Emergency pelvic stabilization in patients with pelvic posttraumatic instability.

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Abstract

[Indexed for MEDLINE] 16. Int Orthop. 2019 Jan;43(1):177-185. doi: 10.1007/s00264-018-4144-z. Epub 2018 Sep 17. Comparison between posterior sacral plate stabilization versus minimally invasive transiliac-transsacral lag-screw fixation in fractures of sacrum: a single-centre experience. Liuzza F(1), Silluzio N(2)(3), Florio M(4), El Ezzo O(5), Cazzato G(5), Ciolli G(5), Perisano C(5), Maccauro G(5). Author information: (1)Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. (2)Università degli Studi di Messina, Policlinico Universitario G. Martino, Messina, Italy. noemisilluzio11@gmail.com. (3)Orthopedic and Traumatology Institute, University Hospital G. Martino, Messina, Italy. noemisilluzio11@gmail.com. (4)Università degli Studi di Messina, Policlinico Universitario G. Martino, Messina, Italy. (5)Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. PURPOSE: The sacrum is a mechanical nucleus working as the base for the spinal column, as well as the keystone of the pelvic ring. Thus, injuries of the sacrum can lead to biomechanical instability and nerve conduction abnormality. METHODS: The common classification is the Denis classification, but these fractures are often part of a lesion of the posterior pelvic ring and therefore the Tile classification is very useful. The goals of operative intervention are to reduce fracture fragments, protect neurological structures, and provide adequate stability for early mobilization. RESULTS: The stabilization of these injuries can be difficult even in a patient with adequate bone stock and concomitant medical comorbidities. The posterior-ring tension-band metallic plate and sacroiliac joint screw are two commonly used methods for posterior internal fixation of the pelvis. CONCLUSIONS: In this study, we evaluate the differences, in the treatment of sacral fractures, between the two techniques, revising the literature and our experience. DOI: 10.1007/s00264-018-4144-z