ABSTRACT

The purpose of the study was to determine the effectiveness of percutaneous iliosacral screw for sacral fractures that cause pelvic instability.

10 patients with sacral fractures were retrospectively assessed. The study consists of 7 males and 3 females, the mean age was 29.1 ± 6.6. Neurologic injury was assessed according to Gibbons classification; fractures were classified according to Denis, Young and Burgess Classification. Clinical (Majeed score) and radiologic (Nelson ve Duwelius criteria) were used to analyze the patients.

Mean follow-up time was 14.3 ± 6.3 months. 2 patients had U-type sacral fractures, two patients had A2 fractures whereas other patients had A1, A3, B3 and C fractures. Totally sixteen screws were inserted including 6 bilaterally and 4 unilaterally inserted screws. One case received sacral laminectomy. The mean postoperative Majeed score was 73.6 ± 21.7, the mean radiographic displacement was found less than 5 mm in 90 % of patients and was found 5-10 mm in 10 % of patients. The mean vertical reduction was found less than 5mm. The mean Gibbons score was decreased from 2 ± 1.3 to 1.75 ± 1.4 after the operation. There was no iatrogenic nerve injury.

Percutaneous iliosacral screw fixation is an effective way to obtain early pelvic stability and decreasing morbidity in sacral fracture cases with additional organ injuries and fractures.