Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Orthopaedics
Published in: International Orthopaedics 1/2012

01-01-2012 | Original Paper

Minimally invasive stabilisation of posterior pelvic-ring instabilities with a transiliac locked compression plate

Authors: Philipp Kobbe, Ingrid Hockertz, Richard M. Sellei, Heinrich Reilmann, Thomas Hockertz

Published in: International Orthopaedics | Issue 1/2012

Login to get access

Abstract

Purpose

Sacroiliac screw fixation is the method of choice for the definitive treatment of unstable posterior pelvic-ring injuries; however, this technique is demanding and associated with a high risk of iatrogenic neurovascular damage. This study evaluates whether minimally invasive transiliac locked compression plate stabilisation may be an alternative to sacroiliac screw fixation in unstable posterior pelvic-ring injuries.

Methods

We performed a retrospective analysis of patients with unstable pelvic-ring injuries treated with a transiliac locked compression plate at a level I trauma centre. Outcome evaluation was assessed using the Pelvic Outcome Score and analysis of complications, intraoperative fluoroscopic time, and duration of the surgical procedure.

Results

Twenty-one patients were available for follow-up after an average of 30 months. The main findings were as follows: Overall outcome for the Pelvic Outcome Score was excellent in 47.6% (ten patients), good in 19% (four patients), fair in 28.6% (six patients), and poor in 4.8% (one patient). Average operation time was 101 min and intraoperative fluoroscopic time averaged 74.2 s. No iatrogenic neurovascular injuries were observed.

Conclusion

Minimally invasive transiliac locked compression plate stabilisation may be a good alternative to sacral screw fixation because it is quick, safe and associated with a good functional outcome.
Literature
1.
Albert MJ, Miller ME, MacNaughton M et al (1993) Posterior pelvic fixation using a transiliac 4.5-mm reconstruction plate: a clinical and biomechanical study. J Orthop Trauma 7:226–232PubMedCrossRef
2.
Atlihan D, Bozkurt M, Turanli S et al (2004) Anatomy of the posterior iliac crest as a reference to sacral bar insertion. Clin Orthop Relat Res 141:145
3.
Beaule PE, Antoniades J, Matta JM (2006) Trans-sacral fixation for failed posterior fixation of the pelvic ring. Arch Orthop Trauma Surg 126:49–52PubMedCrossRef
4.
Carlson DA, Scheid DK, Maar DC et al (2000) Safe placement of S1 and S2 iliosacral screws: the "vestibule" concept. J Orthop Trauma 14:264–269PubMedCrossRef
5.
Cole JD, Blum DA, Ansel LJ (1996) Outcome after fixation of unstable posterior pelvic ring injuries. Clin Orthop Relat Res 160:179
6.
Comstock CP, van der Meulen MC, Goodman SB (1996) Biomechanical comparison of posterior internal fixation techniques for unstable pelvic fractures. J Orthop Trauma 10:517–522PubMedCrossRef
7.
Giannoudis PV, Tzioupis CC, Pape HC et al (2007) Percutaneous fixation of the pelvic ring: an update. J Bone Joint Surg Br 89:145–154PubMedCrossRef
8.
Griffin DR, Starr AJ, Reinert CM et al (2003) Vertically unstable pelvic fractures fixed with percutaneous iliosacral screws: does posterior injury pattern predict fixation failure? J Orthop Trauma 17:399–405PubMedCrossRef
9.
Grossterlinden L, Rueger J, Catala-Lehnen P et al (2010) Factors influencing the accuracy of iliosacral screw placement in trauma patients. Int Orthop [Epub ahead of print] (doi:10.​1007/​s00264-010-1092-7)
10.
Keating JF, Werier J, Blachut P et al (1999) Early fixation of the vertically unstable pelvis: the role of iliosacral screw fixation of the posterior lesion. J Orthop Trauma 13:107–113PubMedCrossRef
11.
Konrad G, Zwingmann J, Kotter E et al (2010) Variability of the screw position after 3D-navigated sacroiliac screw fixation. Influence of the surgeon's experience with the navigation technique. Unfallchirurg 113:29–35PubMedCrossRef
12.
Krappinger D, Larndorfer R, Struve P et al (2007) Minimally invasive transiliac plate osteosynthesis for type C injuries of the pelvic ring: a clinical and radiological follow-up. J Orthop Trauma 21:595–602PubMedCrossRef
13.
Lindahl J, Hirvensalo E (2005) Outcome of operatively treated type-C injuries of the pelvic ring. Acta Orthop 76:667–678PubMedCrossRef
14.
Moed BR, Fissel BA, Jasey G (2007) Percutaneous transiliac pelvic fracture fixation: cadaver feasibility study and preliminary clinical results. J Trauma 62:357–364PubMedCrossRef
15.
Moed BR, Geer BL (2006) S2 iliosacral screw fixation for disruptions of the posterior pelvic ring: a report of 49 cases. J Orthop Trauma 20:378–383PubMedCrossRef
16.
Mullis BH, Sagi HC (2008) Minimum 1-year follow-up for patients with vertical shear sacroiliac joint dislocations treated with iliosacral screws: does joint ankylosis or anatomic reduction contribute to functional outcome? J Orthop Trauma 22:293–298PubMedCrossRef
17.
Nork SE, Jones CB, Harding SP et al (2001) Percutaneous stabilization of U-shaped sacral fractures using iliosacral screws: technique and early results. J Orthop Trauma 15:238–246PubMedCrossRef
18.
Oliver CW, Twaddle B, Agel J et al (1996) Outcome after pelvic ring fractures: evaluation using the medical outcomes short form SF-36. Injury 27:635–641PubMedCrossRef
19.
Pohlemann T, Gansslen A, Schellwald O et al (1996) Outcome after pelvic ring injuries. Injury 27(Suppl 2):B31–B38PubMed
20.
21.
Reilly MC, Bono CM, Litkouhi B et al (2003) The effect of sacral fracture malreduction on the safe placement of iliosacral screws. J Orthop Trauma 17:88–94PubMedCrossRef
22.
Routt ML Jr, Simonian PT, Mills WJ (1997) Iliosacral screw fixation: early complications of the percutaneous technique. J Orthop Trauma 11:584–589PubMedCrossRef
23.
Templeman D, Schmidt A, Freese J et al (1996) Proximity of iliosacral screws to neurovascular structures after internal fixation. Clin Orthop Relat Res 194:198
24.
Tornetta P III, Matta JM (1996) Outcome of operatively treated unstable posterior pelvic ring disruptions. Clin Orthop Relat Res 186:193
25.
van den Bosch EW, Van der KR, Hogervorst M et al (1999) Functional outcome of internal fixation for pelvic ring fractures. J Trauma 47:365–371PubMedCrossRef
26.
van den Bosch EW, van Zwienen CM, van Vugt AB (2002) Fluoroscopic positioning of sacroiliac screws in 88 patients. J Trauma 53:44–48PubMedCrossRef
27.
van Zwienen CM, van den Bosch EW, Snijders CJ et al (2004) Biomechanical comparison of sacroiliac screw techniques for unstable pelvic ring fractures. J Orthop Trauma 18:589–595PubMedCrossRef
28.
Vanderschot P, Meuleman C, Lefevre A et al (2001) Trans iliac-sacral-iliac bar stabilisation to treat bilateral lesions of the sacro-iliac joint or sacrum: anatomical considerations and clinical experience. Injury 32:587–592PubMedCrossRef
29.
Yinger K, Scalise J, Olson SA et al (2003) Biomechanical comparison of posterior pelvic ring fixation. J Orthop Trauma 17:481–487PubMedCrossRef
30.
Yucel N, Lefering R, Tjardes T et al (2004) Is implant removal after percutaneous iliosacral screw fixation of unstable posterior pelvic ring disruptions indicated? Unfallchirurg 107:468–474PubMedCrossRef
31.
Zwingmann J, Konrad G, Mehlhorn AT et al (2010) Percutaneous iliosacral screw insertion: malpositioning and revision rate of screws with regards to application technique (navigated vs. Conventional). J Trauma 69:1501–1506PubMedCrossRef
Metadata
Title
Minimally invasive stabilisation of posterior pelvic-ring instabilities with a transiliac locked compression plate
Authors
Philipp Kobbe
Ingrid Hockertz
Richard M. Sellei
Heinrich Reilmann
Thomas Hockertz
Publication date
01-01-2012
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 1/2012
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-011-1279-6

Other articles of this Issue 1/2012

International Orthopaedics 1/2012 Go to the issue

Original Paper

Pre-operative frontal plane malalignment predicts the extension gap asymmetry in knee osteoarthritis

Original Paper

Single stage corpectomy and instrumentation in the treatment of pathological fractures in the lumbar spine

Original Paper

Validity of published outcome data concerning Anatomic Graduated Component total knee arthroplasty: a structured literature review including arthroplasty register data

Review Article

Arthroplasty options in femoral-neck fracture: answers from the national registries

Original Paper

Osteogenic differentiation is synergistically influenced by osteoinductive treatment and direct cell–cell contact between murine osteoblasts and mesenchymal stem cells

Original Paper

Up-regulation expressions of lysyl oxidase family in Anterior Cruciate Ligament and Medial Collateral Ligament fibroblasts induced by Transforming Growth Factor-Beta 1