Percutaneous posterior transiliac plate versus iliosacral screw fixation for posterior fixation of Tile C-type pelvic fractures: a retrospective comparative study

Kim, Chul‐Ho; Kim, Jung Jae; Kim, Ji Wan

doi:10.1186/s12891-022-05536-x

Cited by 5 publications

(5 citation statements)

References 37 publications

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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%

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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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Section: Discussionmentioning

confidence: 99%

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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“…Ileo-sacral screws may be used both in diastasis of the sacroiliac joint and in sacral alar fractures. In diastasis of the sacroiliac joint, there is a disruption of posterior ligaments of the pelvic ring (sacroiliac, sacrotuberous and sacrospinous ligaments): a compression of diastasis with consequent stabilisation is mandatory, and thus one or two sacroiliac screws are needed 29,30 .…”

Section: Posterior Archmentioning

confidence: 99%

Management and surgical options of Tile C pelvic ring fractures: a narrative review of the literature

et al. 2023

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Tile C pelvic ring fractures are complex and dangerous for patients. It is mandatory to know guidelines and algorithms for pelvic trauma to promptly and carefully treat it. Tile C pelvic fractures require temporary treatment. The aim of surgical fixation is to obtain mechanical and haemodynamic stability. The pelvic ring can be divided in two parts, the anterior arch and posterior arch: it is important to know where to start. According to the pattern of fractures, there are different ways to treat a Tile C pelvic ring fracture: plates, percutaneous screws, and external fixator. regarding outcomes, Tile C pelvic fractures are characterized by poor functional outcomes, with only 30% of patients with excellent or good outcomes.

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“…3,4 With the development of minimally invasive techniques, percutaneous iliosacral screw insertion has become the standard method for the treatment of posterior pelvic ring injuries because it is less invasive and has low infection risk and strong mechanical stability. 5 However, there are several concerns regarding the use of this method. Despite the rapid developments in screw technology and assisted surgical tools, the incidence of complications of percutaneous iliosacral screw insertion remains high.…”

Section: Introductionmentioning

confidence: 99%

“…With the development of minimally invasive techniques, percutaneous iliosacral screw insertion has become the standard method for the treatment of posterior pelvic ring injuries because it is less invasive and has low infection risk and strong mechanical stability 5 . However, there are several concerns regarding the use of this method.…”

Section: Introductionmentioning

confidence: 99%

Incidence of and Risk Factors for Screw Loosening after Iliosacral Screw Fixation for Posterior Pelvic Ring Injury

Zhou,

Chen,

Pei

et al. 2023

Orthopaedic Surgery

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Purposes: Screw loosening is a common complication of iliosacral screw fixation, with subsequent loss of stability and fracture re-displacement. This study aimed to investigate the incidence of and risk factors for screw loosening after iliosacral screw fixation for posterior pelvic ring injury.Methods: A total of 135 patients with posterior pelvic ring injuries who were treated with iliosacral screw fixation in our department between July 2015 and April 2021 were selected for this retrospective analysis. The possible risk factors for screw loosening were investigated using univariate and multivariate logistic regression analyses of patient demographics and trauma-related and iatrogenic variables, including age, sex, body mass index, Osteoporosis Self-Assessment Tool for Asians (OSTA) index, mechanism of injury, Young-Burgess classification, site of injury, type of injury, type of screw, mode of fixation, numbers of guidewire adjustments, accuracy of screw position, and quality of fracture reduction. Results:The incidence of screw loosening was 15.6% (n = 21). The mean duration for screw loosening was 3.2 AE 1.5 months after operation. Univariate analysis results showed that the Young-Burgess classification, type of injury, site of injury, type of screw, mode of fixation, and OSTA index might be related to screw loosening (p < 0.05). According to the multivariate logistic regression, vertical shear injuries (Odds ratios [OR] 9.80, 95% Confidence intervals ], p = 0.008), type of injury (OR 0.25, 95% CI [0.13-0.79], p = 0.027), common screws (OR 6.94,], p = 0.012), screws insertion only at the level of the first sacral segment (S1) (OR 8.79,], p = 0.034), injury site located in the medial sacral foramina (OR 6.28,], p = 0.033), and lower OSTA index [OR 0.41,, p = 0.001] were significantly related to screw loosening.Conclusions: Vertical shear injuries, sacral fractures, injury site located in the medial sacral foramina, and lower OSTA index are significantly associated with the postoperative occurrence of screw loosening. Transiliac-transsacral screw fixation and screws insertion both at the level of the S1 and second sacral segment can prevent screw loosening.

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Percutaneous posterior transiliac plate versus iliosacral screw fixation for posterior fixation of Tile C-type pelvic fractures: a retrospective comparative study

Cited by 5 publications

References 37 publications

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

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

Management and surgical options of Tile C pelvic ring fractures: a narrative review of the literature

Incidence of and Risk Factors for Screw Loosening after Iliosacral Screw Fixation for Posterior Pelvic Ring Injury

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