MINIMALLY INVASIVE LUMBAR-PELVIC STABILIZATION FOR UNSTABLE PELVIC RING INJURIES

Cover Page


Cite item

Full Text

Abstract

Reconstructive operations for unstable  pelvic ring injuries  in most cases are performed  at later  date  after  trauma (period  of complete  stabilization of the vital functions). The paper presents  treatment outcomes  of three  patients with vertically unstable  pelvic ring injuries where minimally invasive lumbar-pelvic fixation with pedicle screws was applied. The morphology  of sacrum  injury  determined a configuration of the  lumbar-pelvic transpedicular system. In all cases the final surgery was performed  in the early period of traumatic disease, which made it possible to restore  the anatomy of the pelvic ring and obtain good functional outcomes.

About the authors

A. K. Dulaev

Dzhanelidze St. Petersburg Research Institute of Emergency Medicine; Pavlov First St. Petersburg State Medical University

Email: fake@neicon.ru

Alexander  K. Dulaev – Dr.  Sci (Med.),  Professor,  Head of the Department of Traumatology, Orthopedics and Vertebrology SPRIEM; the Head of Department of Traumatology and Orthopedics of FSPSMU

3, Budapeshtskaya ul., St. Petersburg, 192242; 6-8, ul. L’va Tolstogo, St. Petersburg, 197022

Russian Federation

I. V. Kazhanov

Dzhanelidze St. Petersburg Research Institute of Emergency Medicine

Author for correspondence.
Email: carta400@rambler.ru

Igor V. Kazhanov – Cand. Sci (Med.),  Leading Researcher of  Department of  the  Combined   Trauma S PRIEM; Head  of Department of Military Field  Surgery  Clinic MMA

3, Budapeshtskaya ul., St. Petersburg, 192242

Russian Federation

V. A. Manukovsky

Dzhanelidze St. Petersburg Research Institute of Emergency Medicine; Kirov Military Medical Academy of the Ministry of Defense of Russian Federation

Email: fake@neicon.ru

Vadim A. Manukovsky  – Dr. Sci (Med.),  Professor, Deputy Director for  Clinical  work S PRIEM;    Professor of Military Field Surgery Clinic MMA

3, Budapeshtskaya ul., St. Petersburg, 192242; 6, ul. Akad. Lebedeva, St. Petersburg, 194044

Russian Federation

S. I. Mikityuk

Dzhanelidze St. Petersburg Research Institute of Emergency Medicine; Kirov Military Medical Academy of the Ministry of Defense of Russian Federation

Email: fake@neicon.ru

Sergey I. Mikityuk  – Cand. Sci (Med.),  Senior Lecturer of Educational Center o SPRIEM;   Head   of  Department of Military Field Surgery Clinic MMA

3, Budapeshtskaya ul., St. Petersburg, 192242; 6, ul. Akad. Lebedeva, St. Petersburg, 194044

Russian Federation

R. A. Presnov

Dzhanelidze St. Petersburg Research Institute of Emergency Medicine

Email: fake@neicon.ru

Roman A. Presnov – Orthopedic Surgeon  of Department of Traumatology and  Orthopedics SPRIEM

3, Budapeshtskaya ul., St. Petersburg, 192242

Russian Federation

Y. V. Gavrishchyuk

Dzhanelidze St. Petersburg Research Institute of Emergency Medicine

Email: fake@neicon.ru

Yaroslav  V.  Gavrishuk  – Cand.   Sci  (Med.),   Head   of Operating Department  SPRIEM

3, Budapeshtskaya ul., St. Petersburg, 192242

Russian Federation

References

  1. Донченко С.В., Дубров В.Э., Слиняков Л.Ю., Черняев А.В., Лебедев А.Ф., Алексеев Д.В. Алгоритм хирургического лечения нестабильных повреждений тазового кольца. Вестник травматологии и ортопедии им. Н.Н. Приорова. 2013;(4):9-16.
  2. Ключевский В.В., Даниляк В.В., Гильфанов С.И. Семилетний опыт в лечении пациентов с нестабильными повреждениями тазового кольца. Margo Anterior. 2009;(1):3-11.
  3. Самохвалов И.М., Кажанов И.В., Тюрин М.В., Ганин В.Н., Денисов А.В. Особенности хирургического лечения переломов крестца. Травматология и ортопедия России. 2012;(2):16-21. doi: 10.21823/2311-2905-2012--2-16-21.
  4. Шаповалов В.М., Дулаев А.К., Дыдыкин А.В. экспериментальная разработка и клиническое применение минимально инвазивной внутренней стержневой фиксации тазового кольца. Вестник травматологии и ортопедии им. Н.Н. Приорова. 2001;(4):33-37.
  5. Швец А.И., Ивченко Д.В., Ивченко В.К., Лубенец А.А., Ивченко А.В. Повреждения поясничного отдела позвоночника в сочетании с переломами крестца. Травма. 2014;15(2):55-59.
  6. Ayoub М.A. Displaced spinopelvic dissociation with sacral cauda equina syndrome: outcome of surgical decompression with a preliminary management algorithm. J Eur Spine. 2012; 21(9):1815-1825. doi: 10.1007/s00586-012-2406-9.
  7. Bellabarba C., Schildhauer T.A., Vaccaro A.R., Chapman J.R. Complications associated with surgical stabilization of high-grade sacral fracture dislocations with spino-pelvic instability. Spine (Phila Pa 1976). 2006;(31):80-88. doi: 10.1097/01.brs.0000217949.31762.be.
  8. Denis F., Davis S., Comfort T. Sacral fractures: an important problem, retrospective analysis of 236 cases. Clin Orthop Relat Res. 1988;(227):67-81.
  9. gibbons K.J., Soloniuk D.S., Razack N. Neurological injury and patterns of sacral fractures. J Neurosurg. 1990;72(6):889-993. doi: 10.3171/jns.1990.72.6.0889.
  10. Gribnau A.J., Hensbroek P.B., Haverlag R., Ponsen K.J. et al. U-shaped sacral fractures: surgical treatment and quality of life. Injury. 2009;40(10):1040-1048. doi: 10.1016/j.injury.2008.11.027.
  11. Griffin D.R., Starr A.J., Reinert C.M., Jones A.L., Whitlock S. Vertically unstable pelvic fractures fixed with percutaneous iliosacralscrews: does posterior injury pattern predict fixation failure. J Orthop Trauma. 2003;(17):399-405.
  12. Iorio J.A., Jakoi A.M., Rehman S. Percutaneous sacroiliac screw fixation of the posterior pelvic ring. Orthop Clin N Am. 2015; 46 (4): 511-521. doi: 10.1016/j.ocl.2015.06.005.
  13. Isler B. Lumbosacral lesions associated with pelvic ring injuries. J Orthop Trauma. 1990;4(1):1-6.
  14. Käch K., Trentz O. Distraction spondylodesis of the sacrum in “vertical shear lesions” of the pelvis. Unfallchirurg. 1994;(97):28-38.
  15. Keel M.J., Benneker L.M., Siebenrock K.A., Bastian J.D. Less invasive lumbopelvic stabilization of posterior pelvic ring instability: technique and preliminary results. J Trauma. 2011;71(3):62-70. doi: 10.1097/TA.0b013e3182092e66.
  16. Kleweno C., Bellabarba C. Lumbopelvic fixation for pelvic fractures. Oper Tech Orthop. 2015;25(4):270-281. doi: 10.1053/j.oto.2015.09.001.
  17. Lindahl J., Hirvensalo E., Böstman O. Santavirta S. Failure of reduction with an external fixator in the management of injuries of the pelvic ring. Long-term evaluation of 110 patients. J Bone Joint Surg Br. 1999;(81):955-962.
  18. Majeed S.A. Grading the outcome of pelvic fracture. J Bone Joint Surg Br. 1989;71(2):304-306.
  19. Park Y.S., Baek S.W., Hong-Sik Kim H.S., Park K.C. Management of sacral fractures associated with spinal or pelvic ring injury. J Trauma Acute Care Surg. 2012;1(73): 239-242. doi: 10.1097/TA.0b013e31825a79d2.
  20. Papakostidis C., Kanakaris N.K., Kontakis G., Giannoudis P.V. Pelvic ring disruptions: treatment modalities and analysis of outcomes. Int Orthop. 2009;33(2):329-338. doi: 10.1007/s00264-008-0555-6.
  21. Pape H.C., Giannoudis P.V., Krettek C., Trentz O. Timing of fixation of major fractures in blunt polytrauma: Role of conventional indicators in clinical decision making. J Orthop Trauma. 2005;(19):551-562.
  22. Roy-Camille R., Saillant G., Gagna G., Mazel C. Transverse fractures of the upper sacrum: Suicidal jumper’s fractures. Spine. 1985;10(9):838-845.
  23. Sagi H.C. Technical aspects and recommended treatment algorithms in triangular osteosynthesis and spinopelvic fixation for vertical shear transforaminal sacral fractures. J Orthop Trauma. 2009;23(5):354-360. doi: 10.1097/BOT.0b013e3181a1143a.
  24. Schildhauer T.A., Ledoux W.R., Chapman J.R., Henley M.B., Tencer A.F., Routt M.L. Jr. Triangular osteosynthesis and iliosacral screw fixation for unstable sacral fractures: a cadaveric and biomechanical evaluation under cyclic loads. J Orthop Trauma. 2003;(17):22-31.
  25. Schildhauer T., Bellabarba С., Nork S.E. Barei D.P., Routt M.L. Jr., Chapman J.R. Decompression and lumbopelvic fixation for sacral fracture-dislocations with spino-pelvic dissociation. J Orthop Trauma. 2006;20(7):447-457.
  26. Solomin L.N. The basic principles of external skeletal fixation using the Ilizarov and other devices. 2nd ed. Milan : Springer, 2012. р. 933-967.
  27. Tan G.Q., He J.L., Fu B.S., Li L.X. Wang B.M., Zhou D.S. Lumbopelvic fixation for multiplanar sacral fractures with spinopelvic instability. Injury. 2012;43(8):1318-1325. doi: 10.1016/j.injury.2012.05.003.
  28. Tonetti J. Management of recent unstable fractures of the pelvic ring. An update conference supported by the Club BassinCotyle (Pelvis-Acetabulum Club). Orthop Traumatol Surg Res. 2013;99(1):77-86. doi: 10.1016/j.otsr.2012.11.013.
  29. Vigdorchik J.M., Jin X., Sethi A., Herzog D.T., Oliphant B.W., Yang K.H., Vaidya R. A biomechanical study of standard posterior pelvic ring fixation versus a posterior pedicle screw construct. Injury. 2015;46(8):1491-1496. doi: 10.1016/j.injury.2015.04.038.
  30. Williams S.K., Quinnan S.M. Percutaneous lumbopelvic fixation for reduction and stabilization of sacral fractures with spinopelvic dissociation patterns. J Orthop Trauma. 2016;30(9):318-324. doi: 10.1097/BOT.0000000000000559.
  31. Zamzam M.M. Unstable pelvic ring injuries. _Outcome and timing of surgical treatment by internal fixation. Saudi Med J. 2004; 25(11):1670-1674.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c)



СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 82474 от 10.12.2021.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies