Highlights
- •Both reduction and fixation of Zone II sacral fractures could be gained by MIAP.
- •Satisfactory results could be obtained through MIAP technique.
- •Repeated projections and iatrogenic sacral nerve injury can be avoided through MIAP.
Abstract
Objective
Fracture line of the sacrum always involves the Zone II region because sacral foramina
are anatomically and physiologically weak regions of the sacrum. The purpose of this
study is to compare the therapeutic effects of a sacroiliac screw and a minimally
invasive adjustable plate (MIAP) for Zone II sacral fractures.
Methods
Patients with unilateral Zone II sacral fractures fixed with a unilateral sacroiliac
screw or MIAP from August 2009 to January 2016 were recruited into this study and
were divided into two groups: group A (sacroiliac screw) and group B (MIAP). Surgical
time, blood loss, frequency of intraoperative fluoroscopy, and relative complications
were reviewed. Radiographs and CT scans were routinely acquired to evaluate the fracture
displacement and reduction quality. Fracture healing was evaluated in the radiographs
at each follow-up. Functional outcome was assessed based upon the Majeed scoring system
at the final follow-up.
Results
Thirty-one patients in group A and thirty-nine patients in group B were included in
this study. No significant differences in average surgical time (P = 0.221) or blood loss (P = 0.234) were noted between group A and group B. The mean frequency of intraoperative
fluoroscopy was 15.74±2.98 in group A and 6.08±1.94 in group B (P = 0.000). All fractures healed well within four months in all patients, and the healing
time exhibited no significant difference between the two groups (P = 0.579). Satisfactory rates of reduction quality and functional outcome were not
statistically different between the two groups (P > 0.05). The complication rate was 16.13% (5/31) in group A and 5.13% (2/39) in group
B (P = 0.222).
Conclusion
MIAP has a fixation effect and exhibits reduction potential for Zone II sacral fractures.
Favourable radiographic and functional results could be obtained through the MIAP
technique, which is easy to conduct without pre-contouring. Compared with the unilateral
S1 sacroiliac screw technique, repeated projections and iatrogenic sacral injury can
be avoided.
Keywords
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Article info
Publication history
Published online: February 13, 2019
Accepted:
February 12,
2019
Identification
Copyright
© 2019 Elsevier Ltd. All rights reserved.
