PDF(Pubmed)
Abstract：
Pelvic ring injuries are uncommon but serious injuries. Percutaneous sacro-iliac screw fixation (SSF) is the standard treatment for posterior stabilization of pelvic fractures. Compression forces of the SSF might cause deformity of the sacrum and the pelvic ring. The aim of this radio-volumetric study is to evaluate the morphometry of the sacrum and pelvic ring in SSF for posterior pelvic fractures. (1) Methods: We conducted a radio-volumetric study measuring the bony sacral volume before and after SSF for a pelvic fracture based on a three-dimensional reconstruction of the pre- and postoperative computed tomography scan of 19 patients with a C-type pelvic fracture. In addition to the bony sacral volume, we assessed the pelvic deformity and the load bearing axis. We compared the results of patients without anterior stabilization (Group A) to patients who had additional ORIF of the anterior pelvic ring. (2) Results: Median age of the patients was 41.2 years (±17.8). All patients received percutaneous SSF with partially threaded 7.3 mm screws. The sacral volume decreased from 202.9 to 194.3 cm3 in group A (non-operative treatment anterior, n = 10) and an increase of sacral volume from 229.8 to 250.4 cm3 in group B (anterior ORIF; n = 9). Evaluation of the pelvic deformity also reflected this trend by a decrease of the ipsilateral load-bearing angle in group A (37.0° to 36.4°) and an increase of this angle in group B (36.3 to 39.9°). (3) Conclusions: Bony sacral volume and pelvic deformity after sacro-iliac screw fixation in pelvic fractures depend on treatment of the anterior pelvic ring. Reduction and fixation of the anterior fracture shows an increase of the bony sacral volume and the load bearing angle leading to a closer to normal reconstruction of the pelvic anatomy.
摘要：
骨盆环受伤并不常见，但伤势严重。经皮骶髂螺钉固定术（SSF）是骨盆骨折后固定的标准治疗方法。SSF的压缩力可能导致骶骨和骨盆环畸形。这项放射容积研究的目的是评估SSF中the骨和骨盆环的形态计量学，以治疗骨盆后骨折。（1）方法：我们根据19例C型骨盆骨折患者术前和术后计算机断层扫描的三维重建，进行了一项放射容积研究，测量了骨盆骨折SSF前后的骨性骶骨体积。除了骨性骶骨体积，我们评估了骨盆畸形和承重轴。我们比较了没有前稳定的患者（A组）与骨盆前环的ORIF增加的患者的结果。(2)结果:患者年龄中位数为41.2岁(±17.8)。所有患者均接受带有部分螺纹7.3mm螺钉的经皮SSF。A组的骶骨体积从202.9减少到194.3cm3（非手术治疗前，n=10），B组（前ORIF；n=9）的the骨体积从229.8增加到250.4cm3。骨盆畸形的评估也反映了这一趋势，即A组中同侧承重角减小（37.0°至36.4°），B组中该角度增加（36.3°至39.9°）。(3)结论:骨盆骨折骶髂螺钉内固定术后骨骶骨体积和骨盆畸形取决于骨盆前环的治疗。前骨折的减少和固定显示骨性骶骨体积和承重角的增加，导致骨盆解剖结构更接近正常重建。
