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Percutaneous Iliosacral Screw Fixation with Cement Augmentation in Osteoporotic Sacral Fracture

대한골절학회지 2019년 32권 4호 p.165 ~ 172
김철환, 정영률, 심승우, 백성년, 김충영,
소속 상세정보
김철환 ( Kim Cheol-Hwan ) - 광주기독병원 정형외과
정영률 ( Chung Young-Yool ) - 광주기독병원 정형외과
심승우 ( Shim Seung-Woo ) - 광주기독병원 정형외과
백성년 ( Baek Sung-Nyun ) - 광주기독병원 정형외과
김충영 ( Kim Chung-Young ) - 광주기독병원 정형외과

Abstract


Purpose: The prevalence of osteoporotic sacral fractures is increasing. Traditionally, conservative treatment is the 1st option, but it can increase the risk of comorbidity in the elderly. To reduce the complications and allow early mobility, iliosacral screw fixation with cement augmentation will be one of the treatment options for patients with osteoporotic sacral fractures.

Materials and Methods: This study reviewed 25 patients (30 cases) who had undergone percutaneous iliosacral screw fixation with cement augmentation for osteoporotic sacral fractures from July 2012 to December 2018 with a minimum follow up of six months. The clinical outcomes were assessed using the measures of pain (visual analogue scale [VAS] score), hospital stay and the date when weight-bearing started. All patients were evaluated radiologically for pull-out of screw, bone-union, and cement-leakage.

Results: Bone union was achieved in 30 cases (100%). The mean duration of the hospital stay was 24 days (4?66 days); weight-bearing was performed on an average nine days after surgery. The VAS scores immediately (3.16) and three months after surgery (2.63) were lower than that of the preoperative VAS score (8.3) (p<0.05). No cases of cement-leakage or neurologic symptoms were encountered. Two patients (6.7%) experienced a pulling-out of the screw, but bone-union was accomplished without any additional procedures.

Conclusion: Percutaneous iliosacral fixation with cement augmentation will be an appropriate and safe surgical option for osteoporotic sacral fractures in the elderly in terms of early weight-bearing, pain reduction, and bone-union.

키워드

Osteoporotic fractures; Sacrum; Fracture internal-fixation; Bone-cement

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