Jumper’s fracture of the sacrum: a novel and reproducible way for successful reduction and fixation

Abstract

Purpose Surgical treatment of jumper’s fractures is a highly demanding situation for the surgeon due to its rareness and frequent association with severe concomitant injuries. There is no current consensus regarding a standard treatment approach, thus reducing quality of care. Our objectives were to describe, apply and assess a novel surgical technic. Methods The presented research is an observational retrospective study of patients who underwent the described novel surgical intervention in a level 1 trauma center. We conducted analyses of the patient cohort using patient-related outcome measures at least 1 year after surgery, as well as investigating pain, quality of life and the clinical effectiveness of the procedure. Results A total of 24 patients (17 male and 7 female) with an average age 47 ± 16.3 years were included. ISS scores ranged from 9 to 66 with a mean ISS of 40 ± 15. Clinical scores exist of 15 out of 24 patients (62.5%). The mean VAS score was 53.7 ± 12.9. The mean EQ-5D index was 0.68 ± 0.22. Significant negative correlation existed between the ISS value and the EQ-5D index (r = − 0.704; p < 0.005) and EQ-5D VAS (r = − 0.809; p < 0.001). Anatomical reduction was achieved in all patients (n = 24). Radiological follow-up was performed in 58%. Conclusion We present one of the largest studies with operatively treated jumper’s fractures of the sacrum. The technique is capable of reproducibly restoring the physiological anatomy of the patient and allows pain-adapted mobilization.

Surgical Management of Unstable U-Shaped Sacral Fractures and Tile C Pelvic Ring Disruptions: Institutional Experience in Light of a Narrative Literature Review

“…For displaced type 3 sacral fractures, Linhart et al [ 43 ] in 2022 presented a two-staged reduction method using maneuvers on hardware: vertical displacement was reduced by distracting L4 pedicle and iliac screws, and anterior displacement was corrected using rod persuasion into L5 pedicle screws ( Fig. 2 ).…”

“…Type 2 and 3 U-shaped sacral fractures (equivalent AO Spine C3) frequently require surgical stabilization. Multiple efficient reduction techniques have been proposed, including external maneuvers [ 7 ], osteotomy [ 42 ], and hardware maneuvers [ 43 ]. Stabilization is achieved using triangular spinopelvic fixation, either with the technique by Schildhauer et al [ 11 ] or modified fixation using a transverse connector [ 24 ].…”

“…The operator should strive to achieve sufficient vertical distraction during spinopelvic fixation using iliac screws associated with L5 and S1 pedicle screws to reduce the risk of adjacent lumbar segment diseases. Nevertheless, sometimes the lever arm is necessary to reduce vertical displacement [ 8 ], the need for hardware maneuver reduction techniques [ 43 ], or the Strange-Vognsen grade four sacral fracture by Strange-Vognsen and Lebech [ 22 ] requires the use of L4 pedicle screws.…”

Outcomes of Lumbosacral Fixation in Patients with Suicidal Jumper\'s Fractures: A Retrospective Study from a Single Center in Turkey

“…The most significant biomechanical advantage of spinopelvic fixation is its ability to create a bridge between the intact lumbar vertebra and the intact iliac wings, restoring spinopelvic dissociation. A study by Linhard et al [ 18 ], involving 24 cases, reported achieving ideal anatomical reduction in all patients and did not encounter signs of screw loosening or implant insufficiency during follow-ups. Defects and fragmentation in the sacrum do not significantly impair the strength of fixation.…”