Department of Orthopaedic Surgery, Pontificia Universidad Catolica de Chile, Santiago, Chile.
Eur J Orthop Surg Traumatol. 2024 Nov 28;35(1):29. doi: 10.1007/s00590-024-04150-y.
Fragility pelvic fractures are an increasingly entity due to increase in life expectancy. A large proportion of these fractures require surgical treatment with stabilization of the posterior ring with ilio-sacral screws. Due to the poor bone quality of these patients, cement augmentation of the ilio-sacral screws can be performed and thus avoid treatment failures. The purpose of this review is to make a revision of the literature and present a novel cementation technique with clinical examples of patients treated with this surgical technique.
Review of current literature on fragility pelvic fractures and modern treatment alternatives. We also describe a novel, easy to perform and low-cost technique for cement augmentation of ilio-sacral screws that we find useful when not having specific commercial instruments for this purpose. Additionally, we present a case series of five patients operated between 2017 and 2024 with augmented ilio-sacral screws due to fragility pelvic fracture.
The surgical technique presented is easy to perform, has a low training curve and requires standard instruments easy to find in a trauma center. Further clinical studies are required to demonstrate superiority of cement augmentation over the standard technique without augmentation.
由于预期寿命的延长,脆弱性骨盆骨折的发病率不断增加。这些骨折中有很大一部分需要手术治疗,通过使用髂骨-骶骨螺钉稳定后环。由于这些患者的骨质较差,因此可以进行髂骨-骶骨螺钉的骨水泥增强,从而避免治疗失败。本综述的目的是复习文献,并介绍一种新的骨水泥固定技术,并结合采用该手术技术治疗的患者的临床实例。
对脆弱性骨盆骨折的现有文献和现代治疗选择进行回顾。我们还描述了一种新颖、易于操作且成本低的髂骨-骶骨螺钉骨水泥增强技术,我们发现当没有专门用于此目的的商业器械时,该技术非常有用。此外,我们还介绍了 2017 年至 2024 年间因脆弱性骨盆骨折而接受增强型髂骨-骶骨螺钉治疗的五例患者的病例系列。
所介绍的手术技术易于操作,训练曲线低,所需的标准器械在创伤中心很容易找到。需要进一步的临床研究来证明骨水泥增强在没有增强的情况下优于标准技术。