[Treatment of sacral fractures with pedical screw systems fixed between lumbar and ilium]

To evaluate the clinical effect of pedical screw systems fixed between lumbar and ilium for treatment of sacral fractures.

From June 2003 to June 2009, 21 cases of sacral fracture (29 sides including monolateral 13 cases and bilateral 8 cases) were treated with pedical screw systems to have reduction and fixation. There were 12 males and 9 females, aging 23-59 years (38.2 years on average). Fracture was caused by traffic accident in 12 cases, by falling from height in 7 cases, and by crash in 2 cases. Screws were inserted into lumbar pedicles and iliac crests. Decompression was used in 4 cases complicated by sacral nerves injury, and reductions and fixations were used in 12 cases complicated anterior pelvic or acetabulum injury. The preoperative proximal displacement at the injured side of the pelvis was (16.29 +/- 6.47) mm compared with contralateral pelvis.

All incisions healed primarily with no complication of infection. Twenty-one patients were followed up 6 months to 6 years. Clinical healing time of fracture was 6-9 weeks. In 4 cases complicated by S1 or S2,3 nerves injury, the function recovered completely after 4-9 weeks. In other 17 patients, no complication of intraoperative nerve injury occurred. All patients could walk and squat after 6-12 weeks of operation. No breakage or displacement of implant occurred. The postoperative proximal displacement at the injured side of the pelvis was (3.51 +/- 0.68) mm compared with contralateral pelvis, showing significant difference (P < 0.01) when compared with preoperative one.

It is a novel choice to have reduction and internal fixation for sacral fracture with pedical screw systems fixed between lumbar and ilium. The strict regulation of indication and skill is the key to prevent complication.