Minimal Access Fixation of Longitudinal Sacral Fractures: The Posterior Internal Fixator with a Minimum of Three Years of Follow-Up

Saoud, Abdelfattah; Sallam, Ahmed M.

doi:10.1016/j.wneu.2018.06.036

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…A deep tunnel was created to percutaneously connect the two screw insertion sites, passing deep to the paravertebral muscles for the passage of the two interconnecting rods. The rod was then positioned between the two parallel iliac screw heads, and the final intraoperative picture was taken [ 7 ].…”

Section: Methodsmentioning

confidence: 99%

Percutaneous Ilioilial Fixator Versus Percutaneous Iliosacral Screw in Managing Unstable Sacral Fractures: A Prospective Randomised Controlled Study

Shaalan,

El Zaher,

Farag

et al. 2024

Cureus

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Introduction: Unstable sacral fractures with pelvic fractures are challenging to both surgeons and patients, particularly in the immediate post-injury phase and later when definitive fixation is undertaken. Percutaneous iliosacral screw fixation is widely regarded as the gold standard treatment for unstable sacral fractures without spinopelvic dissociation. Closed reduction and percutaneous fixation using iliosacral screws for sacral fractures provide early stabilisation without the need for extensive surgical exposure, thereby mitigating major complications associated with open surgical procedures. A new technique for stabilising unstable sacral fractures is the minimally invasive ilioilial fixator, also called a transiliac internal fixator (TIIF), which has gained more attention for its ability to address challenges associated with sacroiliac screw fixation. The objective of this study is to compare the functional, radiological, and surgical outcomes between the percutaneous iliosacral screw and the ilioilial fixator. Methods: A total of 51 patients with sacral fracture injuries sustained between August 2019 and November 2021 were included in this study, with 25 patients in Group A and 26 patients in Group B. Patient randomization was done using computer-generated randomization facilitated by Random Allocation Software (Mahmood Saghaei, Isfahan, Iran). All patients underwent the chosen intervention within 10 days of the trauma. Patients had follow-up at two weeks, six weeks, and 12 months post-treatment. The results of fixation were evaluated radiologically based on the Matta and Tornetta grading system and clinically using the Majeed pelvic scoring system. Complications were detected in both groups during follow-up visits. Results: The study found no statistically significant differences between the two patient groups in terms of final clinical assessment (p=0.79), radiological assessment (p=0.78), or the need for another operation (p=1.0). Moreover, there were no statistically significant differences between the groups with respect to complication rates (p=0.63) or the time of union (p=0.14). No differences were noted in terms of intraoperative blood loss (p=0.93) or operative time (p=0.34) but for longer incision length in the ilioilial fixator group (p<0.001) and an increased risk of intraoperative radiation exposure in the iliosacral screw group (p<00.1). Discussion: Although the iliosacral screw is considered a gold standard for unstable sacral fracture, a TIIF is a good alternative with a very satisfactory outcome. Conclusion: Although the iliosacral screw still remains the gold standard for the management of sacral fractures, the ilioilial fixator emerges as a good alternative with comparable functional and radiological outcomes.

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Section: Methodsmentioning

confidence: 99%

Percutaneous Ilioilial Fixator Versus Percutaneous Iliosacral Screw in Managing Unstable Sacral Fractures: A Prospective Randomised Controlled Study

Shaalan,

El Zaher,

Farag

et al. 2024

Cureus

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“…Through biomechanical tests, Shinohara et al [ 46 ] believed that the posterior internal fixation of the spine had more biomechanical strength than the traditional posterior plate fixation. For the treatment of longitudinal sacral fractures, Fathy Saoud et al [ 47 ] proposed that percutaneous iliac screw fixation with the posterior superior iliac spine as the starting point is a new option for the treatment of sacral fractures. Fifty patients with longitudinal sacral fractures received “ileal” internal fixation.…”

Section: Surgical Treatment Of Sacral Fracturesmentioning

confidence: 99%

Recent Progress in the Classification and Operation of Sacral Fractures

Sun

Liu

Yan

et al. 2023

Emergency Medicine International

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Most sacral fractures are caused by high-energy, violent injuries, often accompanied by lumbosacral plexus injuries, which can cause instability of the posterior pelvic ring or lumbosacral junction in severe cases. Currently, the most commonly used clinical classification methods are Denis classification, Tile classification, Isler classification, and Denis II classification. In recent years, lumbosacral vertebral injury classification and injury degree scoring systems have often been applied clinically as the choice of treatment methods. At present, the internal fixation and implantation methods of sacral fracture are developing in the direction of positive, efficient, safe, and minimally invasive. But different fixation methods have their own indications, which should be strictly followed. This article reviews the classification of sacral fractures and the latest progress in surgical treatment.

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Minimal Access Fixation of Longitudinal Sacral Fractures: The Posterior Internal Fixator with a Minimum of Three Years of Follow-Up

Cited by 2 publications

References 9 publications

Percutaneous Ilioilial Fixator Versus Percutaneous Iliosacral Screw in Managing Unstable Sacral Fractures: A Prospective Randomised Controlled Study

Percutaneous Ilioilial Fixator Versus Percutaneous Iliosacral Screw in Managing Unstable Sacral Fractures: A Prospective Randomised Controlled Study

Recent Progress in the Classification and Operation of Sacral Fractures

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