title: [Percutaneous iliosacral screw fixation for pelvis insufficiency fracture after implantation of a pedestal cup: case report].
abstract: Insufficiency fractures of the sacrum are frequently overlooked injuries especially in postmenopausal women with an osteoporotic bone structure and without a history of significant trauma. Plain radiographs are frequently inadequate in showing insufficiency fractures of the sacrum. Regarding this a fracture of a pubic ramus combined with appropriate clinical symptoms should raise the suspicion of a concomitant sacral injury. Therefore, further investigations including a CT scan are necessary.The case of an osteoporotic female patient with bilateral insufficiency fractures of the sacrum and a fracture of the right superior and inferior pubic ramus 5 weeks after primary total hip arthroplasty and implantation of a pedestal cup due to an intraoperative fracture of the right acetabulum is presented. To ensure early mobilization as well as avoidance of further concomitant morbidities a percutaneous iliosacral screw fixation was performed. This approach has been established as an operative treatment for minimally or non-displaced insufficiency fractures of the sacrum.
authors.affiliation: Abteilung für Unfallchirurgie, Klinikum rechts der Isar der TU München, Ismaningerstr. 22, 81675, München, Deutschland. fensky@uchir.me.tum.de
authors.forename: F
authors.initials: F
authors.lastname: Fensky
authors.forename: A
authors.initials: A
authors.lastname: Schäffler
authors.forename: S
authors.initials: S
authors.lastname: Siebenlist
authors.forename: B
authors.initials: B
authors.lastname: König
authors.forename: U
authors.initials: U
authors.lastname: Stöckle
mesh_terms: D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D015775:Fractures, Stress / Q000209:etiology* / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007085:Ilium / Q000601:surgery; D008875:Middle Aged; D010388:Pelvis / Q000293:injuries* / Q000601:surgery*; D012447:Sacrum / Q000601:surgery; D016896:Treatment Outcome