Yi-Hsun Yu1, Meng-Ling Lu2, I-Chuan Tseng3, Chun-Yi Su4, Yung-Heng Hsu5, Wen-Lin Yeh6, Chi-Chung Wu7. 1. Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, 33302, Tao-Yuan, Taiwan. Electronic address: alanyu1007@gmail.com. 2. Division of Spine, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, 33302, Tao-Yuan, Taiwan. Electronic address: lumengling@gmail.com. 3. Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, 33302, Tao-Yuan, Taiwan. Electronic address: ichuantseng@adm.cgmh.org.tw. 4. Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, 33302, Tao-Yuan, Taiwan. Electronic address: su1491@adm.cgmh.org.tw. 5. Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, 33302, Tao-Yuan, Taiwan. Electronic address: laurencehsu.hsu@gmail.com. 6. Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, 33302, Tao-Yuan, Taiwan. Electronic address: yeh.wenlin@msa.hinet.net. 7. Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, 33302, Tao-Yuan, Taiwan. Electronic address: ccwu@mail.cgu.edu.tw.
Abstract
OBJECTIVE: To report the perioperative results and surgical outcomes of patients with vertical unstable sacral fractures who underwent lumbopelvic fixation through a modified subcutaneous route for iliac screw fixation. SUMMARY OF BACKGROUND DATA: Treating vertical unstable sacral fractures is still challenging for orthopedic surgeons. Among various methods for treating these fractures, lumbopelvic fixation provides a high reduction quality and promising stability for early weight-bearing ambulation. However, wound healing disturbance and surgical site infection (SSI) are the drawbacks of this extensive technique, especially after inserting iliac screws. METHODS: Here, we provide an alternative subcutaneous route for iliac screw insertion during lumbopelvic fixation surgery to lessen soft tissue retraction and injury, and thus decrease soft tissue complications. RESULTS: Using this modified technique, 28 patients with vertical unstable sacral fractures were treated between 2012 and 2014. One patient had an SSI (infection rate: 3.5%). All fractures were united with a mean sacral kyphosis correction angle of 10.5°. The mean Majeed score of the 17 patients during the 12-month follow-up was 84.5. CONCLUSIONS: The subcutaneous route for iliac screw insertion is a simple, safe, and effective technique when performing lumbopelvic fixation for vertical unstable sacral fractures.
OBJECTIVE: To report the perioperative results and surgical outcomes of patients with vertical unstable sacral fractures who underwent lumbopelvic fixation through a modified subcutaneous route for iliac screw fixation. SUMMARY OF BACKGROUND DATA: Treating vertical unstable sacral fractures is still challenging for orthopedic surgeons. Among various methods for treating these fractures, lumbopelvic fixation provides a high reduction quality and promising stability for early weight-bearing ambulation. However, wound healing disturbance and surgical site infection (SSI) are the drawbacks of this extensive technique, especially after inserting iliac screws. METHODS: Here, we provide an alternative subcutaneous route for iliac screw insertion during lumbopelvic fixation surgery to lessen soft tissue retraction and injury, and thus decrease soft tissue complications. RESULTS: Using this modified technique, 28 patients with vertical unstable sacral fractures were treated between 2012 and 2014. One patient had an SSI (infection rate: 3.5%). All fractures were united with a mean sacral kyphosis correction angle of 10.5°. The mean Majeed score of the 17 patients during the 12-month follow-up was 84.5. CONCLUSIONS: The subcutaneous route for iliac screw insertion is a simple, safe, and effective technique when performing lumbopelvic fixation for vertical unstable sacral fractures.
Authors: Emre Yilmaz; Martin F Hoffmann; Alexander von Glinski; Christiane Kruppa; Uwe Hamsen; Cameron K Schmidt; Ahmet Oernek; Matthias Koenigshausen; Marcel Dudda; Thomas A Schildhauer Journal: Sci Rep Date: 2020-09-10 Impact factor: 4.379