Pelvic Fracture Clinical Trial
Official title:
Comparative Study Between Single Trans-sacral Screw Versus Two Iliosacral Screws in Fixation of Unstable Pelvic Fractures
1. To compare Single Trans-sacral screw fixation vs. two Ilio-Sacral screws fixation as
regard time for starting weight bearing.
2. To compare between functional outcome using the Majeed Pelvic Score.
Sacroiliac screws (SISs) have been used since Vidal et al introduced them in 1973. Since
that, SIS fixation has become a common technology in fixing pelvic posterior ring injuries
with important progress in the past 20 years. Currently, SIS fixation represents the only
minimally invasive technique to stabilize the posterior pelvic ring. For that reason, it is
steadily gaining popularity, becoming one of the most commonly used techniques. The sacrum,
serving as the foundation of the spine, transmits the stress between spine and pelvis through
sacroiliac joints. Thus, the goal of surgical fixation is the reconstruction of the
spino-pelvic-junction to allow early weight-bearing and to facilitate nursing care,
particularly for multiple injured patients.
As a result of the deforming forces acting perpendicular to the implant axis, routine
ilio-sacral screws fixation may not provide adequate stabilization, especially in certain
unstable injuries. Longer trans-sacral screws that traverse the entire upper sacrum and exit
the contralateral iliac cortex may improve holding power and also stabilize concomitant
contralateral posterior pelvic injuries. These trans-sacral screws are reliably safe to
insert using routine intraoperative fluoroscopy, and they provide durable fixation.
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