Percutaneous Sacral Screw Fixation Alone Sufficient for Mildly Displaced U-Type Sacral Fractures With Preserved Osseous Fixation Pathways

Authors

• Augustine M Saiz
• Patrick J Kellam
• Adeet Amin
• Zachary Arambula
• Abhi Rashiwala
• Joshua L Gary
• Stephen J Warner
• Milton Routt
• Jonathan G Eastman

Language

English

Publication Date

10-1-2024

Journal

European Journal of Orthopaedic Surgery & Traumatology

DOI

10.1007/s00590-023-03661-4

PMID

37874399

PMCID

PMC11490423

PubMedCentral® Posted Date

10-24-2023

PubMedCentral® Full Text Version

Post-print

Abstract

Purpose: To describe U-type sacral fracture characteristics amenable to percutaneous sacral screw fixation.

Methods: U-type sacral fractures were identified from a trauma registry at a level 1 trauma center from 2014 to 2020. Patient demographics, injury mechanism, fracture characteristics, and fixation construct were retrospectively retrieved. Associations between fracture pattern and surgical fixation were identified.

Results: 82 U-type sacral fractures were reviewed. Six treated with lumbopelvic fixation (LPF) and 76 were treated with percutaneous sacral screws (PSS) alone. Patients receiving LBF had greater sacral fracture displacement in coronal, sagittal, and axial planes compared to patients receiving PSS alone (P < 0.05), negating osseous fixation pathways. All patients went onto sacral union and there were no implant failures or unplanned reoperations for either group.

Conclusion: If osseous fixation pathways are present, U-type sacral fractures can be successfully treated with percutaneous sacral screws. LPF may be indicated in more displaced fractures with loss of spinopelvic alignment. Both techniques for U-type sacral fractures result in reliable fixation and healing without reoperations.

Keywords

Humans, Sacrum, Male, Spinal Fractures, Fracture Fixation, Internal, Female, Bone Screws, Retrospective Studies, Middle Aged, Adult, Aged, Fracture Healing, U-type sacral fracture, Lumbopelvic fixation, Percutaneous sacral screws, Pelvic ring injury

Published Open-Access

yes

Recommended Citation

Saiz, Augustine M; Kellam, Patrick J; Amin, Adeet; et al., "Percutaneous Sacral Screw Fixation Alone Sufficient for Mildly Displaced U-Type Sacral Fractures With Preserved Osseous Fixation Pathways" (2024). Faculty, Staff and Student Publications. 3958.
https://digitalcommons.library.tmc.edu/uthmed_docs/3958