviewed. Six treated with lumbopelvic fixation (LPF) and 76 were treated with percutaneous sacral screws (PSS) alone. Patients receiving LBF had greater sacral fracture displacement in coronal, sagittal, and axial planes compared to patients receiving PSS alone (P < 0.05), negating osseous fixation pathways. All patients went onto sacral union and there were no implant failures or unplanned reoperations for either group.
If osseous fixation pathways are present, U-type sacral fractures can be successfully treated with percutaneous sacral screws. LPF may be indicated in more displaced fractures with loss of spinopelvic alignment. Both techniques for U-type sacral fractures result in reliable fixation and healing without reoperations.
描述可通过经皮骶骨螺钉固定治疗的 U 型骶骨骨折特征。
从 2014 年至 2020 年，在 1 级创伤中心的创伤登记处确定 U 型骶骨骨折。回顾性检索患者人口统计学资料、损伤机制、骨折特征和固定结构。确定骨折类型与手术固定之间的关联。
共回顾了 82 例 U 型骶骨骨折。6 例接受腰骶固定（LPF）治疗，76 例单独接受经皮骶骨螺钉（PSS）治疗。与单独接受 PSS 治疗的患者相比，接受 LBF 治疗的患者在冠状面、矢状面和轴面的骶骨骨折移位更大（P<0.05），否定了骨固定途径。所有患者均达到骶骨愈合，两组均无植入物失败或计划外再次手术。
如果存在骨固定途径，U 型骶骨骨折可通过经皮骶骨螺钉成功治疗。对于伴有脊柱骨盆对线丢失的更移位骨折，LPF 可能是指征。两种治疗 U 型骶骨骨折的技术均可实现可靠的固定和愈合，无需再次手术。
