Supra-acetabular fixation and sacroiliac screws for treating unstable pelvic ring injuries: preliminary results from 20 patients

Abstract

ObjectiveTo analyze the treatment results from 20 patients who underwent an alternative osteosynthesis method as definitive treatment for pelvic ring fractures.MethodsA retrospective analysis was conducted on a series of 20 patients with pelvic ring fractures (Tile type C) and a high risk of postoperative infection, who were treated at Santa Casa de Misericórdia de São Paulo between August 2004 and December 2012. The patients underwent percutaneous supra-acetabular external fixation in association with cannulated 7.0 mm iliosacral screws.ResultsThe patients’ mean age was 40 years (range 22–77 years) and the mean length of follow-up was 18.5 months (range 3–69 months). At the end of the treatment, ten patients (50%) were classified as having good results, nine patients (45%) had fair results and one patient (5%) did not have any improvement. Six patients presented complications, and paresthesia of the lateral femoral cutaneous nerve was the most frequent of these (two patients).ConclusionSupra-acetabular external fixation in association with iliosacral percutaneous osteosynthesis is a good definitive treatment method for patients with a high risk of postoperative infection.

Tile Type C Pelvic Fractures: Initial Management, Surgery and Rehabilitation Results of 12 Cases with Literature Review

“…Technically, the choice is made between anterosuperior (above the iliac crest) or anteroinferior assemblies (supra-acetabular). The latter is more stable and longer lasting as reported by several authors such as Guimarães R P et al [89].…”

Description of Standardized Planes and Angles for Percutaneous Supra-acetabular Screw Placement

“…The results showed equivalent fixation strength of titanium screws compared to standard plate fixation [23]. Other publications detail the application of 7.3 mm screws and report satisfactory stabilization and a safe application with low complication rates [7,24,25]. To determine possible safe zones, this investigation assessed digital cone placement inside a CT 3D CAD model between entry and exit points of the supra-acetabular screws.…”