Regenbogen Stephan, Barbari Jan El, Vetter Sven Y, Franke Jochen, Grützner Paul Alfred, Swartman Benedict
BG Klinik Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany.
Tauernklinikum, 5700 Zell am See, Austria.
J Clin Med. 2024 Sep 4;13(17):5244. doi: 10.3390/jcm13175244.
There has been an increasing number of fragility fractures of the sacrum in the recent decade. With rates of up to 28%, the complication rates after surgical treatment are still at an unacceptably high level, and new treatment strategies are urgently needed. Therefore, the purpose of this study was to evaluate the potential of 3D-navigated trans-sacral bar osteosynthesis in the surgical treatment of fragility fractures of the sacrum. Retrospectively, from 2017 to 2023, all cases with confirmed fragility fractures of the sacrum in patients > 65 years of age that were surgically treated with navigated 3D-navigated trans-sacral bar osteosynthesis were included, and epidemiological data and the course of treatment analyzed in comparison to a matched control group. Finally, 21 patients (18 women and 3 men) were included in this study. The average age of the patients was 82.6 (SD 6.3) in the intervention group and 79.4 (SD 6.7) in the control group. There were postoperatively detected complications in two cases (18%) in the intervention group and in four cases (40%, = 0.362) in the control group. The postoperative in-hospital stay was 10 days (SD 3.8) vs. 11.4 days (SD 3.8) in the control. None of the patients in the intervention group and two in the control group needed revision surgery. : Overall, 3D-navigated trans-sacral bar osteosynthesis seems to be a promising technique, enabling an accurate implant positioning while offering a low complication rate with an excellent short-term outcome in elderly patients with fragility fractures of the sacrum.
近十年来，骶骨脆性骨折的数量不断增加。手术治疗后的并发症发生率高达28%，仍处于难以接受的高水平，因此迫切需要新的治疗策略。本研究的目的是评估三维导航经骶骨棒接骨术在骶骨脆性骨折手术治疗中的潜力。回顾性分析2017年至2023年期间，所有年龄大于65岁、经三维导航经骶骨棒接骨术手术治疗的确诊骶骨脆性骨折患者，收集其流行病学数据并分析治疗过程，与匹配的对照组进行比较。最终，本研究纳入了21例患者（18例女性和3例男性）。干预组患者的平均年龄为82.6岁（标准差6.3），对照组为79.4岁（标准差6.7）。干预组术后有2例（18%）出现并发症，对照组有4例（40%，P = 0.362）。干预组术后住院时间为10天（标准差3.8），对照组为11.4天（标准差3.8）。干预组无一例患者需要翻修手术，对照组有2例需要。总体而言，三维导航经骶骨棒接骨术似乎是一种很有前景的技术，能够实现植入物的精确定位，同时并发症发生率低，在老年骶骨脆性骨折患者中具有出色的短期疗效。
