Minimally invasive reduction of vertically displaced sacral fracture without use of traction table.

BACKGROUND

Treatment of vertically displaced sacral fracture can be difficult even for the expert traumatologist. Traditional reduction methods can show some limitations; we suggest a minimally invasive technique, which could be effective, tissue sparing and economic in terms of equipment needed.

MATERIALS AND

METHODS

Our retrospective study included 11 patients with average age of 40.2 years (range 24-59 years), with type C pelvic ring disruption with monolateral sacral fracture (C1.3), who underwent surgical treatment from April 2007 to March 2008 using the minimally invasive technique. Radiographic examination, using Matta's criteria, was carried out pre-operatively, post-operatively and at least at 1 year after surgery. All patients were functionally evaluated using Majeed's grading scale with mean follow-up time of 18.9 months (range 14-25 months).

RESULTS

Pre-operative displacements averaged 10.8 mm (range 7-21 mm); post-operative displacements averaged 5.4 mm (range 3-12 mm), with excellent or good reduction in 91% of cases. No major complications occurred. On functional evaluation, 82% of patients obtained good or excellent results.

CONCLUSION

The minimally invasive reduction technique, requiring a limited surgical approach and a standard radiolucent table, is in our experience a satisfactory procedure for management of monolateral vertically displaced sacral fracture.