Management of complex pelvic fracture and sacral fracture Denis type 2 using spanning unilateral fixation of L5 to S2AI screw

Sakti, Yudha Mathan; Mafaza, Akbar; Lanodiyu, Zikrina Abyanti; Sakadewa, Galih Prasetya; Magetsari, Rahadyan

doi:10.1016/j.ijscr.2020.11.053

Cited by 4 publications

(5 citation statements)

References 11 publications

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“…Our review confirms the heterogeneity of the data in the existing literature in terms of surgical management for unstable lumbosacral fractures (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27).…”

Section: Discussionsupporting

confidence: 79%

“…The 11 authors that used LP fixation ( 14 , 16 – 26 ) showed that spinopelvic fixation is a good technique for sacral fractures with lumbopelvic dissociation, as it allows immediate mobilization, as well as weight bearing in the postoperative period ( 29 ). Pain, neurological impairment and infection rates were low, and mobilization was earlier.…”

Section: Discussionmentioning

confidence: 99%

“…The main limitation of TOS technique is that it requires a highly skilled surgeon specialized in the treatment of pelvic ring fractures as it is a very complicated procedure (35,36). The 11 authors that used LP fixation (14, [16][17][18][19][20][21][22][23][24][25][26] showed that spinopelvic fixation is a good technique for sacral fractures with lumbopelvic dissociation, as it allows immediate mobilization, as well as weight bearing in the postoperative period (29). Pain, neurological impairment and infection rates were low, and mobilization was earlier.…”

Section: Discussionmentioning

confidence: 99%

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Triangular osteosynthesis and lumbopelvic fixation as a valid surgical treatment in posterior pelvic ring lesions: a systematic review

Rovere,

De Mauro,

Smakaj

et al. 2024

Front. Surg.

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ObjectiveUnstable fractures of the sacrum often occur in patients with pelvic fractures and represent a real challenge for the orthopedic surgeon. Triangular osteosynthesis (TOS) and lumbopelvic fixation (LP) may represent a valid management option for the treatment of this condition. We present a systematic literature review about lumbopelvic fixation and triangular fixation as treatment option for unstable sacral fractures, to assess clinical and radiological outcomes after surgery and to evaluate appropriate indications and impact on the natural history of sacral fractures.MethodsThe review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 50 articles out of 108 titles, were considered eligible for the full-text analysis. Finally, 16 studies that met inclusion criteria were included in this review.ResultsOverall, 212 patients (87 males, 58 females) with sacral fractures treated with TOS triangular fixation or LP lumbopelvic fixation were collected. The mean age was 37.6 years. Mean follow-up reported in all studies was 24.14 months.ConclusionThe results presented by the different authors, highlight the effectiveness of TOS triangular fixation and LP lumbopelvic fixation for the treatment of unstable sacral fractures associated with other pelvic fractures, in terms of function, stability, cost-effectiveness, and quality of life postoperatively.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Triangular osteosynthesis and lumbopelvic fixation as a valid surgical treatment in posterior pelvic ring lesions: a systematic review

Rovere,

De Mauro,

Smakaj

et al. 2024

Front. Surg.

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“…Lumbopelvic fixation and iliosacral screws are currently popular fixation methods. However, both have their limitations and deficiencies 19–24 . Lumbopelvic fixation cannot fix the sacral fracture directly, which leads to a relatively high rate of non‐union because of the excessive motion of the sacrum and malunion caused by re‐displacement of the fracture.…”

Section: Discussionmentioning

confidence: 99%

“…However, both have their limitations and deficiencies. 19 , 20 , 21 , 22 , 23 , 24 Lumbopelvic fixation cannot fix the sacral fracture directly, which leads to a relatively high rate of non‐union because of the excessive motion of the sacrum and malunion caused by re‐displacement of the fracture. Meanwhile, iliosacral screws cannot simultaneously ensure reduction and fixation.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Unstable Sacral Fractures with Robotically‐aided Minimally Invasive Triangular Fixation

Tian,

Jia,

Zheng

et al. 2023

Orthopaedic Surgery

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ObjectiveThe treatment of unstable sacral fractures is huge challenge to surgeons. Robotically‐aided minimally invasive triangular fixation (RoboTFX) is the most advanced technique up to now. This study is to evaluate the clinical outcomes of unstable sacral fractures treated with RoboTFX.MethodsFrom March 2017 to October 2021, 48 consecutive patients with unstable sacral fractures were included in the study. All patients received surgical treatment with triangular fixation (TFX). Patients were divided into four groups according to the number of fractures (uni‐ or bilateral) and surgical method employed (RoboTFX or traditional open TFX). Between these four groups, clinical data on operation time, intraoperative bleeding, intraoperative fluoroscopy time, infection rate, fracture healing rates, insertion accuracy, Majeed pelvic outcome score, Mears' criterion, and Gibbons score were compared. Quantitative data were expressed as mean ± standard deviation and compared using Student's t‐test. Categorical variable were compared using the Pearson's χ2 test.ResultsComparing unilateral RoboTFX versus open TFX, neither fracture healing rate, infection rate, Majeed pelvic outcome score, Mears' radiological evaluation criterion, nor Gibbons score of the two groups were statistically significantly different (p > 0.05). However, operation time, intraoperative bleeding, intraoperative fluoroscopy time, and insertion accuracy in the RoboTFX group were all significantly better than those of the traditional open group (p < 0.05). Likewise, operation time, intraoperative bleeding, intraoperative fluoroscopy time, and accuracy of fixation insertion of the bilateral RoboTFX group were significantly better than those of the bilateral open group (p < 0.05). Meanwhile infection rate, fracture healing rate, Majeed score, Mears' criterion, and Gibbons score of two groups were not significantly different (p > 0.05).ConclusionRoboTFX has the advantages of less operation time, less intraoperative bleeding and fluoroscopy, more accurate fixation insertion, and a higher healing rate compared to traditional open methods in the treatment of unstable sacral fractures. However, RoboTFX requires a few critical considerations, and the indications of its operation should be strictly evaluated.

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Computer-aided automatic planning and biomechanical analysis of a novel arc screw for pelvic fracture internal fixation

Qing

Feng

Song

et al. 2022

Computer Methods and Programs in Biomedicine

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Management of complex pelvic fracture and sacral fracture Denis type 2 using spanning unilateral fixation of L5 to S2AI screw

Cited by 4 publications

References 11 publications

Triangular osteosynthesis and lumbopelvic fixation as a valid surgical treatment in posterior pelvic ring lesions: a systematic review

Triangular osteosynthesis and lumbopelvic fixation as a valid surgical treatment in posterior pelvic ring lesions: a systematic review

Treatment of Unstable Sacral Fractures with Robotically‐aided Minimally Invasive Triangular Fixation

Computer-aided automatic planning and biomechanical analysis of a novel arc screw for pelvic fracture internal fixation

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