title: Technique for reduction and percutaneous fixation of U- and H-shaped sacral fractures.
abstract: We describe an early reduction and percutaneous fixation technique for isolated sacral fractures. Strong manual traction combined with manual counter-traction on the torso is used to disimpact the fracture. Transcondylar traction is then applied bilaterally and two ilio-sacral screws are inserted percutaneously on each side. Open reduction and fixation, with sacral laminectomy in patients with neurological abnormalities, remains the reference standard. Early reduction and percutaneous fixation ensures restoration of the pelvic parameters while minimising soft-tissue damage and the risk of infection. Decompression procedures can be performed either during the same surgical procedure after changing the installation or after a few days. These complex fractures warrant patient referral to specialised reference centres.
authors.affiliation: Service d'orthopédie traumatologie, hôpital Michallon, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France. sruatti@chu-grenoble.fr
authors.forename: S
authors.initials: S
authors.lastname: Ruatti
authors.forename: G
authors.initials: G
authors.lastname: Kerschbaumer
authors.forename: E
authors.initials: E
authors.lastname: Gay
authors.forename: M
authors.initials: M
authors.lastname: Milaire
authors.forename: P
authors.initials: P
authors.lastname: Merloz
authors.forename: J
authors.initials: J
authors.lastname: Tonetti
mesh_terms: D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D015601:Injury Severity Score; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D018570:Risk Assessment; D012447:Sacrum / Q000293:injuries* / Q000601:surgery; D012494:Sampling Studies; D016103:Spinal Fractures / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D014143:Traction / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Ilio-sacral screw fixation; Percutaneous; Reduction; Sacral fixation; Sacral fracture