BACKGROUND: U and H-type sacral fractures are under diagnosed injuries resulting from significant axial loading that are often associated with neurological deficits. No studies to date have compared two common methods of surgical fixation, iliosacral screw fixation (ISF) and lumbopelvic fixation (LPF). METHODS: Patients with sacral fractures from 2009-2015 at one level 1 trauma center were identified by current procedural terminology (CPT) code and imaging reviewed for U/H type sacral fractures. RESULTS: Four hundred and fifty-three sacral fractures were identified during the study period, of which sixteen patients met inclusion criteria for the study. Six patients had the presence of a documented neurological injury at the time of presentation, 9 patients had concurrent spine fractures and 10 patients had concurrent pelvic fractures. Eight patients underwent ISF and 8 patients underwent LPF. There was no significant difference between the two groups in regards to age, intensive care unit (ICU) requirement, length of stay, or estimated blood loss. There was a significant increase in surgical time in the LPF group (P=0.002). In addition, there was a significant difference between those patients that underwent ISF that were discharged to a rehab facility compared to those treated with LPF (P=0.04). CONCLUSIONS: Patients with U/H type sacral fractures can be treated with ISF or LPF without an expected increase in hospital length of stay (LOS) or need for ICU. Treatment with LPF may increase operative time however; the patient is more likely to be discharged to home instead of a rehab facility.
BACKGROUND: U and H-type sacral fractures are under diagnosed injuries resulting from significant axial loading that are often associated with neurological deficits. No studies to date have compared two common methods of surgical fixation, iliosacral screw fixation (ISF) and lumbopelvic fixation (LPF). METHODS: Patients with sacral fractures from 2009-2015 at one level 1 trauma center were identified by current procedural terminology (CPT) code and imaging reviewed for U/H type sacral fractures. RESULTS: Four hundred and fifty-three sacral fractures were identified during the study period, of which sixteen patients met inclusion criteria for the study. Six patients had the presence of a documented neurological injury at the time of presentation, 9 patients had concurrent spine fractures and 10 patients had concurrent pelvic fractures. Eight patients underwent ISF and 8 patients underwent LPF. There was no significant difference between the two groups in regards to age, intensive care unit (ICU) requirement, length of stay, or estimated blood loss. There was a significant increase in surgical time in the LPF group (P=0.002). In addition, there was a significant difference between those patients that underwent ISF that were discharged to a rehab facility compared to those treated with LPF (P=0.04). CONCLUSIONS: Patients with U/H type sacral fractures can be treated with ISF or LPF without an expected increase in hospital length of stay (LOS) or need for ICU. Treatment with LPF may increase operative time however; the patient is more likely to be discharged to home instead of a rehab facility.
Authors: Carlo Bellabarba; Thomas A Schildhauer; Alexander R Vaccaro; Jens R Chapman Journal: Spine (Phila Pa 1976) Date: 2006-05-15 Impact factor: 3.468
Authors: Thomas A Schildhauer; Carlo Bellabarba; Sean E Nork; David P Barei; Milton L Chip Routt; Jens R Chapman Journal: J Orthop Trauma Date: 2006-07 Impact factor: 2.512
Authors: Richard A Lindtner; Carlo Bellabarba; Reza Firoozabadi; Mark F Kurd; Karim A Shafi; Gregory D Schroeder; Alexander R Vaccaro Journal: Clin Spine Surg Date: 2016-06 Impact factor: 1.876
Authors: Thomas A Schildhauer; William R Ledoux; Jens R Chapman; M Bradford Henley; Allan F Tencer; M L Chip Routt Journal: J Orthop Trauma Date: 2003-01 Impact factor: 2.512
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