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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2010 February;61(1):11-9
Surgical treatment of unstable sacral fractures: a 48-case series
Capella M., Deregibus M., Nicodemo A., Valente A., Massè A.
Struttura Complessa Dipartimento Universitario di Ortopedia e Traumatologia, Azienda Ospedaliera Universitaria
San Luigi Gonzaga, Orbassano, Torino, Italia
AIM: The aim of this study was the evaluation of different treatment types for sacral fractures, by means of the analysis of the fracture characteristics, the reduction and fixation method, the result achieved and the possible complications.
METHODS: This retrospective study includes 48 patients with unstable sacral fracture surgically treated from 2002 to 2009 at AO C.T.O./ Maria Adelaide, Turin and AOU S. Luigi Gonza-ga, Orbassano, Turin, with mean age 38.77 years (range 18-63). For every patient initial, post-operative and medium-term (minimum follow-up: 3 months) displacements, reduction technique and hardware type were annotated.
RESULTS: The initial and post-operative displacements resulted strictly related; the reduction was good-excellent in 55% and poor in 10% of cases approximately. We conceived a specific radiographic score for ilio-sacral screws, the most used hardware type: this way, the screw length appeared significantly related to the fracture instability. The symphyseal plate employment showed the higher rate of short-term post-operative complications, even if all of these were low-grade. There were no cases of loss of reduction.
CONCLUSION: Because of the relative rarity of sacral fractures, the optimal treatment often turns out to be a difficult choice for the traumatologist. Few evidence-based indications can be found in literature: further extended studies are necessary, in order to get a reliable evaluation of the different fixation methods about their long-term effectiveness.