Augmented ilio-sacral screws for the treatment of fragility pelvic fractures: review of literature, presentation of a novel low-cost technique, and clinical results of a case series

Eur J Orthop Surg Traumatol. 2024 Nov 28;35(1):29. doi: 10.1007/s00590-024-04150-y.

Abstract

Purpose: Fragility pelvic fractures are an increasingly entity due to increase in life expectancy. A large proportion of these fractures require surgical treatment with stabilization of the posterior ring with ilio-sacral screws. Due to the poor bone quality of these patients, cement augmentation of the ilio-sacral screws can be performed and thus avoid treatment failures. The purpose of this review is to make a revision of the literature and present a novel cementation technique with clinical examples of patients treated with this surgical technique.

Method: Review of current literature on fragility pelvic fractures and modern treatment alternatives. We also describe a novel, easy to perform and low-cost technique for cement augmentation of ilio-sacral screws that we find useful when not having specific commercial instruments for this purpose. Additionally, we present a case series of five patients operated between 2017 and 2024 with augmented ilio-sacral screws due to fragility pelvic fracture.

Conclusion: The surgical technique presented is easy to perform, has a low training curve and requires standard instruments easy to find in a trauma center. Further clinical studies are required to demonstrate superiority of cement augmentation over the standard technique without augmentation.

Keywords: Augmented ilio-sacral screws; Bone cement; Cement augmentation; Fragility pelvic fracture; Ilio-sacral screws.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Cements
  • Bone Screws*
  • Cementation
  • Female
  • Fracture Fixation, Internal* / instrumentation
  • Fracture Fixation, Internal* / methods
  • Fractures, Bone / surgery
  • Humans
  • Ilium / surgery
  • Male
  • Osteoporotic Fractures / surgery
  • Pelvic Bones* / injuries
  • Pelvic Bones* / surgery
  • Sacrum / injuries
  • Sacrum / surgery

Substances

  • Bone Cements