• Xudong Hu, Fuxing Pei, Guanglin Wang, Jingguo He, Qingquan Kong, and Chongqi Tu.
• Department of Orthopaedics, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu 610041, Sichuan Province, People's Republic of China.
• Eur Spine J. 2013 Mar 1;22(3):503-9.

PurposeThe aim of this study was to explore the operative technique and effectiveness of triangular osteosynthesis for vertically unstable sacral fractures.MethodsFrom January 2009 to December 2010, 25 vertical unstable sacral fractures in 22 patients were treated with triangular osteosynthesis using the combination of universal spine system and iliosacral screw in our institution. Patients were followed up prospectively with routine post-operation visits for clinical and radiographic examination. The reduction quality was evaluated according to Matta criterion. Clinical function outcome, and nerve function outcome was evaluated by Majeed and Gibbons criterion.ResultsAll patients were followed up for an average of 14 months (range 8-26 months). Local infection was seen in two patients, and both were healed with debridement and antibiotics. Patients experienced early weight-bearing ability, no fracture reduction loss, and hardware loosening, while all fractures appeared as bone union at the final follow-up. According to Matta criterion for fracture reduction, the results were excellent in 18 sides, good in 6 sides, and fair in 1 side. According to Majeed functional scoring at last follow-up, the results were excellent in 13 cases, good in 6 cases, fair in 2 cases, and poor in 1 case. Neurologic impairment was noted in 13 patients pre-operative, six patients achieved complete recovery, six patients achieved partial improvement, one patient did not have any improvement at the last follow-up.ConclusionTriangular osteosynthesis is a relatively new fixation for vertical unstable sacral fractures, the fixation is rigid, permits early full weight-bearing, and nerve decompression can be performed, which facilitates function recovery.

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